More than three million people in the United States have anemia, with women and those with chronic illness at greatest risk. Anemia is a health condition characterized by red blood cells deficient in hemoglobin, the portion of the blood containing iron. Hemoglobin enables the blood to transport oxygen from the lungs and circulate it throughout the body, and to carry away carbon dioxide. The listlessness, pallor, and shortness of breath experienced by a person with anemia reflect a lack of oxygen and buildup of carbon dioxide in the tissues.
Dr. Dahlia Abraham, a complementary physician from New York City, describes three major classifications of anemia, each of which is associated with a specific cause:
EXCESSIVE BLOOD LOSS—This can result from conditions such as hemorrhoids and a slowly bleeding peptic ulcer, or in association with menstruation.
EXCESSIVE RED BLOOD CELL DESTRUCTION—Dr. Abraham explains: “Normally, old and abnormal red blood cells are removed from the circulation. If the rate of destruction exceeds that of manufacture of new cells, anemia can result. A number of factors can cause excessive red blood cell destruction, such as defective hemoglobin synthesis, injury, and trauma within the arteries.”
NUTRITIONAL DEFICIENCIES OF IRON, VITAMIN B12, AND FOLIC ACID—This is the most common type of anemia, with iron deficiency the most frequent.
Dr. Abraham further explains: “People require extra iron during growth spurts in infancy and adolescence. Pregnancy and lactation are other times when women need iron supplementation. During the childbearing years, many women experience anemia caused by an iron deficiency.”
Do supplements help? “Supplementation may not solve the problem because many people have difficulty absorbing iron,” Dr. Abraham says. “They lack enough hydrochloric acid, the stomach acid that helps the body assimilate iron. This is common among the elderly, who generally produce less hydrochloric acid.” Chronic diarrhea also may cause decreased iron absorption.
A defect in absorption is the most common cause of a vitamin B12 deficiency. Dr. Abraham remarks, “Vitamin B12 must be liberated from food by hydrochloric acid and bound to a substance called intrinsic factor, which is also secreted in the stomach. For B12 to be absorbed, then, an individual must secrete enough hydrochloric acid and enough intrinsic factor.” For this type of anemia, supplements of vitamin B12, hydrochloric acid, and intrinsic factor may help.
A deficiency in folic acid may also cause anemia. Alcoholics and pregnant women are particularly at risk. “Folic acid is vital for cell production in the growing fetus and prevents birth defects, such as neural tube imperfections,” Dr. Abraham says. “This is why prenatal vitamins must contain this nutrient. In addition, a number of pharmaceutical drugs, such as anticancer drugs and oral contraceptives, can drain the body of folic acid.”
Dr. Pat Gorman, an acupuncturist and educator in New York City, explains anemia and other blood disorders in women from an Asian perspective. “In women, blood has an actual cycle that rises and falls every month. There is a building phase that occurs for about a week after the menstrual period. Then there is a peak phase where the blood reaches its richest moment; that’s the moment you ovulate. This is followed by a storage phase. (If you are pregnant, the blood is stored.) A week before the period, you go through a cleansing phase where your organs release toxins into the blood. That’s the week before your period, when you can go through a PMS hell if the toxins are not being properly released. Next is the purging of the actual period.”
Using this philosophy as her framework, Dr. Gorman holds that women become anemic when they are out of touch with their monthly cycles. In a fastpaced society, one of the major reasons for this condition is that women do not rest at the appropriate times. “Women work all the time. They show no vulnerability and just keep on going no matter what. There is no respect for the actual rhythm of the cycle. I believe that we need to bring back the menstrual hut. When you are bleeding, you need to stop working for a day or two. I know I am saying things that sound impossible, but if you have anemia—and 60 to 70 percent of the women I see do—you need to face the fact and work with it.”
Another major reason women become anemic is that they approach pregnancy incorrectly: “There is a law called the one-month, one-year law,” Dr. Gorman says. After a pregnancy is terminated, whether by abortion, miscarriage, or birth, one month of absolute rest is needed. Women say, ‘That’s not possible. I just gave birth, but I have other children. I have to take care of things.’ The Chinese say this is a straight road to a severe problem with anemia.
“The one-year aspect is the avoidance of pregnancy for at least another year. Women who try to conceive and who then miscarry often frantically begin again. They need to build up the blood for an entire year’s cycle before trying to conceive again. It is very difficult for me to help anxious patients relax and understand that this is the way to overcome anemia and to have a really healthy baby.”
Additionally, Dr. Gorman warns that birth control pills disturb the integrity of the blood’s cycle. They trick the body into believing that it is continuously pregnant by locking blood into its storage phase. By eliminating the cycle of building, peaking, storing, cleansing, and purging, oral contraceptives may create many problems.
The general symptoms of anemia are weakness and a tendency to tire easily. When there is a vitamin B12 deficiency, the symptoms may also include paleness; shortness of breath; a sore, red, swollen tongue; diarrhea; heart palpitations; and nervous disturbances.
According to Dr. Abraham, the treatment of anemia is dependent on proper clinical evaluation by a physician. Too often, physicians assume that anemia is caused by an iron deficiency, but this is just one possible reason. “It is absolutely imperative that a comprehensive laboratory analysis of the blood be performed. Do not be satisfied when your physician offers a simple diagnosis of anemia,” she warns. “Insist that your doctor investigate the underlying causes.”
While Dr. Gorman agrees that clinical studies help confirm the diagnosis, she adds that Asian physicians are trained to detect anemia and other blood disorders through observation: “In Chinese medicine, you examine the body. Look at your tongue. Is it pale? Look at your lips. Are they pale? See if the mucous membranes under the eyes are pale. These signs indicate whether you are anemic.”
Green, leafy vegetables are high in iron and folic acid. It is best to purchase organic vegetables, since pesticides interfere with absorption. Eating vegetables raw or lightly cooked preserves their folic acid content. Soy or shoyu sauce, miso (a fermented soybean paste), and tempeh (another soybean preparation) are rich sources of vitamin B12.
Proteins should be eaten every day, preferably vegetarian proteins such as those from grains and legumes such as rice and beans or oatmeal with soy milk. When animal protein is eaten, it should be from fish. Caffeine and alcohol are detrimental to healthy blood and should be eliminated.
Also recommended are wheat grass, barley grass, chlorellla, and spirulina (2 ounces, 2x day).
According to Dr. Abraham, iron, vitamin B12, and folic acid should be prescribed as needed. Additionally, hydrochloric acid and intrinsic factor are often required to aid the absorption of these nutrients.
Naturopath Dr. Tori Hudson, in a column in Prevention magazine, advises that iron citrate and iron aspartate are forms of iron supplementation that are less likely to cause constipation. She suggests taking 1,000 to 3,000 milligrams of vitamin C with the iron to enhance absorption.
Dr. Janet Zand, a naturopathic physician, acupuncturist, and doctor of traditional Chinese medicine, in an article posted on the HealthWorld Online website (www.healthy.net), suggests an herbal program that anemic women can use to build the blood. It is meant to accompany iron and iron-synergistic nutrient supplementation as directed by a health care practitioner. Dr. Zand bases her herbal regimes for women on the shifting hormonal balance over the four weeks of the menstrual cycle.
During all four weeks of the cycle, red raspberry leaf and dong quai are used to build blood and balance hormones. These herbs can be taken as a tea, tincture, capsule, or tablet three times a day. Then, during the specified weeks, one also takes the herbs listed below:
FIRST WEEK—Take yellow dock leaf (Rumex crispus) and chlorophyll as a tea or tincture three times a day.
SECOND WEEK—Take American ginseng (Panax quinquefolius root), a blood builder, as a tea or tincture three times a day.
THIRD WEEK—Take nettle (Urtica dioica leaf) and chlorophyll as a tea or tincture three times a day.
FOURTH WEEK—Take alfalfa (Medicago sativa leaf), with chlorophyll as a tea or tincture three times a day.
Swami Sadashiva Tirtha, who founded one of the first certification programs on Arurveda, says that practitioners of Ayurvedic medicine consider anemia an imbalance of the blood that can have a number of causes. Too many sour, salty, or hot foods; drinking alcohol; poor nutrition; injury; excessive menstruation or bleeding; liver disorders; pregnancy; excessive sexual activity; and fevers are all factors that can cause a disorder in the kidneys, blood, and ojas (life force) and lead to anemia.
