Debate about causes and treatment of anemia

[BattleBack]

I know I'm very late to this thread, only today discovering it, but I actually created an account here because I wanted to respond to someone who'd mentioned they were anemic and hope to help.

There are different types and it's important to know what type you have and there are various tests ( like a Schillings test ) that can help with that, though I think any blood work up would give the docs, if they're up to date on things, a clue. I'll post my experience with this there and maybe it will be useful, if not to the original poster, perhaps to somene else.

Generally:

B12 works on your CNS and B6 on your cardio. If you do not have 'intrinsic factor', a chemical in your digestive system, you CANNOT absorb any B12 just by food. It cannot be done. This is why teh B12 continues to deplete. Someone else might do OK with some broccoli. This will NOT help the person with pernicious/megaloblastic anemia.

SolaRay, sold at any Vitamin Shoppe type place, makes a 'methlycobalamin' sublingual 5000mcg B12 that I use. I also take their B-6 Complex vitamin. When mine was discovered, I was in a bady way but didn't opt for the intramuscular shots. They're not necessary unless you're about dead. It takes some time, but the above vits will work.

Know that you want to avoid taking them within 1/2 hour of ingesting caffeine. For some reason it 'blocks' and makes the vits less effective. And you must take these every day for the rest of your life. Once you get back on balance, if you miss a day or two it's not the end of the world but you cannot ever back to trusting food as your source of B12. It just won't happen. The end road of anemia, untreated, is cardiac arrest, 'madness', or paralysis. Since it's so treatable, and the treatment very easy, there's no point in NOT taking it.

The 'methylcobalamin' is, essentially, the delivery method of the B12. By putting it under your tounge, you are bypassing your liver and getting it into your bloodstream directly. I've read some articles that say most people only absorb about 40% of any *capsule* supplement. The anemic person, particularly if their stores have depleted, needs more and right now.

Many, many doctors are still not quite on the ball about anemia. I mean, just ten or twelve years ago people died of this or wound up in wheelchairs. Also, not all doctors keep their reference books up to date. Some refer to books published two decades ago! LOL So even your own doctor might not understand the new 'norms' in blood levels for who is tecnically 'anemic' and who isn't.

'Iron' is not your problem. Nor is folic acid and frankly, it's my understanding you should never take folic acid supplements IN ABSENCE OF B12. So, I'd ask your doc about that. I have folic acid supps, but take them only rarely. It's my B levels I have to be concerned about. I get a blood test once a year to check them and since beginning the two vits I mentioned, am well within the normal range and sometimes slightly above ( which isn't 'bad' ).

Anyway, maybe the OP has already discoverd this. A lot of people with this blood disorder have to be self-educating. The great thing is it is SO easy to treat!

 

[David Baxter PhD]

Re: Anemic

Thanks for your input, Battleback.

However:

'Iron' is not your problem. Nor is folic acid and frankly, it's my understanding you should never take folic acid supplements IN ABSENCE OF B12.

I'm not sure how you can make a statement like this. First, you don't of course have her medical records. Second, I have been under the impression, perhaps erroneously, that iron and B12 "bind together" in some way so that deficiencies in one often create deficiencies in the other.

 

[forgetmenot]

Re: Anemic

Hi BattleBack thanks for the article. I myself battle anemia for along time now it runs in the family. I have been put on so many different supplements i can't remember all the names but your right that depending what your blood levels are showing the doctor will order what he or she seems fit at the time to correct what deficiency is present at that time. Ferrous fuminate, ferrous gluconate, and vit b12 and another my mind is blank right now. I trust my doctor to know what is going on and go with what is being ordered. I know it is tricky getting everything in balance though take care.

 

[BattleBack]

Re: Anemic

Thanks for your input, Battleback.

However:



I'm not sure how you can make a statement like this. First, you don't of course have her medical records.

I'm going by the context of what she said between the anemia and the iron and it, from what I gathered of her post, was NOT helping. Seriously, anyone can disect a post and infer a meaning that wasn't there, which I think you have done with me. There's a thing called 'context', and that's what I was responding to. I also suggested, which is clearly made in my post, that SHE CONSULT WITH HER DOCTOR. I'm trying to help but not so some sentence can be ripped out of several paragraphs and anaylzed for something to seize on.

