What is Iron Deficiency Anemia?

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I thought I would study Anemia , and here is what I found...

What is Iron Deficiency Anemia?

Iron Deficiency Anemia (also called IDA) is a condition where a person has inadequate amounts of iron to meet body demands. It is a decrease in the amount of red cells in the blood caused by having too little iron. IDA is usually caused by a diet insufficient in iron or from blood loss. Blood loss can be acute as in hemorrhage or trauma or long term as in heavy menstruation.

Iron deficiency anemia is the most common form of anemia. About 20% of women, 50% of pregnant women, and 3% of men are iron deficient.

Iron deficiency anemia and sickle cell anemia are VERY DIFFERENT. To read about sickle cell anemia, click here.

Some people with iron deficiency anemia always feel cold. They feel cold because iron plays a role in regulating the body's temperature.

What is Iron?

Iron is an essential component of hemoglobin, the oxygen carrying pigment in the blood. Iron is normally obtained through the food in the diet.

Iron is part of hemoglobin, the oxygen-carrying component of the blood. Iron-deficient people tire easily because their bodies are starved for oxygen. Iron is also part of myoglobin. Myoglobin helps muscle cells store oxygen. Without enough iron, the body's fuel cannot be properly synthesized.

What Causes Iron Deficiency Anemia?

The main causes of iron deficiency are: poor absorption of iron by the body (Vitamin C aides in iron absorption), inadequate daily intake of iron, pregnancy, growth spurts or blood loss due to heavy period or internal bleeding.

Anemia develops slowly after the normal stores of iron have been depleted in the body and in the bone marrow. Women, in general, have smaller stores of iron than men. Women also loose iron more frequently than men because of the blood loss during menstruation.

In men and postmenopausal women, anemia is usually due to gastrointestinal blood loss associated with ulcers, the use of aspirin or nonsteroidal anti-inflammatory medications (NSAIDS), or colon cancer.

Gaucher Disease may also cause anemia.

Am I at Risk?

High-risk groups include: women of child-bearing age who have blood loss through menstruation; pregnant or lactating women who have an increased requirement for iron; infants, children, and adolescents in rapid growth phases; and people with a poor dietary intake of iron through a diet of little or no meat or eggs for several years. Risk factors related to blood loss are peptic ulcer disease, long term aspirin use, or colon cancer.

Vegetarians are at risk of developing anemia. This usually occurs because they don't eat meat, (especially red meat) which is high in iron. However, vegetarians don't always develop anemia. There are many vegetables that contain iron (such as broccoli and spinach).

Can Anemia be Prevented?

Yes. If your diet is high in iron, you probably won't be anemic. Iron can be found in red meat, liver, raisins, spinach, broccoli, and egg yolks.

What are the Symptoms of Iron Deficiency Anemia?

There are many symptoms of anemia. Each individual will not experience all the symptoms and if the anemia is mild, the symptoms may not be noticeable. Some of the symptoms are: Pale skin color, fatigue, irritability, dizziness, weakness, shortness of breath, sore tongue, brittle nails, decreased appetite (especially in children), headache - frontal.

How will I know if I'm Anemic?

If you believe you may be anemic, ask your doctor and he will perform some tests. The tests are simple. Some of the tests are: red blood cell measures of hemocrit and hemoglobin; size of red blood cells, serum iron level, and iron binding capacity in the blood.

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Description of Anemia

Iron deficiency anemia is the most common nutritional disease in the world.

Anemia literally means, "without blood", and is a deficiency of red blood cells, or the presence of abnormal red blood cells due either to reduced production, abnormal production, excess destruction, or blood loss.

Symptoms of Anemia

Tiredness, dizziness, headaches, depression, slow healing, loss of sex drive, bruising, nervousness, shortness of breath, pallor and palpitation.

Main Causes of Anemia:

Iron deficiency
Vitamin B-12 or folic acid deficiency
Vitamin C deficiency
Vitamin E and B-6 deficiency
Thyroid disorders
Alcoholism
Lead Toxicity
Infectious diseases such as malaria

Seek Professional Help When... Your skin is pale and you feel weak, tired and out of breath.
Your tongue is slick or smooth.
You experience fatigue upon exertion.
Your skin is jaundiced.
You have bleeding under your skin and you bruise in response to the slightest trauma.
You are unable to do your usual physical activities.
You feel tired for more than five days.


Common Sense Care of Anemia:

Include the foods recommended under Food Therapy in your diet. The specific choice of food will be dictated by the type of anemia you have.
Keep track of the foods you eat and find out whether they are rich in iron, folic acid, or vitamin B-12. Use the HolisticOnLine Nutrition database.
As mentioned else where, do not drink coffee, tea, beer or cola with meals as these inhibits the absorption of iron. Instead, drink citrus juices. These are rich in Vitamin C and assists in the absorption of iron.
Take daily multivitamin. Do not take any iron supplements without consulting your doctor.
Avoid excessive consumption of alcohol.
If you are a strict vegetarian, watch your diet very closely.
Do not smoke. Avoid second hand smoke.
Minimize your exposure to lead and other toxic metals such as aluminum, cadmium and mercury.



Herbal Medicine Anemia

Dong quai - This herb is rich in vitamins and minerals.
Chive - This vegetable is rich in vitamin C and iron - eat fresh chives.
Quinoa - This is a grain rich in all eight essential amino acids that form a complete protein.
Gentian - The bitter herb gentian is popular in England for the treatment of anemia. Gentian can be brewed into a tea or you can take a commercially available extract.
Dandelion is also believed to help people with anemia. It is very rich in vitamins and minerals.
Other herbs that are of interest to those suffering from anemia include alfalfa, bilberry, burdock root, cherry, goldenseal, grape skins, hawthorn berry, horsetail, mullein, parsley, nettle, Oregon grape root, pau d'arco, red raspberry, shepherd's purse, watercress, and yellow dock root.

Caution: Do not take goldenseal or Oregon grape root if you are pregnant. If you have a history of cardiovascular disease, diabetes or glaucoma, see your physician before taking any herbs.

Asian ginseng (Panax ginseng) is useful as a general tonic to counteract anemia induced fatigue. Dong quai may be prescribed for women with heavy menstrual flow. For anemic patients with yellow complexion, a Chinese herbalist might recommend a combination of dong quai and Chinese foxglove root. For those with white complexion, they may recommend a combination of ginseng and astragalus.



