Anaemia

Discussion

The primary function of red blood cells is the transport of oxygen from the lungs to all parts of the body. Shortage of red cells, or incorrect functioning, causes fatigue because of lack of oxygen for metabolic purposes.

Haemoglobin is the oxygen‑carrying portion of red blood cells. Anaemia can be caused by a shortage of haemoglobin within each red blood cell, or by too low a concentration of red blood cells within the blood. Shortage of red blood cells can be caused by insufficient production of cells, by excessive destruction, or by excessive loss through bleeding. The most common type is that due to insufficient production of either red cells or haemoglobin. The usual cause of this is nutritional deficiencies, the most common being vitamin C, iron, vitamin B12 and folic acid. Lack of vitamin E is implicated in excessive red cell destruction.

Iron

Lack of this is the most common cause of anaemia. Iron is the major component of haemoglobin, and a low intake will inevitably lead to deficient haemoglobin production. Iron deficiency can, however, also be caused by  blood loss, as in women of childbearing age, extra needed during growth spurts in children and teenagers, and there can be a greatly increased requirement of iron by athletes of all types.

Those at risk of insufficient intake of iron are the elderly, where a shortage of stomach acid can lead to impaired absorption, those on restricted vegetarian diets, and adolescents and others on a junk food diet. Irritable bowel syndrome, ulcers and haemorrhoids are other causes of poor absorption and blood loss.

Vitamin B12

Since the main sources of vitamin B12 are red meats, a strict vegetarian diet is very likely to cause vitamin B12 deficiency. Egg yolks contain fairly high amounts, so they could protect from deficiency. A vegan diet could cause sufficient danger of deficiency to make supplements almost mandatory.

A major cause of poor B12 absorption, however, is probably lack of stomach acid & "intrinsic factor", a molecule which has to bind B12 before it can be absorbed. Both of these substances should be secreted by the stomach wall. The amount is frequently reduced by advancing years, and also by drugs designed to reduce acid production. B12 deficiency can also cause many effects in the nervous system.

Folic Acid

Folic acid is the most available vitamin in the world; yet folic acid deficiency is the most common of all. Folic acid, as its name implies, is present in all leafy vegetables and also in many other plant sources. Is it surprising that, in the modern fast food diet, folic acid deficiency is common? Many common drugs, including oral contraceptives and NSAIDs, can cause malabsorption of folic acid. Crohn's disease and diarrhoea can also cause folic acid deficiency.

Vitamin C

Greatly improves iron absorption.

Vitamin E

This vitamin can aid against the destruction of red blood cells, which leads to haemolytic anaemia. Because of its antioxidant effects, particularly against the oxidation of essential fatty acids, it prevents the breakdown of red blood cell walls and the resulting red cell destruction.

Treatment

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