Second, I have been under the impression, perhaps erroneously, that iron and B12 "bind together" in some way so that deficiencies in one often create deficiencies in the other.

I don't know but to date have yet to read *anything* that focuses on iron for the anemic person. The downfall of the anemic person is the absence of B12. And B6 CANNOT be synthized in its absence. No specialist, no doctor, and nothing I've read emphasized taking iron supplements but I have read that taking too much of it is not good for anyone. I'm not exaggerating when I said that there are still many medical folks who do not have an UPDATED understanding of pernicious anemia in terms of the new 'norms' in blood work that indicate anemia or not. I was lucky to have good doctors and was also motivated to really research this condition.

When it was discovered with me..my hair had been falling out, I lost 40lbs in six months, very serious muscle cramps and spasms, vision issues, and immense fatigue. Because I had just lost my father, I thought it was just grief. I finally went to my doctor, she ran blood tests and I went on a trip before I got the results. On my trip, the lab called my cell phone and said my B6 levels were at an 'emergency level' and I needed to get some B12 in me ASAP.

I'm sorry if my experience or what I know of it comes off as 'know-it-all' syndrome, but I honestly have experienced this and been educated on it. I just wanted to pass it on.

 

[David Baxter PhD]

Re: Anemic

As I said at the outset of my previous post above, I appreciate your input. However, there are different types of anemia and without knowing an individual's personal and family medical history, you really cannot make statements such as

'Iron' is not your problem. Nor is folic acid

The member is being treated by her doctor who is in a position to know that history. My point is simply that it's dangerous to countermand the advice of someone's physician (and it's also contrary to the rules of this forum).

See:

Anemia - MayoClinic.com
March 19, 2009

Anemia is a condition in which you don't have enough healthy red blood cells to carry adequate oxygen to your tissues. If you have anemia, you probably feel tired a lot.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe.

See your doctor if you suspect you have anemia, because anemia can be a sign of serious illnesses. Treatments for anemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anemia by eating a healthy, varied diet.

Symptoms
Signs and symptoms vary depending on the cause of your anemia, but may include:

• Fatigue
• Pale skin
• A fast or irregular heartbeat
• Shortness of breath
• Chest pain
• Dizziness
• Cognitive problems
• Cold hands and feet
• Headache

Initially, anemia can be so mild it goes unnoticed. But signs and symptoms increase as anemia worsens.

When to see a doctor
See your doctor if you're feeling fatigued for unexplained reasons, especially if you're at risk of anemia. Some anemias, such as iron deficiency anemia, are common. But don't assume that if you're tired, you must be anemic. Fatigue has many causes besides anemia.

Some people learn that their hemoglobin is low, which indicates anemia, when they go to donate blood. Low hemoglobin may be a temporary problem remedied by eating more iron-rich foods or taking a multivitamin containing iron. However, it may also be a warning sign of blood loss in your body that may be causing you to be deficient in iron. If you're told that you can't donate blood because of low hemoglobin, see your doctor.

Causes
Blood consists of a liquid called plasma and cells. Floating within the plasma are three types of blood cells:

• White blood cells (leukocytes). These blood cells fight infection.
• Platelets. These blood cells help your blood clot after a cut.
• Red blood cells (erythrocytes). These blood cells carry oxygen from your lungs, via your bloodstream, to your brain and the other organs and tissues. Your body needs a supply of oxygenated blood to function. Oxygenated blood helps give your body its energy and your skin a healthy glow.

Red blood cells contain hemoglobin — a red, iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body, and to carry carbon dioxide from other parts of the body to your lungs so that it can be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a red, spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, other minerals, protein and vitamins from the foods you eat.

