How to Holistically Heal Anaemia

Anaemia is a condition characterised by a decreased red blood cell count or lower-quality haemoglobin, which hinders the availability of oxygen to the body's organs, leading to a range of physiological effects. It is estimated that close to one billion people worldwide suffer from anaemia. Understanding its causes, signs, symptoms, and appropriate medical testing can help individuals become better informed about their blood health.

Anaemia can stem from various factors, and there is no single universal cause. Iron deficiency is one of the common contributors and can result from:

• Lack of dietary iron intake. See below regarding haeme iron and non haeme iron sources.

• Parasitic worms causing intestinal bleeding (a comprehensive stool analysis can determine a parasitic infection - please reach out to my clinic).

• Blood loss: Chronic blood loss, either from gastrointestinal issues (e.g., gastric or duodenal ulcers, polyps, tumours, haemorrhoids) or frequent blood donation, can lead to iron depletion over time. Long-term use of non-steroidal anti-inflammatory drugs can indirectly lead to ulcers.

• Heavy or frequent menstruation and/or endometriosis.

• Malabsorption disorders: Certain medical conditions, such as Crohn's disease, ulcerative colitis, and other malabsorption disorders, can impair the absorption of nutrients, including iron. Coeliac disease is another condition where iron is not absorbed.

• Competing with Zinc : Zinc and iron compete for absorption in the gastrointestinal tract. Therefore, it is advisable to take zinc supplements at a different time from iron supplements to maximise their individual absorption. Taking zinc supplements before bedtime, away from iron-rich meals or supplements, can help optimise absorption of both minerals.

• Tannins bind to iron : Tannins are compounds found in certain beverages like tea, coffee, red wine, and colas. These compounds can bind to iron and reduce its absorption. To enhance iron absorption, it is best to avoid consuming these beverages with iron-rich meals. Separating the consumption of tannin-containing drinks from meals that contain iron can help improve iron absorption.

• Oxalate-rich foods bind to iron: Oxalates are naturally occurring compounds found in certain plant-based foods. Foods rich in oxalates, such as raw: rhubarb, spinach, silver beet, chard, beet leaves, unripe tomatoes, and strawberries, can hinder iron absorption. However, cooking these foods significantly reduces their oxalate content, which may help improve iron absorption.

• Vitamin C deficiency: Certain vitamins can enhance iron absorption. Vitamin C, in particular, is known to increase the absorption of non-haeme iron (the form of iron found in plant-based foods) when consumed together in a meal. Foods rich in vitamin C, like citrus fruits, strawberries, kiwi, and capsicums or peppers, can be paired with iron-rich foods to enhance iron absorption.

• Vitamin A deficiency: Vitamin A plays a role in mobilising iron from storage sites, and its deficiency limits the body's ability to use stored iron.

• Vitamins B deficiencies : Vitamin B6 and vitamin B12 are the two B vitamins that play a role in helping to absorb iron. Vitamin B6 is involved in the metabolism of amino acids, including those involved in haemoglobin production. Haemoglobin is the protein in red blood cells that carries oxygen. Therefore, adequate levels of vitamin B6 are important for the synthesis of haemoglobin and, indirectly, for the proper utilisation of iron in the body. Vitamin B12 is essential for the production of red blood cells. It works together with folate (another B vitamin) to ensure that the bone marrow produces healthy red blood cells. Red blood cells are responsible for transporting oxygen throughout the body. Adequate levels of vitamin B12 are necessary for the effective use of iron in forming haemoglobin and preventing anaemia. Folate, also known as vitamin B9, is another B vitamin that plays a crucial role in supporting iron absorption. Folate is essential for the production of red blood cells and DNA synthesis. It works in synergy with vitamin B12 to help form healthy red blood cells in the bone marrow. Folate is particularly important for the process of erythropoiesis, which is the production of red blood cells. It aids in the maturation of red blood cells, ensuring that they are healthy and functional. Without sufficient folate, the production of red blood cells can be impaired, leading to anaemia.

• Insufficient stomach acid (HCL): This is due to a lack of protein, eating on the run, not chewing food until liquid, overuse of antacids, eating in a stressed state or over alkalising your gut. Adequate stomach acid is essential for digesting protein, which contains iron and other nutrients.

• Pregnancy and breastfeeding: Pregnant and breastfeeding women require more iron to support foetal development and milk production, respectively. If their dietary iron intake is insufficient, it can lead to iron deficiency.

• Rapid growth: Infants, children, and teenagers experience rapid growth, which increases their iron requirements. Inadequate iron intake during these growth phases can result in iron deficiency.

• Vegetarian or vegan diet : Plant-based diets may not provide enough bioavailable iron, as non-haeme iron (found in plants) is not as readily absorbed as haeme iron (found in animal products). Individuals following strict vegetarian or vegan diets may need to carefully plan their iron intake to avoid deficiency.

