Anemia

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Anemia

Anemia is characterized by a deficiency in red blood cells or in the concentration of hemoglobin (iron-containing portions of red blood cells). These deficiencies are caused by either decreased production or increased destruction of red blood cells. Anemia is most common among women in their reproductive years (5.8 percent), infants (5.7 percent), and the elderly (12 percent). Because one of the major functions of red blood cells is to transport oxygen, a decrease in red blood cells decreases the amount of oxygen delivered to the body's tissues, which results in the symptoms of anemia.

Signs and Symptoms

There is tremendous variability among individuals as to when the following symptoms of anemia develop.

	Tiredness
	Shortness of breath
	Paleness
	Lightheadedness
	Headache
	Heart palpitations and chest pain

What Causes It?

Anemia may have the following causes.

	Pregnancy and breast-feeding
	Iron, folic acid, vitamin B₁₂, or other vitamin deficiencies
	Certain chronic conditions
	Gastrointestinal blood loss (caused by ulcers, cancer, parasites)
	Genitourinary blood loss (such as from heavy menstruation)
	Excessive blood loss (after surgery or regular blood donations)
	Excessive alcohol or drug use
	Malabsorption syndromes (for example, celiac disease)
	Congenital diseases (for example, sickle cell anemia)
	Malnutrition

What to Expect at Your Provider's Office

Anemia is often the result of an underlying disease. Laboratory tests to examine your blood will be ordered. If you are anemic, your health care provider will determine why in order to begin treatment.

Treatment Options

Treatment Plan

Treatment depends on the cause and severity of the anemia. If your anemia is the result of an underlying disease, that disease first must be successfully treated. For example, if you have hereditary spherocytosis, you may need to have your spleen removed before the anemia can be cured. Some drugs can cause anemia. You may need to stop taking such drugs before starting your treatment. Blood transfusions help certain types of anemia such as sickle cell anemia.

Drug Therapies

Prescription

	Erythropoietin plus iron—for anemia resulting from chronic failure
	Steroids—for autoimmune hemolytic anemia
	Iron replacement—toxic if too much is taken
	Analgesics—for pain resulting from sickle cell anemia

Over the Counter

Nutritional supplements—vitamin B12, iron, and folic acid aid healthy blood formation

Complementary and Alternative Therapies

Most cases of anemia will respond well to nutritional therapy. Note that excess iron is toxic and you should not take supplements unless lab tests indicate iron deficiency and your health care provider recommends them. Herbal and nutritional treatments may be helpful when used along with medical treatment.

Nutrition

	Ferrous fumerate, glycerate, or glycinate (100 mg per day for three to six months) are the most absorbable forms of iron. Ferrous sulfate (325 mg per day) is poorly absorbed and more frequently causes problems with GI upset and constipation. Dietary sources of iron include meat, beans, green leafy vegetables, beet greens, blackstrap molasses, almonds, and brewer's yeast.
	Vitamin C—up to 1,000 mg three times per day to aid in absorption of iron.
	Vitamin B₁₂—cyanocobalamine, 1,000 IU via injection twice a day for one week, then weekly for a month, then every two to three months. Dietary sources include organ meats, meats, eggs, fish, and cheese.
	Folic acid (1 to 2 mg per day)—for folic acid deficiency. Good food sources include green leafy vegetables and grains.
	Omega-3 and omega-6 essential fatty acids (1,000 to 1,500 IU) have been shown to decrease the frequency of sickle-cell crisis. EFAs can increase clotting times, so if you are taking anticoagulants, your health care provider will need to check these times.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.

You may be treated with the following herbal therapies for one to three months and then reassessed.

	Blackstrap molasses, also known as pregnancy tea (1 tbsp. per day in a cup of hot water), is a good source of iron, B vitamins, minerals, and is also a very gentle laxative.
	Spirulina, or blue-green algae, has been used successfully to treat both microcytic and macrocytic anemias. Dose is 1 heaping tsp. per day.
	Alfalfa (Medicago sativa), dandelion (Taraxacum officinale) root or leaf, burdock (Arctium lappa), and yellow dock (Rumex crispus) have long been used to fortify and cleanse the blood. For mild cases of anemia, they may help bring levels of hemoglobin into normal range. Dosage is 1 tbsp. per cup of water. Simmer roots for 20 minutes and leaves for 5 minutes. A single herb, or a combination of these four herbs, may be used.

Homeopathy

A common remedy used for this condition is listed below. Usually, the dose is 12X to 30C every one to four hours.

Ferrum phosphoricum 12C once a day for iron-deficiency anemia

Following Up

Maintaining a normal balanced diet is very important if the cause of your anemia is nutritional. Also, avoid drugs that can have adverse effects on your gastrointestinal system and avoid excessive alcohol intake if one or both of these are the cause of your anemia.

Special Considerations

Complications from anemia can range from loss of productivity due to weakness and fatigue to coma and death. Some neurologic changes caused by anemia are irreversible. Pregnant women need three or four times as much iron as normal. A folic acid deficiency during pregnancy can result in infants being born with neural-tube defects, such as spina bifida.

Supporting Research

Branch Jr WT. Office Practice of Medicine. Philadelphia, Pa: WB Saunders Company; 1994.

Fauci AS, Braunwald E, Isselbacher KJ et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Kelley WN, ed. Textbook of Internal Medicine. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1997.

Varro TE. The Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed. New York, NY: Pharmaceutical Products Press; 1993.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.