Food and Nutrition Anemia

Anemia can result from a variety of deficiencies. For example, you may be deficient in iron, Vitamin B-12 or folic acid. Once you know, what you are deficient, then you can consume food that is rich in that nutrient. Hence, the first thing you need to do is to determine the cause of your anemia.

You can use HolisticOnLine Nutrition site to determine the foods and vegetables to consume to assure the proper nutrition intake. For example, green leafy vegetables are a good source of iron. Salmon and mackerel are good sources of Vitamin B-12. Black eyed peas, beans, and lentils are good sources of foliate.

It is a good idea to include the following in your diet if you suspect you are suffering from anemia: apples, apricots, asparagus, bananas, broccoli, egg yolks (Avoid if you have cardiovascular disease or have high cholesterol problem), kelp, leafy greens, okra, parsley, peas, plums, prunes, purple grapes, raisins, rice bran, squash, turnip greens, whole grains, and yams. It is a very good idea to eat food high in Vitamin C to improve the absorption of iron by your body.

Avoid foods high in Oxalic acid from your diet. Oxalic acid interferes with iron absorption. Foods such as almonds, cashews, chocolate, kale, rhubarb, sorrel, spinach, Swiss chard and most nuts and beans are high in oxalic acid.

Avoid foods that interfere with the iron absorption. Examples of foods to avoid are: beer, candy bars, dairy products, ice cream, soft drinks, coffee and tea.

Take a tablespoonful of blackstrap molasses twice daily. Molasses is a good source of iron and essential B vitamins. For children, mix the molasses in a glass of milk or in their formula.

Do not take calcium, vitamin E, zinc, or antacids at the same time as iron supplements. These interferes with the iron absorption.

WARNING: Iron is extremely toxic in large quantities. Excessive use of supplements can lead to iron overload, possibly resulting in abdominal pain, nutritional imbalances, digestive problems, or even in death, especially in children. Supplements pose a particular threat to people with the inherited disorder hemochromatosis. Consult a qualified physician before you start any treatment involving iron supplements.



Vitamin Therapy Anemia

Take raw liver extract 500 mg twice daily for red blood cell production.
Folic acid 800 mcg + Biotin 300 mcg twice daily.
If you have iron deficiency, take iron with 100 mg of Vitamin C, under the supervision of your physician. One of the natural source of iron is floradix iron plus herbs from Salus Haus (2 teaspoon twice daily)
Vitamin B-12 - 2,000 mcg 3 times daily. This may be injected 2 cc weekly under the care of a doctor.

Other vitamins and supplements that are important are:

Vitamin B complex - 50 mg 3 times daily
Extra pantothenic acid (vitamin B-5) - 50 mg 3 times daily and pyridoxine (Vitamin B-6) - 100 mg daily
Vitamin C - 3,000 to 10,000 mg daily
You may also consume brewers yeast as recommended on the label.
Copper, Zinc, Raw spleen glandular, Vitamin A, Natural Beta Carotene and Vitamin E.

WARNING: Iron is extremely toxic in large quantities. Excessive use of supplements can lead to iron overload, possibly resulting in abdominal pain, nutritional imbalances, digestive problems, or even in death, especially in children. Supplements pose a particular threat to people with the inherited disorder hemochromatosis. Consult a qualified physician before you start any treatment involving iron supplements.

Juice Therapy: Focus on vegetables that are high in iron. Blend it with juices high in Vitamin C.

Add a teaspoon of turmeric to a cup of plain yogurt. Eat this mixture on an empty stomach in the morning or afternoon.

This was a very helpful article. I like the natural way of healing. We try to stay out of the Doctors office as much as possible.

[benshelpmeet]

This is a long one but interesting!

Understanding Anemia
by Ed Uthman, MD
University Press of Mississippi

Chapter 1. What Is Anemia?
The word "anemia" is composed of two Greek roots that together mean "without blood," but to use this literal translation as a definition would be a gross exaggeration. Still, the modern definition is simple: anemia is any condition characterized by an abnormal decrease in the body's total red blood cell mass. To understand the definition, one has to understand what red blood cells are and what they do, how the body reacts to an abnormally low red cell mass, and what happens when the mass of red cells falls so low that the body cannot adapt to it. We will discuss these matters in this chapter, but first we will look at the history of anemia and its study.

HISTORICAL PERSPECTIVE
The ancients readily recognized the importance of blood as a life- giving substance, believing it to hold the body's vital force. Hebrews back to the patriarchal age maintained that blood was the seat of the soul and demanded through the Mosaic Laws that it be drained before an animal was prepared as food (a practice still followed by Orthodox Jews today). The Romans drank the blood of their enemies, thinking it would confer on them the courage of their vanquished foes. While today the concept of the circulation of the blood seems obvious, it was not until the relatively recent era of the seventeenth century that William Harvey determined that blood was not just a contained static liquid.

The scientific study of blood had to await the invention of the microscope. While magnifying lenses were known to the monastic scholar and natural historian Roger Bacon (1214-94), lenses of sufficient quality for scientific use were not available for another three centuries. The first compound microscope (the great-granddaddy of the clinical microscope of today) was made in 1590 by the Dutch spectacle maker Zacharias Janssen. No one thought to use this instrument to look at blood until the noted Dutch naturalist Jan Swammerdam (1637-80), turned his instrument on the fluid of life and discovered what he called "ruddy globules," which were presumably red blood cells. The first detailed description of the red cells was produced by the famous (also Dutch) microscopist Antonj van Leeuwenhoek (1632-1723). While these men were great "natural historians," they were not medical researchers in the modern sense of the word. In fact, neither they nor those who immediately followed them thought that red cells were of any importance to the body. This realization had to await the insight of an Englishman, William Hewson (1739-74), whose posthumously published opinion that because red cells were present in such abundance they had to be important earned him the title "the father of hematology."