Causes of common types of anemia
When you're anemic, your body produces too few healthy red blood cells, loses too many of them or destroys them faster than they can be replaced. Common types of anemia and their causes include:

• Iron deficiency anemia. This common form of anemia affects about 1 to 2 percent of adults in the United States. The cause is a shortage of the element iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. The result is iron deficiency anemia.
• Vitamin deficiency anemias. In addition to iron, your body needs folate and vitamin B-12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Additionally, some people are unable to effectively absorb B-12.
• Anemia of chronic disease. Certain chronic diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, Crohn's disease and other chronic inflammatory diseases — can interfere with the production of red blood cells, resulting in chronic anemia. Kidney failure also can be a cause of anemia.
• Aplastic anemia. This very rare, life-threatening anemia is caused by a decrease in the bone marrow's ability to produce all three types of blood cells — red blood cells, white blood cells and platelets. Many times, the cause of aplastic anemia is unknown, but it's believed to often be an autoimmune disease.
• Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelodysplasia, a preleukemic condition, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from a mild alteration in blood production to a complete, life-threatening shutdown of the blood-making process. Other cancers of the blood or bone marrow, such as multiple myeloma, myeloproliferative disorders and lymphoma, can also cause anemia.
• Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases can cause increased red blood cell destruction. Autoimmune disorders can cause your body to produce antibodies to red blood cells, destroying them prematurely. Certain medications, such as some antibiotics used to treat infections, also can break down red blood cells.
• Sickle cell anemia. This inherited and sometimes serious anemia, which more commonly affects people of African, Arabic and Mediterranean descent, is caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular-shaped red blood cells die prematurely, resulting in a chronic shortage of red blood cells.
• Other anemias. There are several other, rarer forms of anemia, such as thalassemia and anemias caused by defective hemoglobin.

Sometimes, no cause of anemia can be identified.

Risk factors
These factors place you at increased risk of anemia:

• Poor diet. Anyone — young or old — whose diet is consistently low in iron and vitamins, especially folate, is at risk of anemia. Your body needs iron, protein and vitamins to produce sufficient numbers of red blood cells.
• Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn's disease and celiac disease — puts you at risk of anemia. Surgical removal of or surgery to the parts of your small intestine where nutrients are absorbed can lead to nutrient deficiencies and anemia.
• Menstruation. In general, women are at greater risk of iron deficiency anemia than are men. That's because women lose blood — and with it, iron — each month during menstruation.
• Pregnancy. If you're pregnant, you're at an increased risk of iron deficiency anemia because your iron stores have to serve your increased blood volume as well as be a source of hemoglobin for your growing fetus.
• Chronic conditions. For example, if you have cancer, kidney or liver failure, or another chronic condition, you may be at risk of what's called anemia of chronic disease. These conditions can lead to a shortage of red blood cells. Slow, chronic blood loss from an ulcer or other source within your body can deplete your body's store of iron, leading to iron deficiency anemia.
• Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also may be at increased risk of the condition.

Other factors
Certain infections, blood diseases and autoimmune disorders, exposure to toxic chemicals, and the use of some medications can affect red blood cell production and lead to anemia.

Other people at risk of anemia are people with diabetes, people who are dependent on alcohol (alcohol interferes with the absorption of nutrients) and people who adhere to a strict vegetarian diet, who may not get enough iron or vitamin B-12 in their diet.

Complications
Left untreated, anemia can cause numerous complications, such as:

• Severe fatigue. When anemia is severe enough, you may be so tired that you can't complete everyday tasks. You may be too exhausted to work or play.
• Heart problems. Anemia can lead to a rapid or irregular heartbeat — an arrhythmia. Your heart must pump more blood to compensate for the lack of oxygen in the blood when you're anemic. This can even lead to congestive heart failure.
• Nerve damage. Vitamin B-12 is essential not only for healthy red blood cell production, but also for healthy nerve function.
• Impaired mental function. A shortage of vitamin B-12 can also affect your mental abilities.
• Death. Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.

See also:

• Iron deficiency anemia
• Sickle cell anemia
• Vitamin deficiency anemia
• Thalassemia
• Aplastic anemia

Iron deficiency anemia - MayoClinic.com
March 24, 2009

Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues, giving your body energy and your skin a healthy color.

As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body can't produce enough hemoglobin, a substance in red blood cells that enables them to carry oxygen. As a result, iron deficiency anemia may leave you tired, weak and pale.

You can usually correct iron deficiency anemia with iron supplementation. Sometimes, additional treatments for iron deficiency anemia are necessary, especially if you're bleeding internally.

 

[Andy]

Re: Anemia debate

My Dr., prescribes iron (palifer) for my anemia all the time. Unless your meaning only for the one specific type of anemia? Sorry if I missed something.

