Iron Deficiency – Vitamin B12 Deficiency
What and Why?
Anaemia literally means ‘lack of blood’, which only occurs in the true sense when you bleed from a wounded blood vessel. The term has come to mean that there is something wrong with the main component of your blood — the red material, haemoglobin, in the cells that carry oxygen from your lungs so that every cell in your body can breathe.
Red blood cells are made in your bone marrow and shaped a bit like miniature road-wheels, but very flexible so as to squeeze down even the smallest capillary blood vessel (see Chilblains). Their main content is haemoglobin, a complicated protein with iron attached which can soak up seventy times more oxygen than you can dissolve in the liquid of your blood — the plasma — yet will release it just as easily in parts of your body where oxygen is lacking.
These red cells are so specialized that haemoglobin takes up a third of their total weight. Its overall importance to you can be judged from the amount of it you contain — nearly a kilogram, or one seventieth of your whole body!
There are some families who tend to inherit unusual ways of making haemoglobin or red blood cells, which then either react badly with oxygen or tend to break up too easily. This kind of problem is more common in some parts of the world and European families who are likely to suffer in this way usually know about it already. For this reason we do not intend to discuss the inherited aspects of anaemia any further, but most of what follows and all the practical advice applies to them as well.
There are many things that can go wrong which reduce the oxygen carrying capacity of your blood, which is how otherwise normal people would begin to suffer from anaemia. If your body leaks more than about 1% of your blood every day, you can replace the lost fluid easily but you cannot keep up with the red blood cells. Your blood consequently gets more dilute and less red — enough to make you pale, tired and easily breathless.
Exactly the same symptoms happen if you can make the cells but not enough haemoglobin to fill them up; the cells are pale and small but as numerous as usual. In one kind of anaemia you make the cells over-large, trying to make up for having too little Vitamin B12 to make them properly.
Far the best known form of deficiency that can cause anaemia is lack of iron. This was always common among hard-pressed women making do on a poor diet, who are apt both to menstruate heavily and to absorb iron very slowly. There were, as a result, earlier in this century many anaemic townswomen whose body stores of usable iron were very poor and whose health improved when they received extra iron. This led to a wrong conclusion, however — that lack of iron was their chief problem. As a result there are still many women who are not obviously malnourished yet who seem to need iron tablets all the time to stop themselves getting anaemic.
The truth is that women who eat insufficient fresh fruit or leafy vegetables lack Vitamin C, so that they both menstruate too heavily and absorb iron very poorly. Extra Vitamin C is the best way to break this double bind. However that is not all. Haemoglobin is only a third of red cell contents and we need to look after the other two thirds, which support the general life of the cell and keep it in the best possible physical shape for its job. Many other nutrients turn out to be involved in this is some way, including several minerals which are as difficult as iron to scavenge from food. Zinc and Molybdenum are prominent among these, two of the metals whose importance to human health has come to light only recently.
What can I do?
Advice to maintain and maximise your health
1. You may be turned down as a blood donor because of mild anaemia, or you may suspect it yourself because of tiredness or breathlessness. If you think you may be anaemic compare the colour of your tongue or the palms of your hands with someone else’s. A very simple blood test can easily be organized by your doctor or occupational health nurse to decide for sure and work out why.
2. Maintain a good diet (see also Food for Health) to give your bone marrow a chance to correct the deficiency itself.
3. Take 250mg food-state Vitamin C extra with every meal until your blood tests indicate that the problem is solved. It is worth adding 15mg food-state Zinc and 50mg food-state Iron every day, preferably combined with Molybdenum: Nature’s Own Ltd manufacture a suitable range of products. ‘Food-state’means they have been grown, not chemically synthesised, to make them resemble food; they are much better absorbed and retained. Most minerals must be taken with a dose of Vitamin C to be effective, but the food-state formulations do not.
4. Vegetarians worry a lot about getting enough Vitamin B12 to prevent anaemia. If they still consume at least some eggs or milk there is no problem, since it is actually quite hard to avoid Vitamin B12 in animal produce. Vegans will get sufficient if they use comfrey in salads or drink teas containing comfrey, but need not worry unduly even if they don’t. There are a number of life-long vegans who manage very well, apparently on B12 made by bacteria in their colon which thrive especially on vegetable residues; the B12 released from dying bacteria seems to be absorbed by the vegan for his own use. This mechanism takes months to establish itself so new vegans should not rely on it to begin with.
5. Smoking disables a proportion of your haemoglobin by combining it permanently with carbon monoxide, the killer gas in car exhausts. This will not show as anaemia on a blood test but has just the same effect. If you are tired and breathless but not anaemic, stop smoking.
6. Some people who get angina or intermittent claudication turn out to be anaemic as well, which makes any circulation problem worse. There may not be much you can do in a hurry about blocked or damaged blood vessels but there is a chance you can relieve the symptoms they cause by curing the anaemia.