Family Health Diary

What is Anaemia?
Are your winters marred by a seemingly endless procession of colds, flu and sore throats? If this sad and sorry picture makes you think of yourself, you could be suffering from anaemia. Other less common symptoms include breathlessness on exertion, palpitations, headaches and hair loss.

Essentially anaemia is not having enough red cells in your blood. These carry oxygen from your lungs to all the tissues in your body. Many of the symptoms of anaemia, such as breathlessness and memory and concentration problems, result from poor oxygenation of tissues. This shortage has many possible causes, ranging from iron deficiency, chronic bleeding, increased destruction of red cells in the body, and diseases of the blood-producing tissues in the bone marrow.

What causes Anaemia?
The most common cause of anaemia is blood loss such as occurs with very heavy menstruation or chronic bleeding such as a stomach ulcer. A dietary deficiency of iron and vitamin C is less common but often results in anaemia in conjunction with menstrual blood loss. Women are therefore at greater risk of anaemia, as are people eating an iron-deficient diet: infants under the age of 2, teenage girls and the elderly. Vegetarians may also become anaemic as the most absorbable form of dietary iron (called heme iron) is found only in meat, especially red meat.

Are You Absorbing Enough Iron?
Iron absorption is reduced by:

  • Low hydrochloric acid levels in the stomach.  This can be a problem for elderly people especially.
  • Chronic diarrhoea or malabsorption.
  • Over-use of antacids.
  • Calcium supplements.
  • Substances in tea, coffee (tannin) and wheat bran (phytates).
  • Dietary lack of vitamin C (an essential co-factor for iron absorption).

Dealing with Anaemia or Iron Deficiency

1. If you have any symptoms of anaemia, see your GP for a blood test.
Many women in particular live with chronic, undiagnosed iron deficiency anemia. The first step in rectifying this problem is knowing that you have it! However, remember that in most people symptoms of tiredness and lack of energy are due to lifestyle problems, not anaemia.

2. Seek medical help to resolve health problems causing chronic blood loss.
These may include bleeding haemorrhoids, or excessively heavy menstrual periods. This ongoing loss of iron-rich blood will eventually contribute to falling body reserves of iron, and an increased risk of iron deficiency anaemia.

3. If you are higher risk (eg. a menstruating women), ensure a generous intake of iron-rich foods.
There are two types of dietary iron: Heme iron is found in animal proteins such as red and white meat and fish. This type of iron is more readily absorbed by the body (with red meat, especially liver, most easily absorbed). Non-Heme iron occurs in fruits, vegetables, grains, nuts and seeds etc, and is less readily absorbed. Iron-rich foods include green leafy vegetables, dried beans, apricots, blackstrap molasses, eggs, spirulina, almonds and shellfish. Always try to have a food rich in vitamin C at the same time as your iron-rich foods. For example, drink a small glass of fresh orange juice with your meal; or add a large tomato or handful of bean sprouts to your meal.

4. Avoid foods and supplements which may be reducing your ability to absorb iron.
One of the most common dietary practices for many New Zealanders is the obligatory “cup of tea” at the end of a meal. High in tannin, tea consumption straight after a meal can reduce your ability to absorb iron from your meal by as much as 60%. Leave at least an hour after meals before drinking tea. If you are suffering from indigestion and controlling symptoms by regular use of an antacid, your iron absorption may be compromised. Similarly, if you are taking calcium supplements, make sure that you take them well away from iron-rich meals, or any iron supplements you may be using.

5. Consider using an iron supplement.
Consider using an iron supplement only after seeking medical advice (such as being diagnosed with iron deficiency) or if you are in a high-risk group. Too much iron can cause a disease called haemochromatosis leading to diabetes and heart trouble.

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