At the beginning of the nineteenth century, the word "anemia" was a clinical term referring to pallor of the skin and mucous membranes (the thin linings that cover the inside of the mouth, the whites of the eyes, the inner surface of the eyelids, and other surfaces not covered by skin). At the time of the publication of the first textbook of hematology by the French physician Gabriel Andral in 1843, there was no appreciation for the basic concept held today that clinical anemia is due to inadequate numbers of red blood cells. Before this could be determined, it was necessary to develop a technical method by which blood cells could be counted. This was first done in 1852 by Karl Vierordt, but his technique was too tedious to gain widespread use. Vierordt's student, H. Welcher, counted the cells in a patient with chlorosis (an old word for what is probably our modern iron-deficiency anemia) and found in 1854 that an anemic patient had significantly fewer red blood cells than a normal person. Thus, almost two centuries passed after Swammerdam's discovery of red cells in 1658 before it was shown that a deficiency in the number of red cells was behind the clinical diagnosis of anemia.

The clinical and biological science of hematology was given a tremendous boost in the period between 1878 and 1888, when it became possible to examine the microscopic details of blood cells. Interestingly, the event that provided this opportunity was not the development of the microscope, which was already fairly advanced by that time, but of biological stains. Although the human body is opaque and colorful to the naked eye, at the microscopic level almost all cells are nearly transparent. Most cells are completely colorless, and even those that have their own native color, like red blood cells, appear extremely pale and washed-out when viewed individually. Accordingly, few cellular details can be distinguished by looking at unstained specimens with even the best modern microscopes. It is necessary to stain the cells with dyes to obtain much useful information from them. The preeminent figure in the world of biological stains was Paul Ehrlich (1854-1915), the Silesian-born son of affluent Jewish parents and one of the truly great names in the history of biomedical science.

Ehrlich had done poorly in school as a boy, but he had shown great aptitude for and interest in biology and chemistry. His first major discovery was a good method for staining the bacterium that causes tuberculosis, which made the microscopic diagnosis of that important disease much easier. Unfortunately, he caught a mild case of it and had to take time off to recover. Ehrlich later worked out the details of preparing an antitoxin for another dreaded disease, diphtheria, which represented the first use of immunotherapy to specifically treat an infection (vaccines are also immunotherapy and had been around for much longer, but they prevent infections rather than treating them). Ehrlich's contribution won for his boss, Emil von Behring, the first Nobel Prize for physiology or medicine in 1901. Although Ehrlich had probably done most of the actual work, von Behring was given full credit for the discovery (Ehrlich eventually did get a Nobel in 1908 for other work).

Continuing to be interested in dyes, Ehrlich realized that something about their chemical makeup allowed them to attach themselves to specific parts of a cell. Combining this property with a poisonous one, he reasoned, should make it possible to create a dye-like substance that would attach itself to a specific infection-causing microorganism and kill it. This concept led Ehrlich to develop trypan red, a dye used in the treatment of trypanosomiasis (a class of parasitic infestations that includes African sleeping sickness), and arsphenamine, which was the first effective treatment for syphilis, another major public health problem of Victorian times.

Ehrlich's contribution to routine hematology was his development of the triacid stain, which allowed him to properly classify white blood cells into a scheme similar to the one used today. In 1891, the triacid stain was replaced by the eosin methylene blue stain invented by D. L. Romanowsky of St. Petersburg, Russia. The "Romanowsky stain" was further modified by Richard May of Munich in I902, Gustav Giemsa of Hamburg in 1905, and J. H. Wright of Boston in 1906. All of these modifications were direct descendants of Ehrlich's original ideas. Over ninety years later, we still use two of these, the May-Gruenwald-Giemsa stain and the Wright stain, for the examination of the myriad blood smears routinely prepared in clinical laboratories every day.

Standing on the broad shoulders of nineteenth century giants like Ehrlich, twentieth century hematologists led their science at an ever- accelerating rate into the modern age, providing scientific explanations for the various types of anemia discussed in this book. Ever easier, faster, and cheaper ways to diagnose and classify anemias were developed, and techniques for treating them, from nutritional therapy to blood transfusion to bone marrow transplants, were devised. The era of modern hematology is considered to have begun at Harvard Medical School with the work of George Richards Minot (1885-1950) and his assistant, William Parry Murphy (1892-1987), who, between 1924 and 1926, found that patients who suffered from pernicious anemia could be successfully treated with large quantities of raw liver in their diets. Minot and Murphy shared the 1934 Nobel Prize for their discovery. From this point on, the investigation of anemia revolved around phenomena at the molecular level, which is where we are today.

BLOOD
Given the amount that flows from even a trivial cut, it is tempting to assume that the body is literally full of blood. Actually, blood makes up a small fraction of the body's volume. Consider an "average" man weighing 70 kilograms, or 154 pounds. Since the human body has just about the same density as water, and 1 liter of water weighs 1 kilogram, the total volume of his body is about 70 liters. Of this, only about 5 liters represents the total volume of blood. Therefore, blood accounts for only 7 percent of the total body volume. In the normal state, blood must stay confined to several anatomic structures meant to hold it. The first of these is the circulatory system, which consists of the heart and blood vessels. The heart's main function is to be a pump for the blood (although it has a lesser-known function in the endocrine system concerning the regulation of body water content and blood volume). The blood vessels consist of (1) arteries, thick- walled elastic structures that withstand the high pressures generated by the pumping action of the heart, (2) veins, thin-walled low- pressure vessels that conduct blood back to the heart, and (3) capillaries, microscopic tubes that ramify throughout all the tissues of the body (except the cartilage of the skeletal system and cornea of the eye, which are able to live without a direct blood supply). Arteries conduct blood from the heart to innumerable beds of capillaries, which have such thin walls that exchange of nutrients, hormones, and waste products between the blood and tissues is easily accomplished. The capillaries converge into small veins, which converge into larger veins to conduct the blood back to the heart under very low pressure, where the pumping cycle begins again. The heart actually consists of two separate pumps in series; these just happen to be stuck to each other side by side. The right heart collects oxygen-poor blood, which has a dark purple color, from veins arriving from all the tissues of the body and pumps it into the lungs, where inhaled oxygen is picked up and carbon dioxide is dropped off to be exhaled. The oxygen-rich blood, which is bright red, is returned to the left heart and pumped out to the periphery of the body to complete the cycle.

The other anatomic structure for containing the blood is the reticuloendothelial system (RES), which consists of cavern-like structures called sinusoids lying within the spleen, liver, and bone marrow. The function of the sinusoids is to facilitate the exposure of blood to certain cells that are involved in the immune response to foreign invaders. Sinusoids in the bone marrow also serve as embarkation areas for newly born blood cells beginning their journey in the circulation. Blood flow through the sinusoids is very slow, so as to allow the blood maximum contact time with the tissues charged with these complex interactions.