 

[David Baxter PhD]

Re: Anemic

Additional complexities:

Dietary Supplement Fact Sheet: Iron

Vitamin A helps mobilize iron from its storage sites, so a deficiency of vitamin A limits the body's ability to use stored iron. This results in an "apparent" iron deficiency because hemoglobin levels are low even though the body can maintain normal amounts of stored iron [39-40]. While uncommon in the U.S., this problem is seen in developing
countries where vitamin A deficiency often occurs.

Many men and women who engage in regular, intense exercise such as jogging, competitive swimming, and cycling have marginal or inadequate iron status [1,81-85]. Possible explanations include increased gastrointestinal blood loss after running and a greater turnover of red blood cells. Also, red blood cells within the foot can rupture while running. For these reasons, the need for iron may be 30% greater in those who engage in regular intense exercise [1].

Some researchers have raised concerns about interactions between iron, zinc, and calcium. When iron and zinc supplements are given together in a water solution and without food, greater doses of iron may decrease zinc absorption. However, the effect of supplemental iron on zinc absorption does not appear to be significant when supplements are consumed with food [1,87-88]. There is evidence that calcium from supplements and dairy foods may inhibit iron absorption, but it has been very difficult to distinguish between the effects of calcium on iron absorption versus other inhibitory factors such as phytate [1].

 

[forgetmenot]

Re: Anemic

Thanks STP that is what i was prescribed as well palifer for my anemia

 

[BattleBack]

Re: Anemic

Once again, I did suggest to the poster that she 'ask her doc'. People DO get misdiagnosed and as I recall, she did mention that iron supplements are not helping.

The Mayo Clinics methods as indicated on their site can easily be countered by modern medical textbooks. This is because the latest research is not disseminated nor uptaken, for who knows what reasons, as people might think it is.

Also, I was just trying to help this person and didn't intend to get into a biochemistry discussion. I think she's fully cognizant of what iron does in the body, and I don't think that was her issue.

Asking her doc, and being armed with some information that maybe that doctor is not aware of, ( this happens because..ta da!..doctors are people, not machines ), it wouldn't hurt to do a workup again of her blood using the modern norms for anemia. Not the old ones. Also, the AMA has said that people who do not have anemia tend not to get enough B12 either, so taking extra wouldn't necessarily hurt while taking too much iron CAN.

It's a myth that in order to be even seriously depleted of B12 you MUST also be anemic. That is simply not true and medical research has indicated this. My own blood disorder is one in which I lack something called Intrinsic Factor. Diet has NOTHING to do with my B vitamin defeciencies and this is true for anyone who does have the same disorder as myself. And it's only considered 'rare' because it has often gone undiagnosed. Please recall that the whole depleted B12 issue and standard of treatment are relatively new and that's with the old research! I'd think that someone armed with the MOST RECENT research would be far better off in understanding how to treat it.

I would strongly advise anyone interested to review the following site, built by someone who had to do extensive digging into this matter which has served to educate even doctors Most patients do not personally check out their doctors reference tools and would have no idea if those references are outdated or not. Well, if your doctor or the lab is not aware of current norms - how you can you expect to get the better treatment and understanding?

Anyway, this person explains much far better than myself and for those of you who need many references, you'll be pleased. She cites RECENT research

citationsofmedicalliterature (roseannster)

And just to help make things a little faster, here's some myth debunking that's very useful:
http://sites.google.com/site/roseannster/home

---------- Post added at 11:17 PM ---------- Previous post was at 10:51 PM ----------

Also, you can read other peoples experiences with this here:

B12 deficiency is a differential for Multiple Sclerosis - Page 2 - BrainTalk Communities

 

[Andy]

Re: Anemic

Are you saying this is better for all types of anemia? I'm just asking, not wanting to debate anything.

 

[David Baxter PhD]

Re: Anemic

I am going to split this thread.

BattleBack, you are neither a physician nor a qualified medical researcher. Neither are the authors of the sources you site. There is a great deal of inaccurate information of this sort on the net and if you are trying to claim that such sources are more credible than the Mayo Clinic I must respectfully disagree.

By the way, the Mayo Clinic information is also recent: March 2009.

Additionally, I don't think a debate like this is at all helpful to the original poster. I'll split the thread and move it elsewhere.