• Chronic kidney disease: Individuals with chronic kidney disease may experience reduced production of erythropoietin, a hormone that stimulates red blood cell production, leading to anaemia.

• Blood disorders: Inherited blood disorders, such as thalassaemia and sickle cell disease, can affect the production and lifespan of red blood cells, increasing the risk of anaemia.

• Bariatric surgery: Certain weight loss surgeries can impact the absorption of nutrients, including iron, leading to iron deficiency in some cases.

• Gastrointestinal surgery: Surgical removal of parts of the stomach or intestines can interfere with iron absorption, potentially causing iron deficiency.

Identifying the specific cause of iron deficiency is essential for targeted treatment and prevention strategies. If you suspect iron deficiency or experience symptoms of anaemia, it is essential to seek medical evaluation for proper diagnosis and management. A healthcare professional can conduct the necessary tests and recommend appropriate interventions to address the underlying cause and improve iron levels.

To address anaemia effectively, understanding the underlying cause is crucial. Seeking medical guidance and appropriate testing can help identify the specific factors contributing to an individual's anaemic condition, leading to targeted treatment and improved overall health. A comprehensive approach, including dietary adjustments, addressing infections, managing menstruation-related issues, and treating underlying medical conditions, can aid in restoring proper iron levels and alleviating anaemia symptoms.

Symptoms of anaemia can vary depending on the severity and underlying cause of the condition. Here are some common symptoms and signs of anaemia.

Symptoms:

• Fatigue and weakness : Feeling unusually tired, sleepy and lacking energy, even with sufficient rest.

• Shortness of breath: Breathlessness, particularly with physical activity or exertion.

• Dizziness or lightheadedness: Feeling faint or dizzy, especially when standing up or changing positions quickly.

• Rapid or irregular heartbeat: The heart may beat faster to compensate for the decreased oxygen-carrying capacity of the blood.

• Cold hands and feet : Poor circulation can cause extremities to feel colder than usual.

• Headache : Anaemia can lead to reduced oxygen supply to the brain, resulting in headaches.

• Chest pain : Severe anaemia may strain the heart, causing chest pain (angina).

• Compromised immunity : Anaemia can weaken the immune system, making individuals more susceptible to infections.

• Poor cognition : Anaemia affects the oxygen supply to the brain, which can result in difficulties with cognitive functions such as memory, concentration, attention, and problem-solving. Individuals with anaemia may find it challenging to focus on tasks, have reduced mental clarity, and experience memory lapses. This cognitive impairment can lead to feelings of frustration, decreased productivity, and impact daily activities and work performance.

• Anxiety and moodiness: Anaemia can indeed be associated with both anxiety and moodiness. The decreased oxygen supply to the brain due to reduced red blood cells and haemoglobin can have an impact on neurological function and mental health, leading to changes in mood and increased feelings of anxiety.

Signs (Physical Examination Findings)

• Pale mucous membranes: The inside of the mouth and the conjunctiva (the white part of the eyes) may appear pale.

• Pale nail beds: The nail beds can have a paler colour than usual.

• Pale skin: The skin may appear paler than usual, especially in the face, gums, and nail beds.

• Brittle or spoon-shaped nails (koilonychia): Nails may become brittle and break easily or have a concave shape.

• Hair loss: Anaemia can lead to reduced oxygen supply to hair follicles, affecting their growth and leading to hair thinning or hair loss. This condition is known as "telogen effluvium," and it can be temporary. Hair loss due to anaemia might not be immediately noticeable, but over time, an individual may experience increased shedding and noticeable thinning of the hair.

• Tachycardia : A rapid heart rate, often above the normal range for age and activity level.

• Heart murmur : In some cases, a healthcare provider may detect abnormal heart sounds.

• Inflammation of the tongue (glossitis): The tongue may appear swollen, red, or inflamed in some cases of anaemia.

• Mouth ulcers (aphthous ulcers): Painful sores may develop on the inside of the mouth.

• Enlarged spleen (splenomegaly): In certain types of anaemia, the spleen may become enlarged.

It's important to note that these symptoms and signs can also be present in other health conditions, so a proper medical evaluation is necessary for accurate diagnosis and treatment. If you experience any of these symptoms or suspect you might have anaemia, it is essential to seek medical attention for proper evaluation and management.

Haeme Iron vs Non Haeme Iron Foods

When it comes to iron-rich foods, they can be broadly classified into two categories: haeme iron and non-haeme iron.

Haeme Iron

Haeme iron is found in animal-derived foods and is more easily absorbed by the body compared to non-haeme iron. It is especially beneficial for individuals with low iron levels or those at risk of iron deficiency. Foods high in haeme iron (per 100 grams, approximate iron content):

• Chicken liver: 11.0 mg

• Beef liver: 6.5 mg

• Oysters: 6.0 mg

• Lamb liver: 5.9 mg

• Clams: 5.0 mg

• Beef (lean, cooked): 2.9 mg

• Chicken (cooked): 1.1 mg

• Turkey (cooked): 1.0 mg

• Pork (cooked): 0.9 mg

Note: choose organic and/or pastured or grass fed and finished animal foods as they are also rich in fat soluble vitamins A, D, and K2 which help absorb iron and other minerals. Go to my book I am Food  for more information on this topic as well as recipes!