Blood in a test tube would appear to be an inert liquid, but it is in fact no less a living, breathing tissue than is the heart, brain, or any other body part. Physically, blood consists of cells suspended in a liquid medium. The liquid medium, accounting for about 6o percent of the volume of blood, is called plasma. Of the plasma, about 93 percent is water. The remainder consists of suspended and dissolved solids, the most abundant of which is a protein called albumin. Other proteins in the plasma are called globulins. Both types of proteins have a variety of functions, some of which will be discussed later. There is also a set of important proteins in the plasma involved in the coagulation of the blood; these are called, appropriately enough, coagulation factors. If you take plasma from the blood and allow it to coagulate (form a clot), the resulting fluid left after the clot is removed is called serum. Several of the important laboratory measurements employed in the evaluation of anemias involve the determination of the quantity of nutrients and other substances in serum. These will also be discussed later.

BLOOD CELLS
The cells of the blood constitute about 40 percent of its volume. Of this volume, the overwhelming proportion is represented by the red blood cells (RBCs), or erythrocytes. There are about 5 million RBCs in every microliter of blood. Since there are about 5 million microliters of blood in the body (5 liters times 1 million microliters per liter), there are approximately 5 million times 5 million, or 25 trillion, red cells present. The whole body has an estimated 50 trillion cells of all types; thus, red blood cells account for about half the cells in the body. It may seem surprising that half of the body's cells are confined to 7 percent of its volume, until one considers how small and packed together the red cells are compared to the others. In fact, the red cell is smaller than just about any cell in the body, the sperm being a rather memorable exception.

Red cells, like most blood cells, are made in the bone marrow, the spongy internal core of most bones. In children the entire skeleton contains hematopoietic (blood cell-producing) marrow, but, as we age, marrow cell production becomes confined to bones in the central portion of the body, namely those of the spinal column, pelvis, skull, sternum (breastbone), hip and shoulder. In the adult, the weight of active marrow is about 4 1/2 pounds, making the marrow the second largest organ in the body (after the skin). Red cells begin their existence as marrow cells called erythroblasts (in biological parlance, a "blast" is a primitive cell from which other, more mature, cells form). These cells have nuclei with DNA and can reproduce themselves like the many other self-replicating cells in the body. Some of the erythroblasts reach a point at which they stop reproducing themselves and instead go out into the wide world of the bloodstream as erythrocytes. To do this they have to spend several days in the marrow undergoing a sequence of events called maturation, by which they (1) become progressively more filled with hemoglobin, and (2) eventually lose their nuclei. The resulting cell is essentially a sac containing hemoglobin and the biochemical minifactory necessary to maintain the chemical integrity of hemoglobin. The shape of the red cell is referred to as a biconcave disc. (A donut with its hole partially filled in is a good analogy.) It is essential that the red cell maintain its normal biconcave disc shape; otherwise, it is quickly destroyed by various police cells in the reticuloendothelial system.

After release into the bloodstream, red cells circulate for an average lifespan of 120 days. Therefore, every day, 1/120 of the total erythrocyte mass must be replaced. This comes out to 200 billion red cells per day, or over 2 million per second. If that's not enough of a task, the marrow must also produce most of the other types of cells in the blood.

The other cellular constituents of the blood are the white cells (leukocytes) and the platelets. These make up only a tiny volume of the blood; all the body's circulating white cells would not even fill a bartender's jigger, and all its platelets could easily fit into a teaspoon. In contrast, all the body's red cells would overflow a half-gallon milk carton. Leukocytes are involved in the immune response to foreign substances, and platelets are necessary for proper clotting of the blood. While these cells are not directly germane to our discussion of anemia, they will be discussed briefly in later chapters.

HEMOGLOBIN
The only function of the red blood cell is to keep hemoglobin healthy and happy. With no DNA-containing nucleus, the erythrocyte cannot reproduce itself or program itself to adapt to various challenges by synthesizing new proteins. With no mitochondria (tiny sacs in the cytoplasm filled with sugar-burning enzymes) it cannot generate the large amount of energy enjoyed by almost all other cells of the body. By allowing for the relatively limited role it performs in physiology, the red cell has its work cut out for it in caring for hemoglobin, a most fastidious customer. Hemoglobin is a protein that serves as a carrier for oxygen from the lungs to the tissues. To work properly, the hemoglobin has to hold on to oxygen molecules with just the right amount of force. If the hemoglobin molecule binds the oxygen molecules too loosely, then it will not be capable of picking them up at the lungs. If it binds the oxygen too tightly, then when it gets out to the tissues it will not release the oxygen to the tissues that need it. To perform such a delicate balancing act, the hemoglobin molecule takes advantage of its unusual physical structure (fig. 1.1). Each hemoglobin molecule consists of 4 smaller protein molecules, called globin subunits. There are 2 alpha and 2 beta subunits in each molecule. Each subunit partially encloses an unusual molecule called heme. Heme is similar to a class of compounds called porphyrins, which are widely found in nature in various roles. Chlorophyll, the light-capturing component of green plants, is an example of a porphyrin-based molecule. One peculiar property of porphyrins is their willingness to bind atoms of heavy metals. In the case of heme, that heavy metal is iron. Each heme molecule (4 per hemoglobin molecule) contains 1 atom of iron. Although 4 atoms of iron may seem a trivial amount in an enormous protein molecule (the protein part of hemoglobin weighs almost 300 times more than the iron it contains), iron is an absolutely essential component of hemoglobin. Without iron, there is no hemoglobin. Since without hemoglobin there is no blood, iron is an essential component of vertebrate life. (Iron will be discussed in detail in chapter 3.)

When an oxygen molecule binds to a hemoglobin molecule, the latter changes shape very slightly, which causes the next oxygen molecule to bind to the hemoglobin molecule even more avidly. This again causes a change in shape and again increases the willingness of the hemoglobin molecule to bind with oxygen. The process continues until the hemoglobin molecule has bound a total of 4 oxygen molecules, at which time the hemoglobin is full; it can bind no more oxygen. When the oxygen-laden hemoglobin gets out to the tissues of the body, it begins to drop off its oxygen load. The first oxygen molecule is given up reluctantly, but each subsequent one is released more easily than the last. What is the physiological advantage of this phenomenon?

