Anaemia

Anemia – Causes, Symptoms & Natural Treatment

Anemia is a condition where the body doesn’t have enough red blood cells to carry the oxygen to the tissues of the body.  It is characterised by a deficiency in red blood cell volume (<42% in men, < 36% in women) or in the concentration of haemoglobin (< 130g/L in men, < 115g/L in women).

Red blood cells provide oxygen to body tissues. It is most common among women in their reproductive years, infants and the elderly.  It is common to feel weak, lethargic, irritable, mentally drained and foggy and short of breath when you are anemic.

Causes of Anemia

Decreased production of red blood cells:

• Deficiency of iron, B12 or folate
  • Malabsorption syndromes e.g. celiac disease, Crohn‘s disease, gastritis, gut dysbiosis, SIBO etc
  • Erythropoietin deficiency e.g. kidney disease, drugs
  • Chronic disease states: Rheumatoid arthritis, Irritable bowel disease, renal failure
  • Inherited disorders e.g. thalassemia, sickle cell anemia
  • Destruction of intrinsic factor needed to absorb B12 (pernicious anemia) – common with long term gut issues
  • Chronic alcoholism
  • Bone marrow disorders e.g. lymphoma, leukemia, myeloma, aplastic anemia

Increased destruction of red blood cells (hemolysis):

• Genetic disorders
  • Autoimmune disorders which cause destruction of red blood cells
  • Certain medications

Excessive bleeding

• Slow blood loss e.g. heavy menstrual periods, ulcerative colitis, stomach ulcers
  • Excessive blood loss e.g. surgery, trauma

Signs and symptoms of Anemia

May be asymptomatic if anemia is mild.  Symptoms include:

• Fatigue & lethargy
• Problems concentrating or thinking
• Irritability
• Headaches
• Light-headedness on standing up
• Pale skin
• Shortness of breath
• Bluish colour to whites of eyes
• Brittle nails or thin concave nails
• Glossitis (swollen tongue)- B12 anemia

TREATMENT STRATEGY FOR ANEMIA

• Identify / address underlying cause,
• Replace nutritional factors as needed (iron, folate, B12)
• Facilitate digestion and absorption
• Investigate and correct bacterial overgrowth, SIBO, gut dysbiosis
• Investigate and correct methylation imbalances

Diet plan guidelines for Anemia

• Iron-deficiency anemia
  • Increase iron-rich foods:
    • Heme sources are better absorbed and include red meat, liver, seafood, poultry, eggs
    • Non-heme sources include green leafy vegetables, herbs, soy products, legumes, blackstrap molasses, pumpkin seeds, tahini, sunflower seeds, almonds, raw cacao, dried fruits (apricots), sundried tomatoes
  • Include vitamin C-rich foods with meals to improve absorption
  • Ginger tea with meals improves iron absorption
  • Limit foods that reduce iron absorption:
    • Black and peppermint tea near meals reduces iron absorption by up to 70%
    • Phytates: in non-soaked grains and legumes

·         B12-deficiency anemia

• Increase B12-rich foods: fish and shellfish, liver, red meat, cheese, eggs, yoghurt
  • Strict vegans may need to include fortified foods or take B12 supplements

·         Folate-deficiency anemia

• Increase folate-rich foods: green leafy vegetables, yeast extracts, liver, sunflower seeds, legumes, sprouts, asparagus, whole grains
  • MTHFR gene variants will likely need supplementation

Supplements that support Anemia

• Replace nutritional factors (as indicated by blood test)
  • Iron (caution: excess iron is toxic)
    • Iron supplements – always try and address the underlying cause of iron deficiency before supplementing iron, iron supplements should be a last resort but are needed sometimes in the short term to avoid anemia and boost ferritin levels
  • B12 sublingual, in the methylcobalamin or hydroxocobalamin forms
  • Folate as folinic acid or methyl-folate
  • Spirulina or blue-green algae

•         Support digestion and absorption

• Vitamin C: 500mg with meals in iron deficiency
  • Digestive enzymes

Herbal Medicine Treatment that support Anemia

NB Avoid peppermint, lime flowers, rosemary and vervain when on iron supplementation: all decrease absorption of iron

• Nutritives: alfalfa, dandelion leaf, nettle, withania, codonopsis, licorice
• Anti-anaemic: dong quai
• Digestive Stimulants – gentian, ginger

FUNCTIONAL MEDICINE TREATMENT OF ANEMIA

Anemia is a condition that is presented when the red blood cells are unable to sufficiently meet the oxygen transport needs of the body.  It is commonly caused by deficiency of either iron, B12 or folate. 

It is a condition that often has a strong underlying cause that is contributing to the condition in long term anemic patients.  We often uncover gut dysbiosis, poor digestion and absorption, MTHFR polymorphisms, SIBO and bacterial overgrowth in anemic individuals.

Addressing the underlying cause of anemia is vital in the long term management and reversal of the condition.  Ongoing supplementation without investigating and addressing the cause can be detrimental to the patient.

At our Perth clinic of Advanced Functional Medicine we investigate the multiple root causes of anemia in our patients and provide long term solutions.  If you or a family member are suffering from anemia or have been on long term iron supplementation we would love to hear from you.

Have you investigated and improved your gut health and been able to stop supplementing iron?  Have you improved your iron stores without supplementing, if so, what worked for you?  Have you investigated your genetic snps that may be contributing to anemia?  Please leave a comment below.

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