3

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Cause of Anemia

Answered on September 12, 2014
Created December 15, 2011 at 11:56 AM

I'm trying to determine potential causes for my moderate case of anemia, which has been affecting me for the past several months. I'm consuming large quantities of iron from natural sources, so the problem presumably has to do with absorption. I asked my doctor if there were any clear-cut indicators from the blood test recently done on me, but he didn't have a definitive answer.

After tracking my diet for several weeks on Cron-O-Meter, I have discovered that while my O6/O3 ratio is pretty good (about 3-4:1), I'm taking in substantially more Zinc than Copper, leading to an average ratio of 16:1. Supposedly supranormal amounts of Zinc can lead to anemia through blocked absorption.

Should I strive to lower my zinc intake or up my copper intake? Or both? Or is this not even worth messing around with?

7636e1e02ef91a46f20a42e07b565a4b

(367)

on December 19, 2011
at 10:32 PM

Jenny, hi. I've not read extensively on the subject by any means so I couldn't say, but many studies link iron sequestration with the inflammation of obesity, for instance. I imagine there's a continuum and perhaps a negative correlation between inflammation and serum iron levels, and yes anemia would characterize the extreme end of inflammation-induced iron deficiency. Therefore wouldn't it be possible with high inflammation, independent of chronic disease, to induce anemia? I have multiple food intolerances and no chronic disease that I'm aware of, and labwork showed borderline anemia.

518bce04b12cd77741237e1f61075194

(11577)

on December 17, 2011
at 11:14 PM

From my understanding, sequestering of iron in the form of hepcidin that gets to the point where it causes anemia is quite extreme, and if that was happening there would probably many symptoms of relatively severe inflammation, probably stemming from a chronic diseased state. Correct me if I'm wrong though, iron storage is complex, interesting stuff!

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 17, 2011
at 08:39 AM

running 1 mile a week sounds like over training to me :)

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 10:16 PM

you could be urinating all your electrolytes away. Have a read of a couple of Ray Peat articles; http://raypeat.com/articles/articles/salt.shtml & http://raypeat.com/articles/articles/water.shtml

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 10:14 PM

you could be urinating all your electrolytes away. Have a read of a couple of Rap Peat articles; http://raypeat.com/articles/articles/salt.shtml & http://raypeat.com/articles/articles/water.shtml

Cccb899526fb5908f64176e0a74ed2d9

(2801)

on December 16, 2011
at 12:13 PM

I liberally salt my food so I doubt I'm low on sodium. I also drink anywhere between 3-8 liters of water a day, so it's possible I'm pissing out significant amounts of nutrients. I'm running about 30 miles a week, but getting at least 7 hours of sleep a night and eating 3200 calories. Does that sound like overtraining?

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 08:49 AM

if blood test did reveal low iron, depending on how low, pairing iron rich foods with foods that have a lot of Vitamin C may bring levels up, before trying iron supps. or adding/increasing Vit C supplementation with your iron containing meal. Vitamin C can help your body absorb iron.

518bce04b12cd77741237e1f61075194

(11577)

on December 16, 2011
at 01:12 AM

Interesting fact: iron deficiency is one of the contributing factors that make women's life spans longer than mens! Iron supplementation is important if you simply can't climb on top of the deficiency however, OR if it significantly impacting your life. You shouldn't always be supplementing for iron also, should be done temporarily under supervision!

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13 Answers

4
Da3d4a6835c0f5256b2ef829b3ba3393

on December 15, 2011
at 12:13 PM

It's worth trying to figure out.

I became anemic when I was a vegan. Despite every effort to supplement properly, I didn't get sufficient B12 and iron. Mine was an easy fix.

Your anemia is moderate, which is how I would describe mine. Let me tell you, once you get control of this thing you will not believe how much better you feel. So yes, it's worth messing with!

I just hopped on to answer that one question you asked and to offer some encouragement. Good luck and keep us updated!

3
332d9f75d1077abafff6887681f6b130

on December 16, 2011
at 12:56 AM

Anemia has MULTIPLE causes and treatment varies based on the type of anemia you have. Don't just assume you have one kind or another and treat it based off of internet guesses. A lot of the more common forms of anemia have tell-tale signs that can aid diagnosis:

Iron deficiency anemia usually manifests with ulcers and fissures at the angles of the mouth, and an convex curvature of the nails (a later symptom)

B-12 anemia usually will manifest with bleeding gums, a smooth beefy red tongue, and a poor sense of balance in more chronic cases

Folic acid deficiency anemia is one of the most common, and has similar symptoms to B-12 anemia but blood tests will show low folate levels (you'll obviously need a doctor for this part of the diagnosis)

Frequent infections can indicate yet another form of anemia... My point is, if your doctor can't/won't tell you what kind of anemia you have then do the following:

1) Find a new doctor. The doctor you are using right now is bad at his job.