The answer lies in a basic observation, well known to chemists and physicists, called the law of mass action. Essentially, this law states that chemical substances move spontaneously from areas of greater concentration to areas of lesser concentration. In the lungs, oxygen moves from its high concentration in the inhaled air toward the red blood cells, which have a low concentration. The problem is that, as oxygen moves into the red cells, its concentration becomes greater in the blood, and, because of the law of mass action, it is progressively more difficult to get oxygen to move from the lung to the blood. Accordingly, evolution has provided all vertebrates with the gift of hemoglobin. As the hemoglobin picks up oxygen from the lungs and gets more saturated, the changes in the hemoglobin molecule's shape force it to chemically bind oxygen more tightly, so that, despite the law of mass action, oxygen continues rapidly crossing over into the blood.

Out in the peripheral tissues, the reverse situation takes place. With the high concentration of oxygen in the blood initially assuring transfer of oxygen from blood to tissues, the law of mass action tries to slow this transfer down as the concentration of oxygen in the blood decreases. Once again hemoglobin saves the day, as it increasingly unbinds and delivers oxygen molecules with each of the oxygens that is stripped from it.


to be continued on next post...

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So it is clear that hemoglobin has to have its peculiar structure for proper oxygen transport, even if that structure turns out to be very delicate. Just as schoolyard bullies like to pick on the weakest classmate, almost any type of natural or artificial toxic substance can cause the hemoglobin molecule to denature (be permanently altered so that it does not work). The task of the red cell is to protect hemoglobin from these assailants. It has to continually synthesize certain molecules that destroy the toxins, and also has to maintain the correct pH (the degree of acidity or alkalinity of a liquid). It even has to keep the iron atoms happy. If an iron atom loses even one electron (which it likes to do if left to its own delinquent devices), the hemoglobin in which it resides turns into something called methemoglobin, which is totally worthless as an oxygen carrier.

HOW THE BODY ADAPTS TO ANEMIA
The various causes of different types of anemia will be discussed in later chapters, but first it is important to consider what all anemias and people with anemia have in common. As stated earlier, anemia is the condition characterized by an abnormal decrease in the body's total red blood cell mass. There are two possibilities as to what happens then to the blood's physical properties. The first is that, as the mass of red cells goes down, so does the total volume of blood. In fact, this is exactly what happens whenever there is heavy bleeding over a short period of time, whether from a wound or a disease (such as a bleeding ulcer). When this happens, the blood is just as thick and concentrated as it is in the normal state, but there is less of it left in the body. This is referred to as anemia of acute blood loss. While this does strictly fit our definition of anemia, it is in something of a category of its own, mostly because the loss in red cell mass plays second fiddle to the loss of total blood volume. When acute bleeding occurs, the most important thing for doctors to do is to maintain blood volume, even if they have to use fluids other than blood. This does not replace the lost red cell mass, to be sure, but it does keep the patient from going into shock, which can be irreversible. This is why the first thing that is done for severely injured patients, such as at the scene of an accident, is to get an IV going. The IV (intravenous) fluids can replenish the circulating fluid volume long enough for the patient to get to a hospital, where a blood transfusion can be given.

The second possibility surrounding the loss of total red cell mass is the one that is typically associated with all anemias except anemia of acute blood loss. In this scenario, the loss of red cells is gradual over weeks or months, so that the body has time to adapt to it. In this case, the body starts its own "IV" and adds water to the circulating blood volume. It does this by causing the kidneys to hold on to the water that is taken in by normal drinking. As more water is added to the plasma, and as the mass of red cells continues to decrease, the blood becomes thinner, i.e., less syrupy and more watery. To a point this is a favorable adaptation. Because thinner blood can travel through the tiny capillaries faster than thick blood, in the early stages of anemia the blood actually becomes more efficient at delivering oxygen to the tissues. However, as with many quick fixes the body employs to deal with problems, things eventually go awry. As the blood continues to thin out, less and less oxygen-laden hemoglobin is presented to the tissues per unit time. The result is oxygen starvation at the cellular level. But the body, not ready to give up yet, has several tricks up its sleeve:

Increased cardiac output. The volume of blood the heart pumps through itself per unit time is called the cardiac output. In the normal resting state, the heart pumps about 5 liters of blood every minute, abbreviated 5 L/min. This means that the heart is easily capable of pumping the body's total blood volume through its chambers in one minute. Actually it is capable of much more than that. When there is a greater demand for oxygen, as during vigorous exercise, the heart can increase its output manyfold, to as much as 30 L/min. It does this by increasing not only the number of beats per minute (the heart rate) but also the volume of blood pumped with each stroke (the stroke volume). Mathematically, the cardiac output can be calculated by multiplying the heart rate times the stroke volume. In anemia, the cardiac output increases, and that allows more hemoglobin to be exposed to the peripheral tissues, making up for the decreased hemoglobin concentration. Accordingly, the heart rate increases, which gives us one of the cardinal clinical manifestations of anemia, tachycardia, or fast heart rate.
The heart does not act alone to increase the cardiac output. It has to have cooperation from the peripheral tissues and the blood itself. If nothing changes in the body but the heart rate and stroke volume, the heart will be trying to pump blood faster into a fixed, unchanging bed of blood vessels. This is like trying to squeeze thick dishwasher detergent gel out of its container by pushing harder. The only way to make the gel dribble out faster is to increase the pressure. Analogously, in the body, to push more blood through an ungiving vascular bed would require a higher blood pressure. Higher blood pressure would cause the heart to work harder, because it would have to pump against a high pressure head, just like a muscle has to work harder to lift a heavier weight. Clearly this is not in the best interest of the body. Fortunately, the blood pressure is kept from going up by two factors. The first is the viscosity of anemic blood. Viscosity is the quality of a fluid which tends to cause it to resist being propelled through a tube or opening. Thin, anemic blood is less viscous than normal blood and can be pushed through the vascular bed with less pressure. The second factor is the blood vessels themselves. The wall of each small artery or vein contains one or more layers of muscle capable of responding to nerve signals by contracting. This causes the vessel to close down to a smaller caliber and be more resistant to the flow of blood. Other nerve impulses cause the muscles to relax, letting the vessels expand to a wider caliber and allowing more blood to flow with less resistance. In the anemic patient, the brain sends signals to the muscles around the small vessels telling them to relax and open up. The result is less impediment to the flow of blood. Therefore, because of less peripheral vessel resistance and thinnet, less viscous blood, the cardiac output can rise without causing the blood pressure to go up.


