Anemia is characterized by a deficiency in red blood cells or in the
concentration of hemoglobin (iron-containing portions of red blood cells). These
deficiencies are caused by either decreased production or increased destruction
of red blood cells. Anemia is most common among women in their reproductive
years (5.8 percent), infants (5.7 percent), and the elderly (12 percent).
Because one of the major functions of red blood cells is to transport oxygen, a
decrease in red blood cells decreases the amount of oxygen delivered to the
body's tissues, which results in the symptoms of anemia.
Signs and Symptoms
There is tremendous variability among individuals as to when the following
symptoms of anemia develop.
Shortness of breath
Heart palpitations and chest
What Causes It?
Anemia may have the following causes.
Pregnancy and breast-feeding
Iron, folic acid, vitamin B12, or other vitamin
Certain chronic conditions
Gastrointestinal blood loss (caused by ulcers, cancer,
Genitourinary blood loss (such as from heavy menstruation)
Excessive blood loss (after surgery or regular blood
Excessive alcohol or drug use
Malabsorption syndromes (for example, celiac disease)
Congenital diseases (for example, sickle-cell anemia)
What to Expect at Your Provider's Office
Anemia is often the result of an underlying disease. Laboratory tests to
examine your blood will be ordered. If you are anemic, your health care provider
will determine the cause in order to begin treatment.
Treatment depends on the cause and severity of the anemia. Because anemia is
often the result of nutritional deficiencies, your health care provider can help
you outline a diet that contains all of the nutrients you need for healthy blood
formation such as vitamin B12, iron, and folic acid. If your anemia is the
result of an underlying disease, that disease must first be successfully
Erythropoietin plus iron—for anemia caused
by chronic kidney failure
Corticosteroid medications (such as prednisone)
Immunosuppressant medications (such as azathioprine)
Removal of the spleen (splenectomy)—may be
necessary in cases of hereditary spherocytosis
Transfusions—may help treat certain types of
anemia, such as sickle-cell anemia
Complementary and Alternative Therapies
Most cases of anemia will respond well to nutritional therapy. Note that
excess iron is toxic and you should not take supplements unless lab tests
indicate iron deficiency and your health care provider recommends them. Herbal
and nutritional treatments may be helpful when used along with medical
Ferrous fumerate, glycerate, or glycinate (100 mg per day for three
to six months) are the most absorbable forms of iron. Ferrous sulfate (325 mg
per day) is poorly absorbed and more frequently causes problems with
gastrointestinal upset and constipation. Dietary sources of iron include meat,
beans, green leafy vegetables, beet greens, blackstrap molasses, almonds, and
Vitamin C—250 to 500 mg twice a day to aid
in absorption of iron.
Vitamin B12—cyanocobalamine, 1,000 IU via
injection twice a day for one week, then weekly for a month, then every two to
three months. Dietary sources include organ meats, meats, eggs, fish, and
Folic acid (1 to 2 mg per day)—for folic
acid deficiency. Good food sources include green leafy vegetables and
Omega-3 and omega-6 essential fatty acids (1,000 to 1,500 IU) have
been shown to decrease the frequency of sickle-cell crisis. EFAs can increase
clotting times, so if you are taking anticoagulants, your health care provider
will need to check these times.
Herbs are generally a safe way to strengthen and tone the body's systems. As
with any therapy, it is important to work with your provider on getting your
problem diagnosed before you start any treatment. Herbs may be used as dried
extracts (capsules, powders, teas), glycerites (glycerine extracts), or
tinctures (alcohol extracts). Unless otherwise indicated, teas should be made
with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or
flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures
may be used singly or in combination as noted.
You may be treated with the following herbal therapies for one to three
months and then reassessed.
Blackstrap molasses, also known as pregnancy tea (1 tbsp. per day in
a cup of hot water), is a good source of iron, B vitamins, minerals, and is also
a very gentle laxative.
Spirulina, or blue-green algae, has been used successfully to treat
both microcytic and macrocytic anemias. Dose is 1 heaping tsp. per
Alfalfa (Medicago sativa), dandelion (Taraxacum
officinale) root or leaf, burdock (Arctium lappa), and yellowdock
(Rumex crispus) have long been used to fortify and cleanse the blood. For
mild cases of anemia, they may help bring levels of hemoglobin into normal
range. Dosage is 1 tbsp. per cup of water. Simmer roots for 20 minutes and
leaves for 5 minutes. A single herb, or a combination of these four herbs, may
Although very few studies have examined the effectiveness of specific
homeopathic therapies, professional homeopaths may consider the following
remedies for the treatment of anemia based on their knowledge and experience.
Before prescribing a remedy, homeopaths take into account a person's
constitutional type. A constitutional type is defined as a person's physical,
emotional, and psychological makeup. An experienced homeopath assesses all of
these factors when determining the most appropriate treatment for each
Ferrum phosphoricum -- for iron deficiency
Calcarea phosphorica -- particularly for children with
nighttime bone aches, cool hands and feet, lack of energy, and/or poor
Maintaining a normal balanced diet is very important if the cause of your
anemia is nutritional. Also, avoid drugs that can have adverse effects on your
gastrointestinal system and avoid excessive alcohol intake if one or both of
these are the cause of your anemia.
Complications from anemia can range from loss of productivity due to weakness
and fatigue to coma and death. Some neurologic changes caused by anemia are
irreversible. Pregnant women need three or four times as much iron as normal. A
folic acid deficiency during pregnancy can result in infants being born with
neural-tube defects, such as spina bifida.
Branch WT Jr. Office Practice of Medicine. Philadelphia, Pa: WB
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Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C
based on antioxidant and health effects in humans. Am J Clin Nutr.
Fauci AS, Braunwald E, Isselbacher KJ, et al., eds. Harrison's Principles
of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.
JAMA Patient Page. How much vitamin C do you need? JAMA.
Johnston CS. Recommendations for vitamin C intake. JAMA.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and
recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.
Tyler VE. The Honest Herbal: A Sensible Guide to the Use of Herbs and
Related Remedies. 3rd ed. Binghamton, NY: Pharmaceutical Products Press;
Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin
Review Date: August 1999
Reviewed By: Participants in the review process include: Dahlia Hirsch, MD, Center for
Holistic Healing, BelAir, MD; Sherif H. Osman, MD, President, Medical Staff
Harford Memorial Hospital, Falston General Hospital, Bel Air, MD; Leonard
Wisneski, MD, FACP, George Washington University, Rockville,
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regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed