Anemia from a Nutritionist's Perspective

Anemia, also known as anemia, is a decrease in hemoglobin (Hb) levels below normal and/or a reduction in erythrocytes (red blood cells) and hematocrit levels. Depending on the level of hemoglobin, the following types of anemia are distinguished: mild Hb 1012, 0 g/dl in women, 1013 g/dl in men, moderate 89, 9 g/dl, severe Hb 6, 57, 9 g/dl, life-threatening Hb less than 6, 5 g/dl. The main types of anemia are: iron deficiency anemia (also known as microcytic anemia) is the most common type of anemia, erythrocytes are very small and cannot transport oxygen, which is their most important function; anemia due to vitamin B12 and/or folic acid deficiency (also known as macrocytic or megaloblastic anemia) the number of erythrocytes in the blood is too low or the erythrocytes have an irregular shape. In addition to these, other types of anemia can also be distinguished, such as anemia caused by acute blood loss, hemolytic anemia, or aplastic anemia, which is associated with bone marrow insufficiency. Micro- and macrocytic anemias are, however, the most common.

Microcytic anemia usually occurs due to iron deficiency, which can be caused by: – inadequate intake of this component in the diet, – absorption disorders (e.g. during infection with Helicobacter pylori), – excessive iron loss (e.g. during menstruation, injuries). It should be noted that the need for this component increases in pregnant women, during puberty, and sometimes in individuals with iron deficiency.. Symptoms of iron deficiency include: – fatigue, – weakness, – drowsiness, – pale skin and mucous membranes, – decreased appetite, – headaches and dizziness, – difficulty concentrating, – excessive hair loss, – brittle nails, – rapid heartbeat, especially after exertion, – frequent feeling of cold. Macrocytic anemia usually develops due to vitamin B12 and/or folic acid deficiency.. A deficiency of these vitamins can occur in an unbalanced vegetarian or vegan diet.. Elderly people and alcohol abusers are also at risk of deficiency.. Anemia can develop due to absorption disorders of the mentioned vitamins, e.g. in case of obesity or SIBO.. The symptoms are similar to those that occur in iron deficiency anemia.. It should be noted that folic acid deficiency is particularly dangerous for pregnant women or women planning pregnancy.. It increases the risk of miscarriage, neural tube defects in the fetus, and serious disorders.. Therefore, both a balanced diet and appropriate supplementation are of great importance.. The causes of anemia can also include certain chronic diseases, medications taken, and genetic factors.

The significance of the growing emphasis on the importance of preventive medical examinations, including blood tests, at least once a year, cannot be overstated. The evaluation of morphology is not only significant in assessing the patient's overall health condition but can also aid in detecting serious conditions, such as anemia. A comprehensive morphological evaluation includes the examination of hemoglobin, hematocrit, red and white blood cell count, as well as platelets responsible for blood clotting. Furthermore, the following parameters are assessed in morphology: - RBC (Red Blood Cell count) - a decrease in value may indicate anemia, - MCV (Mean Corpuscular Volume) and RDW (Red Cell Distribution Width) - a marker helpful in differentiating the type of anemia. If there are deviations in morphology or unsatisfactory results, and the patient exhibits symptoms of anemia, the doctor will refer them for further diagnosis. This may include examinations of iron, ferritin, transferrin, Total Iron Binding Capacity (TIBC), Unsaturated Iron Binding Capacity (UIBC), Soluble Transferrin Receptor (sTfR), folic acid, and vitamin B12 levels. Ferritin, a protein that binds and stores iron in the body, is worth noting. A low level of ferritin indicates that the body has limited iron reserves, which may only be sufficient for a short period. If the ferritin level is low (even with normal remaining parameters), this may indicate a latent or subclinical iron deficiency that may progress to anemia in the future. To prepare for the test, it is important to: - draw blood between 7:00 and 9:00 a.m., preferably in the same laboratory, - be fasting for at least 12 hours, - the last meal should be light and dairy-free, - all medications should be taken after the test, not before, - supplements and herbs should be discontinued for 3-5 days, - alcohol should be avoided a few days before the test, - strenuous physical activity should be avoided a day or two before the test, - stress levels should be reduced.

To commence dietary therapy for anemia, it is essential to comprehend its cause. Diagnosing the trigger for anemia is crucial. The diet plan should be tailored individually to the needs of the person. It is recommended to increase the consumption of products rich in iron, from both animal (heme iron) and plant (non-heme iron) sources.

Substances with high iron content include: offal (including liver), red meat (especially pork), poultry, fish, eggs; tofu, soybeans, beans, veal, lentils, peanut butter, broccoli, leafy greens, pumpkin seeds, whole grain products, oatmeal, beets (particularly valuable is pickled beet juice)... In case of deficiency of vitamin B12, one should turn to meat, offal, fish, eggs, as well as dairy products (cheese, curd, fermented milk drinks)... A source of folic acid, which is also necessary in case of anemia, is dark leafy greens (e.g. spinach), grain sprouts, yeast, eggs... Intestinal bacteria produce vitamin B12 in the large intestine, but the body cannot use it, as the absorption of this vitamin takes place in the small intestine with the participation of an internal factor IF (which is produced in the stomach).

In addition to the absolute iron content in food, its absorption efficiency and bioavailability are paramount. Heme iron from animal products is significantly better absorbed than non-heme iron from plant sources. Inhibitors of iron absorption include: calcium (milk and dairy products), polyphenols (tea, coffee, cocoa, red wine), phytates (grains, nuts, legumes), and certain proteins (casein, whey, soy protein). Sprouting, soaking, and fermentation activate phytase, which degrades phytic acid and liberates iron. Conversely, absorption enhancers—especially for non-heme iron—include vitamin C (bell peppers, citrus fruits, berries, sauerkraut), organic acids, beta-carotene, and the presence of meat/fish proteins ('meat factor').

Ideally, the body should receive nutrients naturally, but under certain conditions, supplementation may be necessary. Depending on the type of blood insufficiency, iron, vitamin B12, and/or folic acid are administered. It is important to select the most accessible form of the supplement, determine dosage based on symptoms, and be aware of any potential interactions with other medications. Supplementation should be conducted under the supervision of specialists (doctor, dietitian).

Anemia is a common problem in society, many people are not aware that they have to combat anemia. No symptoms should be taken lightly as they can lead to serious consequences. It is recommended to carry out preventive tests, including blood morphology. To begin an effective fight against anemia, the cause must be determined. It is important to check if the daily diet is lacking in specific components and to increase the consumption of products that are rich in iron, folic acid, and vitamin B12.