Redistribution of blood flow. The various organs of the body are quite capable of cutting deals among themselves when times are bad. In the case of anemia, all the organs conjoin to protect the two most oxygen-demanding organs in the body, the brain and the heart. If these organs don't get enough oxygen, the rest of the body is in real trouble. Fortunately, two other organs can get by without nearly as much blood as they normally enjoy in good times. The first of these is the skin. As a response to anemia, small blood vessels in the skin contract, causing a greater resistance to the flow of blood than is present in more vital organs. Since the blood being pumped out of the heart will preferentially follow the path of least resistance, it will go through the more vital organs faster than it will through skin with contracted vessels. The result is a partial diversion of blood from the skin to other organs. The second organ which sacrifices its right to blood supply is the kidney. Now the kidney is a very vital organ, to be sure, but it is normally endowed with much more blood flow than it needs to stay alive and function properly. Both kidneys, taken together, weight about 350 grams (or about 1/2 of 1 percent of the total body weight), but they receive 20 percent of the cardiac output, or about 1 liter per minute. Gram for gram, then, the kidneys receive 50 times the cardiac output of the body as a whole. Clearly they could give up some of that for the benefit of their fellow organs, and as part of the adaptation to anemia, they do so.
The diversion of blood flow from the skin causes one of the cardinal clinical features of anemia--pallor. Pallor is the pale color observed in the skin of a light-skinned anemic individual, and in the mucous membranes and nailbeds of all anemic individuals, light-skinned or otherwise. It should be noted that anemic patients are pale not because their blood is thin (anemic blood is just as opaque and highly colored as normal blood), but because the diversion of blood means that there is less of it in the skin, and more of the pale color of bloodless human tissue shows through.


Decrease of hemoglobin-oxygen affinity. Earlier we discussed how the affinity (or the "willingness" to bind) between oxygen and hemoglobin changed with the number of oxygen molecules gained or lost by hemoglobin. It turns out that hemoglobin-oxygen affinity can be accomplished by other chemical means as well. There is a simple organic acid, called 2,3-diphosphoglycerate (2,3-DPG) that is elaborated within the red cell under anemic conditions. This 2,3-DPG causes hemoglobin to bind oxygen less avidly and to give up as much to the starved tissues as possible. Of course, the other side of the coin is that oxygen is more difficult to pick up in the lungs, but, since the respiratory system is not the main concern in an anemic patient, something has to give, and the healthy system ends up taking up the slack for the sick one.
WHEN COMPENSATION FALLS: THE CLINICALLY ANEMIC PERSON
A recurring theme in the study of disease is the sequence of events by which the body withstands some sort of insult (in the case of anemia, the decrease of red cell mass) by engineering various physiological workarounds to compensate for the damage done. Fortunately the body's various systems have a tremendous amount of reserve function to draw on to support these schemes. The down side is that when the insult becomes so great that the healthy systems, which are stretched to their limits, cannot overcome it, then the whole physiology comes crashing down like a house of cards. The result is a sick person in need of medical attention. In anemia, such a person appears with a characteristic constellation of symptoms and signs. These are listed below, along with the physiologic phenomenon responsible for each.

Pallor is due to the shunting of blood flow away from the skin, as discussed above.
Tachycardia, or fast heart rate, results from the increased cardiac output, also discussed above.
Dyspnea (shortness of breath) occurs on exertion. Although the respiratory system in the anemic person is healthy, the tissues out in the body are starved for oxygen, because there is not enough hemoglobin to get it to them. When they need even more oxygen, as in a period of strenuous exercise, they send signals to the respiratory system asking it to deliver more. The respiratory system responds by increasing the depth and rate of breathing, which the anemic person experiences as shortness of breath.
Easy fatigability is an effect of oxygen starvation at the tissue level.
Dizziness and fainting are due to relative lack of oxygen in the brain.
Tinnitus means the perception of noises which do not exist, or "ringing in the ears." In the anemic patient, this may actually be more of a buzzing or roaring. One possible explanation for this is that the cardiac output is so increased that the rushing of the blood through the vessels in the region of the ear is perceived as sound. Oxygen starvation of the brain cells is an alternative explanation.
Headaches can be a symptom of anemia, although the exact cause is unknown.
Miscellaneous symptoms include dimmed vision (which suggests oxygen starvation of the brain), loss of appetite, nausea, and constipation.
Heart failure may occur. The cardiac output can increase only up to a certain point. After that, if the heart is called on to deliver even more blood per minute, it fails. When this happens the heart is unable to pump through all the blood presented to it by the veins, causing a buildup in pressure there; the blood then backs up into the capillaries. In this high-pressure environment, fluid from the plasma of the blood begins to seep out of the capillaries into the tissues. When this happens in the peripheral tissues of the body, swelling occurs, a condition referred to as edema. This swelling is seen particularly around the ankles (pedal edema) and over the lower back (sacral edema). When edema occurs in the lungs, the fluid not only causes the thin walls of the alveoli to swell, thus stiffening the lung and making inhaling more difficult, but it also fills up the alveolar sacs themselves, interfering with the exchange of oxygen and carbon dioxide. This is called pulmonary edema, and it is a dire event in the clinical course of the severely anemic patient. Without treatment (or with unskillful treatment) such a condition will quickly lead to the patient's demise.
Now that we have a person with clinically full-blown anemia in need of medical care, we will look at how doctors make a diagnosis and how they classify each person's case for proper management.

Whew...That was long..........

[Andrea]

Thank you for this Sister Darlene. I have been diagnosed with iron deficient anemia. I am supposed to be taking iron pills but they make me sick. These symptoms describe me perfectly... Some of the symptoms are: Pale skin color, fatigue, irritability, dizziness, weakness, shortness of breath...

Sometimes this can be very debilitating.. it makes getting through the day very difficult at times.

[benshelpmeet]

sister Ruth,

You are so welcome Ruth. Bro. Ben is anemic and he's so cold in the winter. I thought I would look into a natural cure or at least healpful things I can do to help him.

After reading this I think I might be anemic too. I have... some of these symptoms...fatigue, irritability, dizziness ( sometimes ), weakness, shortness of breath , ( no sore tongue though , brittle nails, decreased appetite,( no headache - frontal. ) quote: Each individual will not experience all the symptoms and if the anemia is mild, the symptoms may not be noticeable. After having 8 children it's likely that I am anemic.... I'm going to beef up on my broccli, spinich, rasians, eggs, Vitamin B-12 , folic acid,
Vitamin C , Vitamin E and B-6 . And feed Bro. Ben the same. This will be good for the children too to eat more of these iron rich foods.

Love, ~ Darlene ~

[blessed]

Thank you for all your hard work in research Sister Darlene. I'm sure your post will be very helpful for many of us.

Anemia is very Common in women who have had more than 3 babies. Many of us who prefer a Simple life-style don't realize this. If you have a local midwife she May be able to test your hemoglobin with a finger stick much like the devices used for checking blood sugar. I had one when I Was doing that and it was part of the regular checkups. (sorry about some of the odd punctuation etc. I'm writing on a tablet and it has to recognize my handwriting) Any way, I Could also bring in a blood sample to the clinic and they would test it for $20.00.

So check out your local midwife if any of you are interested.

Also, Colon Cancer is the second leading Cancer killer in the U.S. If Someone is middle aged and anemic especially a man who usually eats a normal amount of red meat, One of the first Concerns is Colon Cancer. I don't say this to cause alarm but it is worth thinking and praying about.

while liver is a very good source of iron I prefer to avoid it... I know everyone else likes it and I'm in the minority here. The reason I avoid it, especially in concentrated capsules is because the liver works a lot like the oil filter in a Car. It filters toxins out of the blood. These toxins Can come from food eaten, medicine Such as Tylenol and even from the environment. when we eat an animal's liver, we are also ingesting the toxins. I don't know of any medical studies done on this. I would Just use some Caution especially for pregnant women.

Again, thank you for the great topic!


Joanne

[glenda]

Thanks for all the information sister Darlene. i am also iron diff. And well I think i am going to read this information and see what i can change in my life....

glenda

[Sister Penny]

Dear Sister Darlene,
I wish I had read this thread..where was I??? I was just recently diagnosed with Anemia, I have never had anemia or any "iron" issues ever..but since this med therapy for the Rheumatoid Arthritus..I take a DMARD, which is refuted to alter the way your body uses folic ace, which is necessary for cell growth...it supresses the immune system and makes it a lot longer to heal..but it also helps with the effects of RA and sometimes stope the painful swollen joints and reduce the RA's disease activity.

In any event..we are not vegans here but do try to use fresh greens in our salads and your posting sure helps educate me even more.

Thank you again!!!

God bless,
Sister Penny

[benshelpmeet]

Dearest sister Penny,

So sorry to hear you are anemic. Bro Ben is anemic to a bit, I think it might be from his Arthritis meds. Beets are a good source of iron if you like them.

We are not Vegan either. We also love veggies and greens. We eat a good amount of varied fruits and veggies.

Bro Ben was given this rub on stuff from a preacher we know, it is made from the Balsam fruit. This man has the seeds and grows this cucumber looking plant, you pick the fruit before it turns orange, you slice it into a mason jar and pour alcohol over it screw on the lid and let set 1 month at least, you can use the same fruit for another batch. You rub it on your aching joints it has been helping Ben's joints, I had a sore arm and it worked on that too. Just a plant can help arthritis pain...how neat! I do not know if it works for everyone but it sure is worth a try. You can get this veggie from a Mexican or Oriental Market. Ben is trying to do internal things too. He is taking 2 Tb of Cod Liver Oil twice a day on an empty stomach he seems to be getting some good results from that as well. We are trusting the Lord for wisdom and healing. God is able!

Love your sister and friend, ~ Darlene ~

bal·sam (bôl“s…m) n. 1.a. Any of several aromatic resins, such as balsam of Peru and Tolu balsam, that contain considerable amounts of benzoic acid, cinnamic acid, or both, or their esters. b. Any of several other fragrant plant resins, such as Canada balsam. c. A similar substance, especially a fragrant ointment used as medication; a balm. 2. Any of various trees, especially the balsam fir, yielding an aromatic resinous substance. 3. See jewelweed.

[Sister Penny]

Dear Sister Darlene,
I am planning on stopping at the local "health food" store to see if they have any of the balsam fruit..that is a new one for me.

I know I have never had any issue with anemia, until recently, as Jeff and I donate blood every 2 months faithfully to the Red Cross...the Dr. recommended I start Ferrous Succinate, which is iron :-)

I am sure my meds for RA have been the culprit with a great deal of the recent new health issues..Azulfidine is the one I take now..that will run out next week, then I switch to Methotraxate, which is most commonly used for Cancer treatment in higher doses, it's once a week versus 6 pills a day...

Does Brother Ben get a good deal of relief from the Balsam ointment? If there is any way you can post the address of the person who has the seeds, I most certainly will give them a try to grow!

God bless,
Sister Penny

[benshelpmeet]

Dear sister Penny,

The Bro that gave us the bottle, is kind of particular about giving this stuff out. He first asked us to bring him a bottle of alcohol then he would give us a bottle of the stuff, we were to try it if it worked he then would give us more. We have not even finished the first bottle yet. We have not even asked for the seeds yet.

He told us we could get the fruit from the Oriental or Mexican markets and you can get seed from the fruit it's self. I do not have his address. I can talk to him next time I see him.

I would try getting some of the fruit in your area and dry out the seeds to plant and make the solution with the fruit and alcohol. It's worth a try.

This seems to be a temporary help so far.

Ben was strongly advised to take the Methotraxate, but with much prayer and study we decided it was too risky of a drug to take, they have to heavily monitor you, it is very dangerous to take that stuff. I would reconsider. Pray about it study up on the adverse side effects and the damaging side affects.


What are the possible side effects of methotrexate?

