Ask anyone who has been anemic, and you’ll hear the same thing, “I was just so tired!” Extra sleep didn’t make a difference. What is the real problem? The body may be lacking iron, which is a vital nutrient. One key action it takes is that it carries oxygen in the blood. Iron based anemia is a medical condition in which the body is not getting enough of that oxygen-loaded-blood to the cells. The end result – fatigue.
According to the World Health Organization, anemia is the leading nutritional deficiency worldwide, with an estimated 2 billion people suffering. Significantly more women than men have anemia. The numbers are greater still in the Hispanic/African American population. The US Preventive Task force estimates that 2 percent of adult men, 9- 12 percent of adult Caucasian women and 20 percent of African American/Hispanics have anemia in our country. There are many causes of anemia, such as rapid growth (in children and in pregnancy), inadequate diet (seen in vegetarians as well as the elderly), blood loss (from disease, injury and heavy periods) or poor absorption (particularly in people with Celiac and Crohn’s diseases and in gastric bypass patients).
There are many symptoms associated with anemia beyond being tired. According to The National Heart Lung & Blood Institute, symptoms of anemia are:
• Short of breath
• Dizziness
• Light Headed (particularly when standing up)
• Headache
• Cold hands & feet
• Pale skin
• Chest pain
• Irregular heart beat
• Heart murmur
• Enlarged heart
• Heart failure
If it is iron-based anemia, you may also be experiencing these signs: brittle nails, swelling/sore tongue, cracks at the corners of the mouth, enlarged spleen, restless leg syndrome, blue color in whites of eyes and frequent infections. Also, some people with iron based anemia exhibit Pica; a type of food craving in which non-food items are eaten such as ice, dirt, paint and starch.
If you have one or more of the symptoms of anemia, it is important to get checked by your primary care provider. Your visit will most likely include a complete physical. There are several blood and urine tests that are used to check for anemia such as Hemoglobin, Hematocrit, TIBC (Total Iron Binding Capacity), Iron and UIBC (Urine Iron Binding Capacity). You may also be tested for ferritin and B12 to distinguish iron based anemia from other types.
Once you get the diagnosis confirmed that it is iron based anemia, you can take action! Most often, your PCP will recommend that you start taking an iron pill. The best absorbed iron pills are Ferrous Fumarate, Ferrous Sulfate and Ferrous Gluconate. Since iron can be tough on your digestive tract (GI), it is recommended that you buy an enteric coated or slow release iron pill. To lessen the blow to the GI, consider taking the iron pill with food AND start out taking half the dose. If you have no problems with the half dose of iron pills, then slowly advance to the full dose. The most common full dose is325-mg. iron (of which you will absorb only about 50- 60 mg. each time).
If you take other medications, check with your pharmacist or PCP about timing. You will need to separate antibiotics, antacids, Parkinsons and Seizure medications from the iron pills. Also, separate by at least 2 hours, any milk/dairy/calcium pills from the iron pills.
You can also make a big difference by adding iron rich foods to your plate every day. The best-absorbed iron is from animals. Every day, have a couple of servings (3- 4 ounces or the size of deck of cards/serving) of high iron foods such as chicken, turkey, fish, shellfish (especially clams, mollusks), and lean meats (beef, pork, lamb, veal). Additionally, you can get iron from plants (it is just significantly less absorbed). Good sources are: iron fortified ready to eat cereals & hot cereals, cooked dried peas/beans (e.g. kidney beans, lentils), tofu, dark green leafy vegetables, molasses, and raisins.
Get an extra boost in your ability to absorb iron from your foods by combining those iron rich foods with a good source of vitamin C. You need to have both the Vitamin C and Iron rich foods at the same meal. So, make sure you fill your plate with a fruit and/or vegetablehigh in Vitamin C. See below for ideas:
Produce high in Vitamin C
Fruit: apricot, berries, cantaloupe, citrus, honeydew melon, kiwi, papaya and mango
Vegetables: bell peppers, hot peppers, broccoli, brussel sprouts, cabbage, green cauliflower, collard greens, green beans, kale, spinach, tomatoes and white potato
Once you start to replenish your iron stores, be patient. It can take up to 2 months to start to really feel significantly better. Having energy, not always feeling tired, is well worth the wait.
Jennifer Giffune, R.D., L.D.N. is a freelance author, professional speaker and nutrition counselor. She currently is providing nutrition counseling services for Hampden County Physician Associates at their offices in Westfield, Southwick and West Springfield. If you would like to schedule a counseling session with Jennifer, please call (413) 569- 2257.