2) Tell your new doctor your old doctor said you were anemic, but couldn't tell you what kind of anemia you had, or offer any treatment options. Your new doctor will be happy to diagnose what kind of anemia you have and treat that condition.

Depending on what kind of anemia you have, you may be able to treat it with lifestyle/diet changes, you may not. Some types of anemia can really only be treated -dare I say it on this board- with medication that you will have to take for the rest of your life.

Any way you slice it, anemia can be serious. Get a real doctor and get taken care of, then come back and let us know what kind you had (I'm curious), and what doctor you had that wasn't able to treat this so we can all avoid him (public service).

2
332d9f75d1077abafff6887681f6b130

on December 16, 2011
at 01:07 AM

One caution against just blindly going on iron supplementation if it isn't needed: Iron can be bad for you. It has side effects just like anything else you put in your body, and if your iron levels get too high it can cause organ failure. (Organ failure is an extreme outcome, and would require chronically high iron levels, but it is a possibility.)

My point is, find out what you're trying to treat before you start treating it. Please.

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 08:49 AM

if blood test did reveal low iron, depending on how low, pairing iron rich foods with foods that have a lot of Vitamin C may bring levels up, before trying iron supps. or adding/increasing Vit C supplementation with your iron containing meal. Vitamin C can help your body absorb iron.

518bce04b12cd77741237e1f61075194

(11577)

on December 16, 2011
at 01:12 AM

Interesting fact: iron deficiency is one of the contributing factors that make women's life spans longer than mens! Iron supplementation is important if you simply can't climb on top of the deficiency however, OR if it significantly impacting your life. You shouldn't always be supplementing for iron also, should be done temporarily under supervision!

2
100fd85230060e754fc13394eee6d6f1

(18706)

on December 16, 2011
at 12:25 AM

If absorption is the problem, you might consider taking lactoferrin. It is an iron transporter that hides iron from bacteria which might otherwise be stealing it from you. See for example this summary page: Lactoferrin & Anemia.

Lactoferrin sequesters iron so that microorganisms can???t use it, and binds to bacteria and viruses to prevent them from binding to your cells, according to a 2005 research paper published in ???Cellular and Molecular Life Sciences.??? The iron-binding protein also regulates iron absorption and puts it into storage for later use.

...

A 30-day course of oral lactoferrin increased total iron and hemoglobin levels more so than iron supplements in pregnant women with iron deficiency anemia.

It also is known to prevent biofilm formation, and aid in bone formation.

ETA: That is to say, one possible cause is that bacteria are getting to it before you can. This is a potential solution.

2
E2b72f1912f777917d8ee6b7fba43c26

(2384)

on December 15, 2011
at 01:02 PM

Are you sure you're not eating anything you're allergic/sensitive to? There was a time when I ate about 3000 kcal a day, because I wanted to gain weight. But the opposite happended: I lost weight and felt weaker and weaker, when I stood up I felt dizzy, had a pale face etc. Then i figured out that I am sensitive to olive oil and coconut oil - my main fat sources at this time. Thus, my body wanted to get rid of the offending ingredients as soon as I had swallowed them - and all the other precious nutrients went with them. So in a nutshell: A sensitivity/allergy to food might be causing you absorption problems. (e.g. some common paleo foods that cause trouble: nuts, eggs, beef if you're allergic to dairy, salicylates etc)

1
543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 07:47 AM

did your doctor run enough tests to try & determine what type of anemia you have?
apart from the fbc/fbe (full blood count/exam) panel, some other tests that will help are;
1. Full Iron Studies (iron, transferrin, transferrin saturation, ferritin)
2. Vitamin B12
3. Red Cell Folate.

Also are you over training? if so you may want to look in to something often referred to as 'athletic anemia', 'athlete's anemia' or 'swimmer's anemia' & see 'Edit' below.

another possibility may even be drinking too much water (overhydration) &/or low sodium in the body (hyponatremia). low sodium levels in the body may be the result of inadequate dietary salt intake, excessive water or other health factors. if you are low in sodium you may also be low in potassium and other electrolytes.

& here's a link with info on diet-related anemia http://www.healthcastle.com/iron-anemia-different-types.shtml

Edit: also called 'athlete's hemolysis' & 'sports anemia'. Actually it may not be over training at all; Here's a good article by Dr. Randy Eichner that covers it http://www.gssiweb.com/Article_Detail.aspx?articleid=276
Here's some of the text;

E. Randy Eichner, M.D.
Department of Medicine
University of Oklahoma Health

Sports Anemia
Athletes, especially endurance athletes, tend to have slightly low hemoglobin levels as judged by general population norms. Because a low blood hemoglobin concentration defines anemia, this has been called sports anemia.