• Methotrexate may cause side effects that could be dangerous or life-threatening. Discuss with your doctor the risks and benefits of using methotrexate before starting treatment. Methotrexate has been reported to cause blood and bone marrow problems (fever, chills, sore throat, unusual bruising or bleeding, black, bloody or tarry stools,); lung problems (unexplained shortness of breath, coughing, or wheezing); stomach problems (diarrhea, abdominal pain); sores in or around the mouth; liver problems (yellow skin or eyes, unusual fatigue); kidney problems (blood in the urine; darkened urine, swelling of the feet or legs); and others. Notify your doctor immediately if you develop any of these symptoms.
• If you experience any of the following serious side effects, seek emergency medical attention or contact your doctor immediately:
· an allergic reaction (shortness of breath; closing of the throat; difficulty breathing; swelling of the lips, face, or tongue; or hives);
· joint pain; or
· confusion, unusual behavior, or seizures.
• Other, less serious side effects may be more likely to occur. Continue to take methotrexate and notify your doctor if you experience
· nausea, vomiting, or decreased appetite;
· itching or a skin rash;
· hair loss;
· boils or acne;
· dizziness;
· increased sensitivity of the skin to sunlight;
· headache;
· drowsiness; or
· blurred vision.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.


Side Effects

Methotrexate is a nasty drug in large doses, with numerous side effects, mostly accruing from its inhibition of rapidly dividing cells, such as hair cells, skin cells, blood cells, and gastrointestinal lining cells.



Notable side effects include:

nausea, vomiting, diarrhea, heartburn, and stomach or intestinal bleeding
mouth sores and ulcers
hair loss or thinning
thinning and translucence of the skin
kidney damage
liver damage
lung damage
nerve damage
myelosuppression (decreased bone marrow function)
thrombocytopenia (low platelet counts)
neutropenia (low white blood cell counts)
immunosupression
gritty eyes due to inflammation of the cornea

Even when it is administered in relatively low doses, methotrexate's side effects must be carefully monitored to prevent a host of more severe conditions from developing. Most or all of the side effects can be reduced with a daily intake of 1-5mg of folic acid, which doesn't reduce the effectiveness of the drug. Alcohol, aspirin, and ibuprofen increase some of the side effects, and should be avoided.

In the United States, methotrexate powder is classified as dangerous goods under the Transportation of Dangerous Goods Act and must be declared as such for the purposes of transportation.

Methotrexate is another sarcoidosis medication which is also used to treat other diseases. These include cancer, psoriasis and rheumatoid arthritis. The drug works in a high percentage of people with sarcoidosis (about 60 to 80 percent). However, it takes up to 6 months to relieve symptoms and methotrexate has side effects which can be dangerous or life-threatening.

Methotrexate side effects include:

nausea
mouth sores
an allergic reaction - can affect the lungs (rare)
boils or acne
joint pain

Methotrexate can also kill white bloods cells which are used by the immune system to fight off infection. People taking this drug should have regular blood tests to check white blood cell levels.

Long term use of methotrexate can lead to serious liver problems. If methotrexate is taken for more than 2 years a biopsy should be carried out on the liver to see if there is damage & if this treatment can still be used.

When methotrexate is taken in small doses side effects are usually limited.

Folic acid can be taken to reduce the chances of side effects.

Azathioprine
Azathioprine (brand name: Imuran) is another multi-use drug & is used to treat a number of diseases including rheumatoid arthritis - its is also used with organ transplants. Azathioprine treatment lasts for 6 months or more. Azathioprine can improve the symptoms in about 50 percent of people with sarcoidosis.

Azathioprine side effects include:

nausea
itchy rashes
sore mouth, throat and/or ulcers
skin becomes sensitive to ultraviolet light.
a lowering of white blood cells - regular blood tests should be used to monitor white blood cell levels


I hope this has been of some help to you dear sister, We felt for Ben the risks outweighed the possible benefits. His arthritis is severe, we have tried many drugs over the past 23 years just to find they do not cure the problem and their healing powers do not last, the Rheumatoid Arthritis always comes back and needs further treatment. The meds have side effects that are very disturbing even the mild medication he takes for inflammation just to be able to go to work and provide for his family. It has greatly effected his kidneys and weakened them. And it has not really helped the problem at all but just lessoned the swelling a bit so he can function at work.


He takes 1/2 the dose recommended. We are searching out natural cures. We are seeking out what is malfunctioning in his body to cause the arthritis, so we can treat the problem instead of just treating the symptom witch is only a temporary help with bad side effects which will have to be treated and healed themself.

Natural cures that help the body heal and restore itself are what were seeking out.

May the Lord give us wisdom as we seek him.

Love, ~ sister Darlene ~

[Sister Penny]

Dear Sister Darlene,
I am very nervous about taking this particular med..my sister's husband has a co-worker who took it and developed many of the side effects..none are any I would want.

I have been searching out more natural remedies, I never had a lot of the "health issues" in the past when I stuck to a regime of exercise, lots of water, and herbals..I used cayenne capsules, basically a gelatin filled capsule of cayenned pepper, that keeps the body warm and I rarely had any muscle or joint pain then.

The Methotraxate was explained is some detail from a pamphlet from the Arthritus Foundation and also in the Pharmacist's warning... I still have not decided on if I will take it.

I just don't understand why a physician would put you on a medication that caused blood issues, such as anemia, when I am already anemic now.

Having a sister with Lupus and she has a lot of problems, she does know her meds and what works..Methotraxate was one she was adament about NOT taking...

The flyer said it could work in as little as 3 weeks, with the Azulfidine, I have been on that since March and really no changes that are noticeable..with warmer weather I find I am not as stiff and can use my hands a lot quicker than in the colder months..

Thank you again for all of your advice and the postings... I know of one hispanic grocery store not too far from us here..I will see if they have that fruit..and then get some seeds too!

God bless you and Brother Ben...and your family.

Love,
Sister Penny

[christena]

Wow, well those were some lengthy posts so I didn't get a chance to read them all. I've dealt with iron Def. for years. I've been pregnant every other year and lactacting perty much for the last decade.

I am delighted to report that simple changes can be made that really prevents anemia!

I ditched all the plugging up iron pills the nurses and doctors always shoved at me and began reseraching practical things...and those ole home remedys really work well.

Biggest tip to keeping up not just my iron but the whole familys was cooking as much as possible in CAST IRON skillets and the like.

I also try to consume those iron rich foods that also includes beans and well the list is quite long.

You can purchase liquid iron from any decent health food stores and when you konw your levels are too low you may take the suggested dosage with orange juice to bring it up.

I have a 6mth baby girl and throughout my pregnancy my iron stayed fine thereafter and remained fine by just doing these simple things so give it a try for iron issues folks.

Blessings,
Christena