Anemia

Iron Deficiency Anemia

EXERCISE PROGRAM

Strenuous exercise should be avoided as this can increase nutrient needs, including iron. Remember that iron deficiency—even without anemia—reduces physical endurance[4]. Stretching exercises can be helpful for associated issues, such as restless leg syndrome, that can develop as a result of iron deficiency anemia[5].

HOLISTIC NUTRITION

Foods high in iron include red meat, egg yolks, dark leafy greens (such as spinach and collard greens), dried fruit (such as prunes and raisins), and mollusks (such as oysters, clams, or scallops). Animal sources of iron are better absorbed than vegetable sources because it is in the heme form[6]. For vegetarians, a non-meat source of available iron is blackstrap molasses. As tea and coffee inhibits iron absorption, reduce consumption of these beverages, particularly after meals[7].

Iron-fortified food products in the diet are effective. For example, it was shown that the addition of iron-fortified infant rice cereal to the diet of infants can prevent development of iron deficiency anemia[8]. Iron-fortified milk was also used with great success[9].

Additionally, adding fermented dairy products into the diet can colonize the gut with probiotics and enhance iron absorption[10].

SUPPLEMENTS

A primary care provider will often recommend iron sulfate, which may cause adverse gastrointestinal (GI) side effects, such as constipation and cramping. Note that other forms of iron are available; fumarate and gluconate have less GI side effects and are less likely to cause constipation.

The therapeutic dosage of elemental iron supplements for anemia for adults is 50 to 100 milligrams, three times daily. Smaller doses (e.g., 60 to 120 milligrams daily) also have been recommended, and may be particularly useful for minimizing GI intolerance, but the possibility that iron stores will be replenished at a slower rate should be considered.

Hemoglobin production usually increases at a rate of 100 to 200 milligrams per deciliter (mg/dL) of blood daily; normal hemoglobin values are usually attained in two months unless blood loss continues. Because iron stores remain depleted, recurrence of anemia may result if iron therapy is discontinued at this time. In the treatment of severe deficiencies, iron therapy should be continued for approximately six months. A primary care physician should repeat a complete blood count at three months to see if the red blood cell numbers, hematocrit, and hemoglobin levels have returned to normal.

Be aware that iron in supplement form can be toxic in high amounts. The recommended daily allowance (RDA) for iron for woman is 15 to 18 milligrams per day and the tolerable upper limit for women is 45 milligrams per day. A non-prescription iron supplement should not go over the tolerable upper limit. An effective supplement may have up to 150% of the RDA or around 25 milligrams of iron.

Oral iron preparations should be taken between meals for maximum absorption (e.g., two hours before or one hour after a meal) but may be taken with or after meals, if necessary, to minimize adverse effects. To help support optimal RBC production, vitamin C, B12, and folate are also needed. A supplement that contains all of these would be helpful.

For more information, here is a great fact sheet from the National Institutes of Health📷Links to an external site. (NIH)[11].

BOTANICALS

A number of herbs with high iron content can be added to the diet, including: Alfalfa Medicago sativa(L.), common nettle Urtica dioica (L.), dandelion Taraxacum officinale (F. H. Wigg.), watercressNasturtium officinale (W.T. Aiton), and yellow dock Rumex crispus (L.).

Dandelion T. officinale and watercress N. officinale can be included in the diet as salads. Use as you would any salad greens.

HOMEOPATHY

The following homeopathic remedies are commonly used: Ferrum metallicum, Ferrum citricum, and Ferrum iodatium. Take the remedy once daily in 30c potency.

OTHER MODALITIES

AYURVEDIC MEDICINE

Ayurvedic medicine recommends a number of preparations that can be used to address iron deficiency anemia. Studies demonstrate that daily supplementation of Sootshekhar rasa (250 milligrams) plus Sitopaladi churna (400 milligrams) can produce improvements in the case of anemia[12]; Panduhara yoga was also successfully used[13].