If you are anemic, your blood is not delivering enough oxygen to your body. The effects vary, and you may not notice symptoms until they become severe. Symptoms include increasing fatigue, weakness, headache, irritability, difficulty exercising, sore tongue, brittle nails, tingling or restless legs, and skin that has become pale or even slightly yellow.
If anemia results from rapid blood loss, as with severe bleeding due to a major trauma, childbirth or surgery, symptoms can be quite abrupt and dramatic. They include fatigue, dizziness when standing, rapid pulse, shortness of breath, inability to exercise, and even confusion.
The word anemia comes from Latin: an — not; emia — blood. It describes a reduction in the number or quality of red blood cells circulating in the blood stream. This is measured by blood tests of:
Hemoglobin is a major part of red blood cells. Its job is to carry oxygen to all of the tissues in the body. When hemoglobin is reduced, or if it is abnormally formed and does not work properly, all cells in all of the organs and tissues struggle to get enough oxygen. Oxygen is essential to every function of the body. Your heart needs oxygen to beat, your brain to think, and your lungs to breathe. Without enough oxygen, important parts of the body can be damaged and may even die. As it is the hemoglobin in blood that carries oxygen to tissues, an adequate amount of healthy hemoglobin is essential.
Gradual anemia comes from a slow reduction of hemoglobin. The two most common causes of this reduction are:
Your doctor has many tests that can pinpoint the cause of your anemia. Identifying the cause and starting proper treatment is very important.
Iron, vitamin B12 and folate are the building blocks of hemoglobin. Getting too little of them can cause anemia. Including more of these nutrients in the diet (and perhaps using supplements) can treat it.
Iron: The most concentrated natural source of iron in the diet is red meat (beef, pork, bison), and organ meats (beef kidney and liver). A valuable source of added iron is in fortified cereals (such as Cream of Wheat‚Ñ¢). Dried peas and beans, such as chickpeas, kidney beans, lentils and white beans, are moderate sources of iron, as are almonds, peanuts, and dried prunes.
A word of warning: More cases of iron deficiency anemia are appearing where poultry and fish are used as the main sources of animal protein in the diet. It also happens in those who follow a vegetarian diet without being mindful of the need for adequate iron. While vegetarian sources of iron are available, the body is less able to absorb them. To get more iron from non-meat sources, eat larger quantities along with high vitamin C foods such as tomato or citrus. Young women with heavy menstrual periods and a vegetarian diet are at great risk of iron deficiency anemia.
Vitamin B12 (cobolamin): The most concentrated sources of this important vitamin are seafood, fish, liver, and red meats. It is also added to fortified cereals and flour. Vitamin B12 requires stomach acid to be properly absorbed. Certain people may have difficulty getting vitamin B12 from food or vitamin supplements, including:
For these people, higher doses of oral supplements or vitamin B12 by injection may be necessary.
Folate (folic acid): The best sources of folate are asparagus, dried peas, beans, lentils, and dark green leafy vegetables such as spinach, broccoli, and turnip greens. Folate is also added to many fortified grains and cereals in Canada.
As both vitamin B12 and folate are water-soluble vitamins, they do not store well in the body. You need to eat an adequate amount every day.
If anemia is due to sudden blood loss or cannot easily be corrected by improving the diet, supplements may be necessary.
How much iron should I aim for?
|Age||Daily intake goal*||Do not exceed|
|Men 19 and older||8 mg||45 mg|
|Women 19-50||18 mg||45 mg|
|Women 51 and older||8 mg||45 mg|
19 and older
|27 mg||45 mg|
19 and older
|9 mg||45 mg|
|*This includes sources of iron from food and supplements.
Go to Dietitians of Canada website www.dietitians.ca and search ‚'Food Sources of Iron' to see other tables that list iron sources.
Iron supplements: These should generally only be taken on the advice of a health care provider, as side effects, effectiveness, and toxicity must be monitored. Iron supplements are almost always kept behind the counter at the pharmacy because of such concerns. To make sure your levels are adequate, your doctor will want to check the hemoglobin and body iron levels after you have taken the supplements.
Vitamin B12 (cobolamin) supplements: Most people do very well taking vitamin B12 supplements by mouth, unless they have a severe shortage of stomach acid or pernicious anemia. Since B12 is a water-soluble vitamin, overdosing on it is almost impossible. However, if your anemia is due to vitamin B12 deficiency, the doctor will test to ensure the level improves. While B12 is not as carefully controlled at the pharmacy, this supplement is still best taken under supervision.
At one time, it was thought that B12 needed to be given by injection to achieve adequate levels. We now know that for most people, oral supplements of 1000 to 2000 micrograms (mcg) per day are enough to restore the body.
If B12 must be rapidly replaced in the system, the injectable form may still be used. This method is often needed when severe vitamin B12 deficiency is causing problems in the nervous system.
Folate (folic acid) supplements: Folate is another water-soluble vitamin, so overdosing with it is unlikely. It also requires daily supplements to build levels in the body.
Generally, one mg of folate daily will be enough to replace a folate deficiency. Rarely, a doctor may recommend up to five mg of folate daily, but this dose should only be taken with a doctor‚Äôs recommendation.
Usually therapy first treats the cause of the anemia, and in some cases stimulates the body to make more red blood cells.
When anemia is severe or cannot be cured, blood transfusions are necessary to replace red blood cells so that the tissues and organs of the body can survive.
While anemia is common, its causes are many. It may be the first sign of a serious illness or condition. If you suspect you have anemia, see a doctor for a correct diagnosis and get on track with the right treatment. To prevent the most common anemias, eat a healthy, varied diet including iron, vitamin B12, and folate.