Non-Haeme Iron

Non-haeme iron is found in plant-based foods and fortified products. While the absorption of non-haeme iron is influenced by other dietary factors, consuming these foods along with vitamin C-rich foods can enhance iron absorption. Foods high in non-haeme iron (per 100 grams, approximate iron content):

• Soybeans (cooked): 6.6 mg

• Lentils (cooked): 3.3 mg

• Kidney beans (cooked): 2.7 mg

• Chickpeas (cooked): 2.4 mg

• Spinach (cooked): 2.7 mg

• Tofu: 2.0 mg

• Quinoa (cooked): 1.5 mg

• Pumpkin seeds: 10.3 mg

• Dried apricots: 2.7 mg

To enhance the absorption of non-haeme iron from plant-based foods, it's essential to prepare them in ways that reduce the content of phytates and lectins, which can inhibit iron absorption.

• Phytates (Phytic Acid): Phytates are naturally occurring compounds found in certain plant foods, particularly grains, legumes, nuts, and seeds. They serve as the primary storage form of phosphorus in plants. While phytates have some health benefits, they can also bind to minerals, including iron, zinc, and calcium, forming complexes that are not easily absorbed by the body. Phytates' ability to bind to iron reduces its bioavailability, meaning the body cannot absorb and utilise the iron effectively. This can be a concern, especially for individuals following plant-based diets, as they rely more on non-haeme iron sources.

• Lectins: Lectins are proteins present in many plant-based foods, including legumes (beans, lentils, peas), grains (wheat, barley, rice), and certain vegetables. Lectins are part of the plant's natural defense mechanism against pests and predators. In humans, lectins can interact with the lining of the gut and potentially interfere with nutrient absorption. In the case of iron, lectins can bind to iron in the digestive tract and reduce its absorption. This can be of particular concern for individuals who consume large quantities of raw or undercooked legumes and grains.

Ways to Reduce Phytates and Lectins

• Soaking: Soaking legumes, nuts, seeds, and grains in water with a little natural salt and a little whey liquid or lemon juice for several hours or overnight can help reduce their phytate content. The process of soaking initiates germination, which breaks down phytates and makes minerals, including iron, more bioavailable.

• Sprouting : Sprouting involves allowing seeds, legumes, or grains to germinate. This process also reduces the phytate content and may improve iron absorption.

• Fermentation: Fermentation is a traditional method of food preservation that also reduces phytates and lectins. Foods like fermented soy products (e.g., tempeh) and sourdough bread may be better options for individuals concerned about phytate and lectin content.

• Cooking: Cooking legumes, grains, and vegetables can help break down phytates and lectins, making iron more bioavailable. Steaming, boiling, and pressure cooking are effective methods.

• Pairing with Vitamin C : Consuming foods rich in vitamin C alongside iron-rich plant foods can enhance iron absorption. Vitamin C reduces the binding of phytates and improves the uptake of non-heme iron.

Iron Requirements

The recommended daily intake of iron varies based on age, gender, and life stage. Here are the approximate daily iron requirements for different groups:

• Infants (7-12 months): 11 mg

• Children (1-3 years): 7 mg

• Children (4-8 years): 10 mg

• Males (9-13 years): 8 mg

• Females (9-13 years): 8 mg

• Males (14-18 years): 11 mg

• Females (14-18 years): 15 mg

• Males (19-50 years): 8 mg

• Females (19-50 years): 18 mg

• Pregnant females: 27 mg

• Breastfeeding females: 10 mg

A Note on Iron Supplements

I’ve intentionally not made a blanket recommendation for a specific iron supplement, as the form and dosage of iron you may need is highly individual. The ideal supplement is one that is gut-friendly —meaning it does not cause constipation or digestive discomfort —and is highly absorbable to correct deficiency efficiently and gently.

Some forms of iron are better suited when there is inflammation present , while others are more appropriate when iron deficiency is linked to a B vitamin deficiency (such as folate or B12), or to genetic variations like the MTHFR mutation , which can affect how the body processes certain nutrients. In these cases, a more comprehensive approach is needed—often combining iron with cofactors and supportive nutrients that enhance its absorption and utilisation without burdening the gut.

The kind of iron supplement that's right for you should always be recommended by your healthcare practitioner, ideally with the guidance of recent pathology or functional testing. It’s important to understand the root cause of your deficiency, rather than simply treating the symptom.

If you don’t currently have a naturopath or holistic practitioner guiding your care, you're welcome to  book a consultation with me  . Together, we can determine the most appropriate iron support tailored to your individual constitution, health history, and unique nutritional needs.