Swami Sadshiva recommends certain foods that help build blood. These foods include organic milk, pomegranate or black grape juice, boiled black sesame seeds, and molasses. Otherwise, people should follow the diet that is appropriate for their body type, according to Ayurvedic guidelines. Ayurveda uses meat as a medication only when anemia is extremely severe.
Women should use blood-building herbs after the menstrual period. To properly assimilate iron supplements, take them with ginger or cinnamon. You can take two or three teaspoonfuls of chyavan prash twice daily with warm milk as well as turmeric and ghee.
Aloe vera gel and triphala are very gentle laxatives that regulate the bowels and thus can help remove excess bile from the liver, a common reason for thinning of the blood. Other Ayurvedic herbs used to treat anemia are saffron, shatavari, manjishtha, and punarnava.
I was born in Nicaragua, and I used to be a very healthy person. [One day] I went to the emergency room. My hemoglobin was down to 2.8; the normal count for a woman is between 12 and 14. There I was with aplastic anemia, meaning that my bone marrow was not making any blood cells: no red cells, no white cells, no platelets. I almost had no blood.
The doctor said that my sickness was idiopathic, meaning that they didn’t know what caused it. They said that one possible cause was the use of an antibiotic. But the only time I had ever taken one was fifteen years earlier. Another possible cause was exposure to chemicals or pesticides. A lot of towns in Nicaragua are surrounded by cotton plantations where cotton growers use a lot of pesticides to spray their crops.
I was referred to a bone marrow transplant unit and was put on a medication, a kind of chemotherapy. After one month of treatment, the medication failed to work. Then the doctors wanted to do a bone marrow transplant. I have seven siblings, so I had donors, and one of them was a perfect match. But I had reservations. A bone marrow transplant is very costly. Also, you get bone marrow that is working, but because of the chemotherapy or radiation, your liver, kidneys, pancreas, and so forth, pay a terrible toll.
Before my sickness I was following a macrobiotic diet. I was starting to use alternative medicine, and I knew about the power of the body to heal itself. I decided to stay on my macrobiotic diet and was able to more or less clean myself of the chemotherapy. During this time I did not even get a cold. I didn’t sneeze through all my sickness.
I was clean, but my blood counts were still very low. I needed a transfusion every ten days. The transfusions were very helpful, and I was grateful to be able to get them. But through transfusions I was also receiving a lot of genetic and other information completely foreign to my body. I could not control what the person who donated that blood was eating. So I was trying to clean my body of toxins, and I decided to look for help.
I went to a naturopath, who helped me a lot. Then I read an article on Ayurveda. It said that Ayurveda is very specific, even with the use of grains and vegetables. There are grains and vegetables that are not appropriate for your body type. I went to an Ayurvedic doctor. He gave me a very gentle treatment consisting of diet, aromatherapy, massage, and meditation. After three weeks of following that treatment, my blood count went up for the first time.
I keep up with this treatment still. My last checkup at the hospital showed normal white cells. Red cells were a little bit low. They were 3.83, and the normal count is 4. But they are increasing day by day. My energy level is excellent. I went back to work three months ago and am now leading a completely normal life. I am very grateful to Ayurveda.
—Yolanda
An increasing body of evidence is showing the benefits of natural modalities to overall health and well-being. Following is a sample of recent peer-reviewed scientific studies in the area of anemia.
A 2010 cross-sectional study in Annals of Hematology confirmed the suspected link between vitamin D deficiency and anemia. In 2013, researchers from the Johns Hopkins Children’s Center reported in the Journal of Pediatrics that examination of blood samples from more than 10,000 children revealed that vitamin D levels of 30 nanograms per milliliter or less nearly doubled the risk of developing the condition. According to a 2010 report in the Journal of Nutrition, a micronutrient supplement taken two times per week for twenty-six weeks significantly increased hemoglobin levels in girls with nutritional anemia. In 2011, BMC Public Health showed that pregnancy outcomes were similarly affected. A case report and literature review in the Journal of Pediatric Hematology and Oncology, also in 2011, found that high dose vitamin D supplements completely eliminated pain symptoms in a patient with sickle cell anemia. Several other studies have documented the oxidative stress-reducing activity of N-acetylcysteine (NAS) in patients with anemia.