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Video Transcript:

Have you ever struggled with anemia or you've just been curious to learn more about it?

If so, you've come to the right spot because that is the topic for today.

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We are going to talk about the different types of anemia, what it is, what labs you might get run for workup for anemia, and what foods you should consider including if you are struggling with the two forms of anemia that we are going to talk about today.

What to think about with supplements and there's actually a symptom that I really want to point out in regards to iron supplementation that you should just be cautious about if you have this we'll talk about that later on in this topic,

So keep reading until towards the end, and then lastly we will talk about just some other fun facts. So thank you for showing up.

I really am grateful to you for doing that because it helps push my topics up in organic search, which will allow me to continue to make these topics for you. So thank you so much. And now let's dive in.

What is Anemia?

So let's just start off by talking about what anemia is. Anemia is a condition where your body lacks enough red blood cells to carry oxygen to your tissues.

There are different forms of anemia and the two farms that we're going to talk about today are the most common ones, which are iron deficiency anemia and vitamin deficiency anemia.

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Having anemia might make you feel weak and tired. It might also be the reason for having heart palpitations, shortness of breath, cold hands and feet, cold extremities, pale skin, pale tongue, hair loss, and even maybe brittle nails.

So there are a lot of root causes, Functional medicine is all about root causes, right? so a lot of reasons that someone might get anemia.

Some of the most common are maybe somebody's just not eating enough of these nutrients that we'll talk about it a bit like iron vitamin B12 folate from their food. So vegetarians and vegans are at higher risk of it getting anemia.

Also, somebody has digestive issues that might not be absorbing the nutrients from food properly. Celiac disease can be a reason for iron deficiency anemia or things like SIBO, so small intestine bacteria overgrowth.

Women during their menstrual cycle lose blood. Blood loss can be a reason for being at risk of getting anemia and also pregnancy. So women who are pregnant have a higher risk and a higher need for iron, which we will talk about.

Further and certain medications could put you at risk of getting a nutrient deficiency. If you're curious about this, I suggest you go to, type in your medications and it will pull the resources that'll show, what research we have connecting opossum medication with nutrient efficiency.

One set of medications that's very common or proton pump inhibitors. Now don't stop your medication. These topics are not even nutrition advice, definitely not medical, or medication advice.

But I just want you to be aware of this so that if you're struggling with this and you've been struggling with anemia for a while, it can be something that you present to your physician. Just ask your physician about it.

Lab work

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And that brings me to our next discussion, which is lab work. So, what to ask when you're concerned about anemia?

Present your concerns to your physician, or your provider. And they will probably run something called a CBC in an iron panel.

What they're going to be looking at is your hemoglobin and then something called the MCV, which if your hemoglobin is low, MCV high, might indicate that you have a low vitamin B12 or folate level.

If your MCV is normal or low and your hemoglobin is low, that would indicate iron deficiency, and work with your provider cause they can look at the other labs and really kind of put together the picture for you.

Now I bring this up because as a dietitian I want to make sure that you're getting the proper labs for checking nutrient levels like vitamin B12 and folate.

And so a lot of times just a serum of vitamin B12 will be checked that this is not the most accurate what you're going to want to track as methylmalonic acid, which is something that if we have enough B12 it breaks it down.

So if we're checking methylmalonic acid and it's high, it means that our body does not have enough of that vitamin B12 indicating a loss or a deficiency that we should supplement and replace.

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The other lab is homocysteine. Homocysteine needs B12 and folate to break down. So if our homocysteine level is elevated, it means that again, we don't have enough vitamin B 12 and folate to break that down. And once again, I bring this up because checking serum B12 is not the most accurate.

So if you still have suspicions of having a low level of that, even though your lab is normal, your suspicion might be correct. And I would recommend getting asking for that methylmalonic acid level.

So we talked about possible symptoms of iron deficiency and possible symptoms of a B12 deficiency. Vitamin B12 is everything from memory loss that can actually cause permanent brain damage if left unattended, it can cause a tingling in the extremities.

Again, hands, feet, as a digestive health dietitian, something that as really kind of my forefront is thinking about these Villa, these little ridges in our intestine that really help with absorption, food absorption and having a B12 deficiency is going to not allow those to grow and be as healthy as they should to help with absorption.

Something else I want to note for you about checking iron levels versus just suspicion and supplementing is you do always want to get your iron checked because some people don't regulate iron properly and that can be very concerning if somebody is supplementing with iron, but they're one of those people, individuals who don't regulate it because they might be at risk then for iron toxicity, which nobody wants.


Food for Anemia

Okay. So now for the fun part, food. Let's talk about vitamin B12 first.

What foods contain vitamin B12?
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Well, it's mostly animal products. So meat, some dairy, eggs. So poultry, fish, bison, choose grass-fed, it's going to be higher in those Omega-3 healthy fats for you. I would say grass-fed beef, and grass-fed bison are going to be great. There aren't a lot of non-meat forms of vitamin B12 but nutritional yeast is one of them.

And there are some fermented foods like kombucha so you could use not all of those some of the vegan products do have vitamin B12 fortified. So it means that the food manufacturer is adding it back to, you can think like a supplement of B12 just being broken up and added to your foods such as happens with cereal. I am not recommending that you eat cereal.

We could have that whole discussion, but I would say we want to try to get B12 from a more natural food source so that yeast is nutritional yeast if somebody is vegan, and then, of course, those animal products, organs grass-fed beef, the bison.

