Anaemia is a condition of insufficient oxygen-carrying capacity of the blood due to reduced numbers of red blood cells or haemoglobin. Anaemia may be caused by decreased red blood cell production, increased red blood cell breakdown (aplastic anaemia), excessive blood less (wounds, stomach ulcers, menstruation, cancer), or genetic disorders in haemoglobin (thalassaemia, sickle cell).

The most common cause of decreased blood cell production is iron deficiency due to insufficient dietary iron. This may also be caused by poor iron absorption or impaired metabolism due to a lack of intrinsic factor in the stomach, vitamin B12 deficiency or folate deficiency.

Iron is a key mineral in metabolism present in haemoglobin, myoglobin and many enzymes. It is not only necessary for oxygen transport, but energy metabolism, neurotransmitter synthesis (dopamine, serotonin, noradrenaline), thyroid hormone synthesis, vitamin A metabolism and the formation of collagen.¹

Iron is transported in the blood attached to a transport protein called transferrin. Oxides of iron must be transported in this way in order to prevent them reacting and forming free radicals. Iron is stored in the liver, bone marrow, spleen and blood in the form of ferritin, and blood levels of ferritin are normally used to give a measure of iron status in tissues because they approximate one another. Iron deficiency anaemia exists only when the haemoglobin level or red blood cell count (haematocrit) are low.

Symptoms of anaemia include fatigue, pallor, cold intolerance, elevated heart rate, shortness of breath, sore mouth and tongue, cracked or spooned nails. Because iron is involved in neurotransmitter synthesis (serotonin, dopamine, noradrenaline) a deficiency may cause apathy and mood disorders.

Treatment:

General

A full blood exam will indicate a change in size or distortion of red blood cells. Ferritin is a reliable indicator of early iron deficiency (ferritin falls and total iron binding capacity rises). The classic signs of low haemoglobin, low haematocrit, pallor and spoon nails are found in late stage anaemia.

Test for poor folate metabolism (MTHFR), B12 deficiency and thyroid function (affects digestion)

An excess iron intake, caused by taking too many supplements, can inhibit zinc absorption. Furthermore, excess iron will nourish bacteria so supplementation should be discontinued during infections. Iron is usually safely sequestered during infections, raising ferritin.

Avoid antacids because they inhibit absorption, and treat reflux or peptic ulcer holistically.

Hair Mineral Analysis will identify mineral deficiencies (copper, selenium, iron etc.²), or high heavy metal levels (copper, lead, chromium, cadmium, manganese, zinc, nickel).

Take calcium and zinc supplements away from meals because they inhibit iron absorption.

Diet

Iron is derived from both plant and animal foods. Compounds of iron must first be broken down in the intestine by the action of acid and enzymes before the iron is solubilised, and the condition of the digestive system is therefore important.

Iron absorption is assisted with vitamin C, which is why lemon juice makes a good salad dressing. Several things can inhibit iron absorption by as much as 80%, including include tannins present in tea and coffee, oxalic acid and phytates.

Foods rich in iron are red meat, liver, shellfish, egg yolk, salmon, wholegrains, beans, lentils, peas, almonds, brazil nuts, sesame, pumpkin seed, dandelion leaf, spinach, kale, dried fruits (apricot, raisin, prune), molasses, chlorophyll. Cooking in old-fashioned iron pots can also provide a source of iron.

Iron supplements—iron chelate, gluconate. Take with a meal.

Tissue Salts

Ferrum-phos—increases haemoglobin. The patient is weak, pale, palpitations, increased heart rate, sweaty.

Herbs

Aletris farinosa—weak, fatigued, faint.

Angelica-s (Don quai)—blood deficiency, builder.

Gentian—deficient digestion, improves iron absorption, low appetite.

Parsley—contains iron and other minerals.

Yellow dock—helps iron absorption and liver metabolism.

Nettle—contains iron and trace minerals.

Kelp (bladderwrack)—glandular tonic, rich in iron and minerals.

Homeopathy

Arsenicum-a—pernicious anaemia, weak, restless, anxious worse night.

Aletris-f—tired anaemic girls, pregnant women, faint, heavy menstruation.

Calc-c—poor nutrition, sluggish digestion, constipated, overweight, chilly, PICA.

Calc-phos—anaemic children, flatulent, acne, crave smoked meats.

Cinchona—heavy blood loss with weakness and fainting. Marked pallor.

Ferrum-m—blood loss, fatigue, flushes, short of breath, chilly. Vertigo, headache, feel better moving about slowly.

Nat-m—Anaemia with headache. Malnourished, emaciation, palpitations at night, salt cravings, ailments from grief.

Nux-v—nutritional disturbances, digestive disorders, acid reflux, constipated, chilly, irritable.

Phosphorus—bleeding, weakness, numbness in limbs, loose bowel, craves cold things. Pernicious anaemia.

Disclaimer: this article is intended for the purpose of general education only, and is not a substitute for a diagnosis, treatment advice, or a prescription given in a consultation with a qualified physician.

References:

1.         Gropper, Smith, Groff. Advanced Nutrition And Human Metabolism. 5th ed. Wadsworth: Cengage Learning; 2009.

2.         Sahin C, Pala C, Kaynar L, et al. Measurement of hair iron concentration as a marker of body iron content. Biomed Rep 2015;3:383–7.