What is Anemia?
Anemia literally means “lack of blood.” It refers to a decrease in red blood cell (RBC) percentage in the blood or a decrease in the hemoglobin present in the RBCs. This can occur through blood loss, a decrease in RBC production, or an increase in RBC breakdown.
The main job of the red blood cells is to carry oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs for exhalation.
The protein that allows RBCs to do that is hemoglobin, which binds to oxygen molecules, delivering oxygen throughout the body. Iron-rich hemoglobin is what gives blood its vibrant red color. Low hemoglobin is why anemic people are often pale and experience poor circulation.
According to the National Institutes of Health, the most common symptoms of anemia are:
- Shortness of breath
- Dizziness and fainting
- Jaundice (yellowing of the skin)
However, the severity of the anemia affects symptoms, meaning that mild anemia may not cause symptoms and more extreme anemia may lead to more severe symptoms and other health issues.
Anemia in general is defined as a reduction in hemoglobin or hematocrit (red blood cells in blood by percentage). It may also refer to a low red blood cell (RBC) count, but that is not used as often in clinical practice today. Low hemoglobin is defined as less than 13.5 g/dL in men and less than 12.g/dL in women. Low hematocrit is defined as less than 41.0% in men and less than 36.0% in women.
In determining the severity of anemia, the National Cancer Institute grades it as mild, moderate, severe, or life-threatening:
- Mild: Hemoglobin 10.0 g/dL to lower limit of normal
- Moderate: Hemoglobin 8.0 to 10.0 g/dL
- Severe: Hemoglobin 6.5 to 7.9 g/dL
- Life-threatening: Hemoglobin less than 6.5 g/dL
The most common way of addressing anemia is with iron supplements. However, it’s not always that simple.
It’s Not Just a Matter of Taking Iron
There are several causes of anemia; however, the best known is probably iron-deficiency anemia. Most people assume that if they are anemic, it’s simply due to low iron, so all they need to do is get an iron supplement. It’s not necessarily that simple. As stated, anemia can be caused by more than just an iron deficiency. It can be caused by other deficiencies (like B12, folate, or vitamin A), autoimmunity, or absorption issues. It can also be due to more complicated imbalances in the body, such as parasitic infections, kidney disease, or leukemia.
However, a little-known (yet second most common) type of anemia is “anemia of inflammation” or “anemia of chronic disease.” This type of anemia is caused by chronic illness and/or exposure to infections and leads to a reduced number of red blood cells. In anemia of inflammation, you may have normal or increased iron in your body tissues, yet a low level in your blood. Some conditions associated with anemia of inflammation include:
- Autoimmune diseases
- Inflammatory Bowel Disease (IBD) –Crohn’s and ulcerative colitis.
- Chronic kidney disease
- Chronic infections
- Other chronic diseases, like diabetes
- Chronic inflammation in general
Inflammation is something we talk about a lot at The Wellness Way. It can cause symptoms in all systems of the body. What causes inflammation? It all goes back to stressors that fall into one of three categories: Trauma, Toxins, and Thoughts.
Trauma, Toxins, and Thoughts
The concept of the Three Ts originally comes from chiropractic care but it also applies to other imbalances in the body. Here’s how trauma, toxins, and thoughts contribute to anemia.
Trauma and Anemia
Anemia can certainly be caused by physical stress on the body – particularly, any trauma that leads to blood loss. When the blood supply goes down far enough, it results in anemia, sometimes even life-threatening anemia, if someone is “bleeding out.” Some physical stressors leading to anemia may include:
- Gunshot wound
- Car accident or another severe injury
- Internal injury/ulcers –an ulcerative colitis flare
Any type of injury that leads to heavy bleeding would be primarily trauma-induced anemia.
Toxins and Anemia
Toxins are biochemical stressors that can negatively impact the nervous system and general health of the body. Toxins that may cause or contribute to anemia include:
- Medications –Many medications reduce iron absorption, leading to anemia
- Cancer treatments
- Metal toxicity–especially lead
- Parasitic and other infections, which produce toxins
- Any type of chemical or toxin creating chronic inflammation
Thoughts and Anemia
There probably are not a lot of thought- or emotional stressors that directly contribute to anemia. However, a chronic state of stress leading to chronic inflammation can aggravate the kidneys and gut and contribute to anemia by reducing iron production or absorption.
The Swiss Watch and Anemia
Your body’s systems work together like the gears of a Swiss Watch. Each of the gears affects all the others. If something is out of balance in one area of the body, it will have consequences for other areas. That’s why Wellness Way practitioners don’t just tell you to eat spinach or give you an iron supplement. There are many potential causes of anemia in other systems of the body, including the gut and the immune system.
Gut Inflammation or Dysbiosis
One of the main things to look at with chronic anemia is the gut. After all, the gut is where we absorb nutrients, including folate, vitamin B12, and iron. If the gut is inflamed, overgrown with certain bacteria, or has compromised absorption, it’s going to be difficult to utilize the iron you’re consuming. Anemia is common with gastrointestinal conditions like irritable bowel syndrome, celiac disease, and inflammatory bowel diseases (IBD) like Crohn’s and ulcerative colitis. Parasites in the gut may also be to blame.
Immune Response and Anemia
Another potential contributor to anemia is an altered immune response from chronic inflammation, as mentioned earlier. Both cancer and autoimmune disease are associated with anemia. Pernicious anemia is a specific type of B12 deficiency anemia. It’s caused by autoimmunity to intrinsic factor in the stomach, which is needed for the body to absorb vitamin B12 for healthy RBCs.
Hormone Imbalances and Anemia
Hormones can also alter RBC production, leading to anemia. Chronic Kidney Disease (CKD) can impair your ability to produce certain hormones needed for red blood cells, such as erythropoietin, needed for erythropoiesis (RBC production). Low thyroid (hypothyroidism) can also create anemia in a few ways, including affecting the bone marrow, decreasing erythropoietin, or causing Macrocytic Anemia or enlarged RBCs.
Dietary & Nutritional Factors
Diet affects everything — We know that what we consume directly impacts our health. Even if your gut is in great shape and you have a balanced immune response if you aren’t eating the food components needed to create hemoglobin, you could end up with anemia. Foods that are rich in iron include:
- Organ meats (like liver)
- Red meat
- Dark green leafy vegetables (like spinach and broccoli)
- Beans and legumes
Green leafy vegetables are a key component for hemoglobin production as they provide chlorophyll.
However, it’s also crucial to eat a non-inflammatory diet that follows your personalized nutrition program. Since everything begins with the gut, we have to make sure our daily food intake doesn’t contribute to chronic inflammation or get in the way of your body’s ability to heal itself.
The Wellness Way Approach to Anemia
The Wellness Way doctors don’t just tell you to eat more spinach or red meat. We don’t guess; we test! Wellness Way practitioners will look behind the causes of low iron levels to determine the right course of action for healing. After going over your health history and current symptoms, we’ll do specialized testing to learn which factors within the three Ts are affecting your body and how. That will likely include food allergy testing, gut testing, immune panels, and more. From there, it’s a matter of living a healthy lifestyle, with a non-inflammatory, whole foods diet, supportive supplements, and a positive mindset.