Forms of Iron

So now let's talk about food sources of iron. I'm not sure if you know this, but there are two forms of iron and there's heme iron and there's non-heme iron.

  • Heme iron gets absorbed in the body at 20 to 30%.

  • Non-heme iron at five to 12%.

So as you can see, we want to try to choose food sources that are richer in this heme iron because it's more absorbed in the body.

How much iron do we need?
  • The dietary recommended intake is between eight to 18 for most adults.

  • Lower for men, higher for women pregnancy, it is 27 milligrams per day.

So heme iron, that better-absorbed iron is found in animal products. So again, the clams, oysters, the sardines, the beef, the bison. Non-heme iron is more so in those plant foods, so blackstrap molasses, cooked spinach, lentils, beans, and tofu.

If you do eat a lot of foods that are high and non-heme iron, what you can do is you can add some vitamin C foods to the non-heme iron foods to help with the absorption.

Research shows that just a hundred milligrams of vitamin C can increase absorption of that. Not about iron by 67%. So pretty significant. Some high vitamin C foods. I mean you all probably know about oranges that are ready. Red peppers are actually higher than oranges and some more of those citrus foods, the tomatoes.

So if you think about combining them, beans being high and non-heme iron tomatoes behind vitamin C chili, right? So that will be a good combination to help aid in the absorption of that non-heme iron.

So some foods can also inhibit, and prevent the absorption of iron so you're going to want to be careful to avoid having these foods when you have these iron-rich foods if you're really trying to replace your stores.

Calcium can prevent absorption. So avoid taking any calcium supplements, coffee, and tea because the polyphenols in it can prevent your end absorption. So hold off, you're taking an iron supplement if you need that, which we'll talk about in a bit. Hold up on taking that with your morning coffee. Also fighting acid, which is found in Franz and legumes.

And so I, which is interesting cause I told you lentils are high and non-heme iron well thus phytic acid that can further inhibit the absorption of that non-heme iron, which is already lower absorption than heme iron, right?

So be cautious of that and that's all the more reason that you're going to want to add a little punch with some high vitamin C foods. So tomatoes again, the peppers, just do a Google search, what foods are high in vitamin C or if you want to try to be consistent if you're traveling and you could always bring along a vitamin C rich, drink packet or just a chewable supplement.


So while we're on that topic, supplements to do right. Well, first of all, as I kind of hinted at already don't supplement until you have labs run because believe me, nobody wants to have high iron issues, so if you indeed are anemic iron deficiency anemia and your provider recommends a supplement to you, I want you to know that these supplements aren't always well tolerated.

They can sometimes cause nausea and the biggie is that they can make constipation worse. So if you're someone who struggles with constipation, you're going to want to be careful about this fact and you're going to want to work with your provider, maybe even connect with a dietitian like a functional nutrition dietitian to work through why you might be struggling with that constipation, maybe even work to resolve that before you start on an iron supplement or just combined something with that iron so that constipation doesn't get worse.

It's very, very important that we're having one to three bowel movements a day for a variety of reasons. Again, we can talk about or we can make another topic, but the purpose of this is iron and know that about iron. The one that is least constipating is going to be most tolerated is iron glycinate.

So if you're talking with your provider, maybe just bring that up and you could also try to find a combination product of the iron with the vitamin C so that you're really kind of maximizing the absorption of that supplement of those nutrients. And B12 supplementation is just something to be aware of.

There is, there are different forms of B12 on the market and not everybody does well with certain forms of different B12 so again, check with your provider. Methylcobalamin is a very kind of common go-to Cyanocobalamin might not be well absorbed by you, which can be a genetic predisposition, and sometimes it can give people a little bit of anxiety.

So if this has happened to you, talk with the dietitian and just see if switching forms might be helpful, or again, rewind back to those food options and maybe try to get some more in through your diets.

And of course, always look for what those root causes might be that might have put you in this place for having the B deficiency in the first place.

Fun Fact about Iron Deficiency

Have you ever had your hemoglobin a1c checked? A lot of people have, and this is an indicator of the average blood sugar over the past three months. Well, you don't want it to be too high because that could just mean that you either have prediabetes or you're going down that road to diabetes.

Something to know is that if your hemoglobin a1c is elevated, it's high, but you really feel like what you eat, your lifestyle routine, you shouldn't be having elevated blood sugars. Well, iron deficiency, could be causing that to be falsely high. So by treating the iron deficiency, you might find that your hemoglobin a1 c normalizes. So just a fun fact there for you.

All right, so hopefully you've learned a lot of really fun information that you can now go out and press all your friends with. I know this is something that probably everybody loves to talk about, so share it with the world.

Just to review, we have a bunch of different types of anemia. The two we talked about today are iron deficiency anemia and vitamin deficiency anemia, so talking about iron, vitamin B12, and folate.

We talked about some foods that are rich in those nutrients, and really a lot of it is those meat products and especially organ products, so liver and other organs of the animal are going to be very rich in both iron and vitamin B12 so if you can find a way to incorporate those, that would be great.

Then also vitamin C, which can aid an increase in the absorption of iron. Again, a study shows how just a hundred milligrams increase absorption by 67%.

We have come to the end and I thank you so much for reading this topic.

I hope you have a wonderful day.

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If you'd like to explore any of this information further or obtain an individualized nutrition plan, you can schedule an initial appointment at our clinic. We also take insurance and some of our clients get full coverage, which is great.

food for anemia, understanding anemia, improve low iron level, best food for anemia

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