But sports anemia is a misnomer because in most such athletes???especially men???the low hemoglobin level is a false anemia. The total volume of red cells in the body is normal, not low. Hemoglobin level is decreased because aerobic exercise expands the baseline plasma volume; this reduces the concentration of red cells, which contain the hemoglobin. In other words, the naturally lower hemoglobin level of an endurance athlete is a dilutional pseudoanemia.

Pseudoanemia is an adaptation to hemoconcentration that occurs during workouts. Vigorous exercise acutely reduces plasma volume by 10-20% in three ways. One, a rise in blood pressure and muscular compression of venules boost the fluid pressure inside the capillaries of the active muscles. Two, generation of lactic acid and other metabolites in muscle increases tissue osmotic pressure. These forces drive plasma fluid, but not red cells, from blood to tissues. Three, some plasma water is lost in sweat.

In response comes the release of renin, aldosterone, and vasopressin to conserve water and salt. Also, albumin is added to the blood (Nagashima et al., 2000). As a result, baseline plasma volume expands. Even a single bout of intense exercise can expand the plasma volume by 10% within 24 h (Gillen et al., 1991).

So it is common for an endurance athlete to have a hemoglobin concentration 1 g/dL or even 1.5 g/dL below "normal". Recognizing this as pseudoanemia depends on knowing the setting (aerobic training at sea level) and excluding other anemias. Plasma volume waxes and wanes quickly in concert with level of exercise, so athletes who train the most have the lowest hemoglobin levels and when daily workouts are stopped, hemoglobin level soon rises.

Pseudoanemia is key to aerobic fitness. The rise in plasma volume???plus the adaptations of "athlete's heart"???increases cardiac stroke volume. This more than compensates for the fall in hemoglobin concentration per unit of blood, so more oxygen is delivered to muscles. Result: A better athlete.

Cccb899526fb5908f64176e0a74ed2d9

(2801)

on December 16, 2011
at 12:13 PM

I liberally salt my food so I doubt I'm low on sodium. I also drink anywhere between 3-8 liters of water a day, so it's possible I'm pissing out significant amounts of nutrients. I'm running about 30 miles a week, but getting at least 7 hours of sleep a night and eating 3200 calories. Does that sound like overtraining?

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 17, 2011
at 08:39 AM

running 1 mile a week sounds like over training to me :)

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 10:16 PM

you could be urinating all your electrolytes away. Have a read of a couple of Ray Peat articles; http://raypeat.com/articles/articles/salt.shtml & http://raypeat.com/articles/articles/water.shtml

543a65b3004bf5a51974fbdd60d666bb

(4493)

on December 16, 2011
at 10:14 PM

you could be urinating all your electrolytes away. Have a read of a couple of Rap Peat articles; http://raypeat.com/articles/articles/salt.shtml & http://raypeat.com/articles/articles/water.shtml

1
518bce04b12cd77741237e1f61075194

(11577)

on December 16, 2011
at 12:56 AM

When it comes to solving an anemia problem, it is important to identify what kind of anemia you are suffering from. If you have an iron deficiency ("hypochromic microcytic anemia"), your Hgb will be <140 g/L for men or <120 g/L for women. If you can get a hold of your test results, if your doctor isn't being helpful, just ask to look at them and you can identify this for yourself. This can be caused by: decreased dietary iron, inhibition of absorption (if you are consuming lots of calcium or zinc, in particular), GI bleeding, or heavy menstrual flow (females, obviously). If you are eating lots of meat, poultry, and fish you are probably getting plenty of heme iron, so a greater concern may be checking out if you could be inhibiting the absorption (if you are taking other mineral supplements in particular), or if you are losing too much iron (GI bleeds, hemolysis, menstruation).

In your case, it sounds like zinc is interfering your absorption of iron. If the anemia is causing problems, probably your logical next step is to decrease your zinc intake. See if that helps, and then maybe you can start adjusting your copper intake.

Another kind of anemia is "megaloblastic" or "pernicious", which is from a folate or B12 deficiency. If you had either of these less-likely anemias, your doctor probably would have informed you. This kind of anemia is largely attributed to the loss of ability to absorb B vitamins through the intestine, and would indicate a GI problem that may require significant intervention.

If you are having a hard time getting on top of your anemia and it is causing significant enough fatigue that it is seriously disrupting your life, your stores may be so depleted that it would be worth going on an iron supplement temporarily. I'm not sure where you live, but in Canada we have an iron supplement called "Bob's Iron Formula" that my mother had to go on for a while, she said it's the best and really helped her get on top of her iron deficiency so she could get back to moderating it with a healthy diet.

