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Anaemia - A Natural Approach

Updated on October 7, 2011

Anaemia is a rather difficult subject to deal with, because it is very often a symptom of some underlying disorder. In such cases, it is necessary to deal with the underlying cause first. I will set out some possibilities for the underlying causes, but it is by no means an exhaustive list and if you think you may be anaemic then you need to see a professional.

Anaemia is usually defined as impairment of the oxygen-carrying capacity of the blood, and has several symptoms. The most obvious, but also usually the last to appear, is pale skin and also paleness of such areas as the inner eyelids and the inside of the mouth. Someone with naturally dark skin will show anaemia less obviously. Another symptom is fatigue with no obvious cause, and another is elevated heart rate. However, all of these symptoms can be caused by other problems so the only definitive test is a blood test.

First, I’ll list a few medical problems that cause anaemia.

Recent Injury

This is rather obvious, but recent significant injury or surgical procedures can lead to anaemia. Rather less obvious, however, is that anaemia can set in some time after such an event, especially if the immediate problem was dealt with by transfusion. The reason for this is that transfused blood, particularly the red blood cells in it, does not last as long in the body as internally-generated blood. The reason has to do with the immune system slightly attacking the foreign cells, but also because the transfused blood cells are partly “worn out”. Red blood cells have a lifespan of approximately 120 days; as will be apparent, the average remaining life of the cells in transfused blood will be about 60 days – or perhaps a bit less, because the storage and processing of blood inevitably causes damage.

Bone Marrow Disorders

Numerous medical problems, and also some treatments (particularly cancer chemotherapy and radiation therapy), can cause problems with creation of red blood cells in the bone marrow thus reducing the supply of new red cells. This needs dealing with by professionals.

Ongoing Blood Loss

Many medical problems, and at least one natural function (menstruation), can cause anaemia because of ongoing blood loss that the blood-forming organs can’t keep up with. This is probably the reason why far more women than men in the (roughly) 16-45 age group suffer from anaemia. Some women lose more blood at this time than others, and this needs attention. But the other reasons for ongoing blood loss are not quite as obvious. Most of them involve blood loss in the digestive system; some examples are active, bleeding peptic ulcers and also ulcers in the small or large intestine. Unfortunately, a possible reason for blood loss by this route is bowel cancer. For this and other reasons, to reiterate, unexplained anaemia needs to be investigated.

Pernicious Anaemia

This type of anaemia is caused by lack of absorption of vitamin B12, which is necessary for the production of haemoglobin (the oxygen-carrying protein in blood) in the body. The most common cause of this is simply advancing age, because vitamin B12 absorption needs sufficient stomach acid for its absorption and elderly people produce less stomach acid. Also, this problem can be caused by not having a stomach; the usual reason for this is surgical removal of all or part of the stomach, which can be necessary for various reasons. Another possible reason for this problem is extensive use of drugs or products intended to reduce stomach acid.

Vitamin B12 deficiency does not only cause anaemia; it can also cause damage to the nervous system among other things. So this type of anaemia needs careful attention, too.

Genetic and Metabolic Abnormalities

A fairly large number of genetic problems can cause anaemia; the best-known one is probably sickle cell trait. There are also various known problems with absorption of iron or other nutrients needed for the production of red blood cells. Again, this sort of problem needs professional help. If you are in this group, you may well already be getting that help.

Nutritional Deficiencies

Anaemia caused by this group of problems is by far the easiest type to deal with. If you are anaemic and the professionals can’t find a specific reason, then this is the next problem to address. The body needs numerous nutrients to make haemoglobin, but the main ones that often cause problems are iron, vitamin B12, folic acid, vitamin C and vitamin E.


Iron is essential for the production of haemoglobin and for quite a lot of other purposes too. Unfortunately, it is quite easy for the diet to be either short of iron or have the iron bound in a form in which it is mostly unavailable; the latter applies to vegetarian and especially vegan diets unless you are careful. Just as an example, the outer layers of various grains are quite high in iron but also high in a substance called phytic acid, which binds iron and other minerals making them difficult to absorb. As an aside, most people who eat muesli do not eat it as it was intended by its inventor to be eaten. Grains contain phytic acid but also an enzyme called phytase, which destroys it; but this process takes time. Ideally, therefore, muesli should be prepared the night before consumption – and almost nobody does that. Iron is found in reasonable amounts in egg yolk, so lacto-ovo-vegetarians don’t have much of a problem here – but vegans might. The richest source of iron is red meat, and even more so liver.

Vitamin B12

Vitamin B12 deficiency is rather easy to run into. As discussed above, malabsorption is quite common in the elderly and others with compromised stomach acid; also, most vegan foods contain no vitamin B12 at all unless it has been deliberately added. The only commonly used exception to this is various fermented soya products such as miso. Vegetarians who eat dairy products and eggs are better off, because eggs are reasonably high in vitamin B12, but animal foods such as red meat and offal are the highest in vitamin B12.

Folic Acid

Folic acid is very easy to get, especially for vegetarians. However, many people eat nothing like enough of the main source of folic acid, which is vegetables especially leafy ones. If you have a diet high in junk food, you are quite likely to be low in folic acid – because folic acid is also easily destroyed by food processing.

Vitamin C

Apart from its very many other uses, vitamin C makes iron more absorbable; this is especially true for vegetable sources of iron.

Vitamin E

Vitamin E is a special case, because its effects are on the red blood cells. Lack of vitamin E causes the red blood cells to become more susceptible to damage, and thus can lead to anaemia because the blood-forming tissues can’t keep up with destruction of these cells. The extreme version of this is called haemolytic anaemia, but there are many other causes of this form of anaemia.

What to Do

If you are anaemic, you need to make sure of adequate intake of iron, vitamin C, folic acid, vitamin B12 and vitamin E. Because vitamin B12 is often poorly absorbed, it might be a good idea to use a high-dose sublingual supplement of this vitamin; sublingual means “under the tongue” and the reason for this form is that a small amount of vitamin B12 can get straight into the bloodstream through the delicate membranes in that area. Vitamin B12 is essentially non-toxic; there is very little risk of overdose.


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