Looking pale? Feeling weak and tired? A quick blood test can assess if anaemia is to blame – and, if so, whether it is caused by iron-poor blood or something else. Your doctor is the best person to ask about whether certain supplements might be right for you.

What it is

Anaemia is a condition in which there is a shortage of red cells in the blood or a deficiency of haemoglobin (the oxygen-carrying pigment) in these cells. When anaemia occurs, the body doesn´t get enough oxygen, and weakness and fatigue result. Although symptoms may not appear – or may be very mild – for a long time, the condition can be life-threatening if it is left undiagnosed and untreated. If you suspect you are anaemic, it is essential that you see your doctor promptly to ascertain the underlying cause. Treatment will vary, depending on the diagnosis.

Symptoms

• Weakness, fatigue, dizziness, irritability or mental confusion.
• Paleness, especially of the gums and eyelids or under the nails.
• Palpitations; shortness of breath.
• Sores in the mouth or on the tongue; unusual bruising or bleeding.
• Numbness and tingling of the feet or legs.
• Nausea and diarrhoea.

What causes it

Iron deficiency, the most common cause of anaemia, usually results from a gradual, prolonged blood loss, which depletes the body´s iron stores. Without enough iron, haemoglobin levels fall. Menstruating women, particularly those with heavy periods, are prone to iron deficiency anaemia. However, men and women can develop iron deficiency from any condition that causes slow bleeding – including long-term haemorrhoids, rectal polyps or ulcers; stomach or colon cancer; or prolonged use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Because so many foods are fortified with iron, iron-deficiency anaemia can rarely be attributed to a lack of this mineral in the diet.

Less common is anaemia that results from a deficiency of vitamin B12 (in which case it is called pernicious anaemia) or folic acid. Both nutrients are essential to red blood cell production. Alcoholics, smokers, people with certain digestive disorders, vegetarians, those over the age of 50, and pregnant or breastfeeding women are the most likely to be at risk, through either poor or inadequate nutrition or an inability to absorb these nutrients properly. Other forms or anaemia can be traced to chronic illnesses (for example, cancer, lupus or rheumatoid arthritis); hereditary disorders, such as sickle-cell anaemia, or exposure to toxic drugs, chemicals or radiation.

How supplements can help

Before taking supplements you need to determine the underlying cause of your anaemia. It is especially important to see a doctor about iron-deficiency anaemia, which may be caused by internal bleeding. If you are advised to take supplements, have your blood tested every month to see if they are improving your condition.

If iron-deficiency anaemia is diagnosed, it may be beneficial to combine iron with vitamin C. Iron is a key component of haemoglobin, and vitamin C helps the body to absorb the mineral. Take iron only under your doctor´s supervision, because too much can be dangerous.

Various herbs may also be useful. Echinacea has a reputation for promoting the regeneration of red blood cells, while nettle has been successfully used by herbalists for the treatment of anaemia. Although herbs cannot make substantial contributions to the vitamins and minerals required by the body, they provide phytonutrients to support their utilization. Taken as a tincture, juice or tea, some herbs (dandelion, burdock, yellow dock, gentian and red clover) may enhance the body´s ability to utilise iron from foods or supplements.

Vitamin C may be beneficial if anaemia is caused by a deficiency of vitamin B12 or folic acid as well; it aids the body in absorbing these nutrients. Vitamin B12 and folic acid should always be taken in tandem, and under a doctor´s supervision, because a high intake of one can mask a deficiency of the other. Together they work to boost production of red blood cells. Once anaemia is corrected, and a problem with absorption has been ruled out as a cause, the amount of B12 and folic acid in your daily multivitamin may be sufficient to prevent recurrence.

Supplement recommendations

	Dosage	Advice
Iron	up to 17 mg a day, taken with meals	your doctor may prescribe a higher dose
Vitamin C	500 mg twice a day	take with food
Vitamin B12 / folic acid	1000 mcg B12 and 400 mcg folic acid twice a day for one month	always take B12 and folic acid together
Echinacea	200 mg extract twice a day	standardised to contain 3.5% echnacosides
Nettle	250 mg nettle leaf extract twice a day	standardised extracts of nettle leaf are not available

 

What else you can do

• Eat foods rich in iron (dried beans, liver, red meat, dried fruits, nuts and shellfish); in folic acid (citrus fruits, asparagus, spinach, mushrooms, liver, soya beans and wheat germ); and in vitamin B12 (liver, shellfish, lamb, beef, cheese, fish and eggs).

Recent findings

A study involving 28 strict vegetarians found that 500 mg of vitamin C, taken after lunch and dinner for two months, raised haemoglobin levels by 8% and blood iron levels by 17%. Vitamin C increases the body´s ability to absorb iron.

Studies suggest that people over the age of 50 are less able than younger people to absorb vitamin B12, and are therefore more susceptible to anaemia. The US National Academy of Sciences now urges all senior citizens to take B12 supplements.

See your doctor:

• If you have any symptoms of anaemia – your doctor must find the underlying cause.
• If you are pregnant (or are considering pregnancy) or menstruate heavily.
• If you are following a treatment plan for anaemia – regular check-ups can determine if supplements are working.

REMINDER: If you have a medical condition, consult your doctor before taking supplements.