Edit: Seeing as zinc blocks iron absorption and copper is required to reduce ferrous iron to ferric iron, it seems like your problem probably lies herein. Could be a potentially easy fix, then.

0
5d0a23aefb2876433cc0e0679f714826

on March 19, 2014
at 07:14 PM

I think the cause of anaemia cannot be attributed to one thing, and probably some people like myself have a tendency to be low in iron. If you want some tricks that have helped me:

-In order to increase iron absorption eat vit C rich foods along with iron rich ones. I think it is a good idea to drink lemon juice as it stimulates stomach acid (people with low stomach acid are more prone to anaemia).

-Eat liver, one of the richest in iron.

-Avoid drinking tea, with your meals as it contain tannins which block iron absorption.

Also some nutritionists say that lysine contributes to iron absortion, but I haven´t investigate any further.

0
687bcdeaf37909fd0a6c3dbcc244f1de

on March 19, 2014
at 06:05 PM

make a good environment for iron absorption. Ijust had tested for hair loss. I scored 20 for my iron on 13-150 scale. Doc wants me to take 325 mg. Pills twice a day. I get bad stools with it even though no additives. I am going to change my diet and retest. I won't tell him right away I ditched the pills. I had orthosta5ic hypotension bad too.

I am adding iron sources like cooked spinach and kale, bone broth, liver, bone marrow, red meat, once or twice a day. I avoid iron binding calcium at that time....I'm heavy on almond products normally and some veggies high in calcium. Then I take vitamin C with the iron rich food. I ate a chicken leg and thigh, eating some end of bones and marrow, and a plum. Grapefruit on greens, etc. I have to avoid coffee and black teas...they hurt iron absorption. Also,vitamin A helps utilize iron from storage, like sweet potatoes.

I may have gotten low due to no red meat, excess calcium, pounding coffee, and depletion from heavy vitamin A consumption that only got me so far. Will see!

0
7636e1e02ef91a46f20a42e07b565a4b

on December 16, 2011
at 01:07 AM

Agreed about the possibility of iron-deficiency anemia being caused by inflammation, from either food allergies/sensitivities, infections/dysbiosis, etc. As far as I understand it, inflammation induces hepcidin to sequester iron which can lead to anemia. http://www.ncbi.nlm.nih.gov/pubmed/19786207

518bce04b12cd77741237e1f61075194

(11577)

on December 17, 2011
at 11:14 PM

From my understanding, sequestering of iron in the form of hepcidin that gets to the point where it causes anemia is quite extreme, and if that was happening there would probably many symptoms of relatively severe inflammation, probably stemming from a chronic diseased state. Correct me if I'm wrong though, iron storage is complex, interesting stuff!

7636e1e02ef91a46f20a42e07b565a4b

(367)

on December 19, 2011
at 10:32 PM

Jenny, hi. I've not read extensively on the subject by any means so I couldn't say, but many studies link iron sequestration with the inflammation of obesity, for instance. I imagine there's a continuum and perhaps a negative correlation between inflammation and serum iron levels, and yes anemia would characterize the extreme end of inflammation-induced iron deficiency. Therefore wouldn't it be possible with high inflammation, independent of chronic disease, to induce anemia? I have multiple food intolerances and no chronic disease that I'm aware of, and labwork showed borderline anemia.

0
Cf4576cbcc44fc7f2294135609bce9e5

on December 15, 2011
at 04:07 PM

im surprised your doctor cant or wont help you.especially since he was being paid for his or her "help". Red cells have a life span of about sixty days. if you are running low it means your not making new ones fast enough or you are loosing blood. i hope he or she at least checked for stool blood loss, that would take two minutes. (Ocult Blood stool test).

-1
Df71255c6b6f96d29cc58f05b51ebe7e

on January 30, 2013
at 10:14 AM

It is a common blood disorders and also red blood cells decreases. Less ablility of the red blood cells to carry oxygen.Fatigue is main symptom of most types of anemia. Dizziness, Insomnia, Loss of energy, Chest pain, Shortness of breath, Pale skin are the common symptom of many types of anemia. Iron deficiency anemia, Vitamin deficiency anemia, Blood loss, Folic acid deficiency are the few types of anemia. prevention of some type of anemia is to eat healthy foods,rich in iron, vitamin B-12, folate.Use this Anemia Forum to discuss more.

-2
Fa827367db96e402bd1446081c53eb4a

(26)

on September 04, 2013
at 06:26 AM

Anemia from active bleeding: Loss of blood through heavy menstrual bleeding or wounds can cause anemia. Gastrointestinal ulcers or cancers such as cancer of the colon may slowly ooze blood and can also cause anemia. Use this International Drug Mart's Anemia Forum to know more about the causes and treatment options.

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