I went to my GP, complaining of shortness of breath on exercise. The results of a blood test showed I was anaemic. I am a very health-conscious female, do not drink and rarely eat meat. Why have I developed this and what can I do to prevent its recurrence?
Conventional remedy:
There are many causes for anaemia, but iron deficiency is probably the most common.
Iron is one of the essential chemicals of haemoglobin, the red pigment in red blood cells that carries oxygen to all parts of the body. If iron is deficient in the body, the production of haemoglobin is reduced and the red cells are weakened, causing anaemia.
There may be no symptoms at first. Tiredness, weakness, faintness or shortness of breath on exercise can occur. Symptoms of anaemia result from the shortage of oxygen being carried to the cells in the body.
In older people, angina - heart pain - can result from anaemia. The skin and lining of the mouth may look pale because of low haemoglobin in the blood.
Your doctor has made a diagnosis of anaemia based on the results of your blood tests. The next step is to pinpoint the cause.
The most common reason for low iron supplies in the body is loss of blood. This can be as a result of heavy periods or disorders of the stomach and bowel. If you have been pregnant recently, your iron supplies may be low as a result of iron being diverted to your baby. A diet that is low in iron can also cause anaemia.
You mention that you rarely eat meat - which is rich in iron - and this may be contributing to your problem. If you are vegetarian and therefore unable to include red meat in your diet, you should ensure you are getting adequate iron supplies from other dietary sources.
Fish, shellfish, eggs and seeds are high in iron, as are dried fruits, fresh fruit and green vegetables. Iron-fortified breads, dry cereals and oatmeal cereals also provide a good supply of iron.
The treatment of iron-deficiency anaemia involves replacing the iron supplies by means of iron tablets. This allows bone marrow to produce red blood cells with normal amounts of haemoglobin.
It is important to take the iron tablets for approximately three months after the haemoglobin levels have returned to normal.
Your iron levels will be monitored by means of blood tests. Iron can also be given by injection, but this is usually reserved for more serious cases.
Iron treatment does not usually cause any serious side effects, although it may cause indigestion, loose stools or constipation. While on iron treatment it is quite usual to have black bowel motions.
Dr Muiris Houston
Alternative remedy:
There are several types of anaemia, the most common being iron-deficiency anaemia, which is characterised by low haemoglobin levels. Women are more at risk from this type of disorder, as common causes may be heavy periods or the demands of pregnancy and breastfeeding.
While nutrition is of primary importance, it is crucial to ensure that the iron we are taking in the diet is being correctly absorbed. Herbal bitters are very useful in this regard, and very small amounts of gentian, barberry or wormwood can assist greatly, by improving gastric secretions.
Look to the diet and ensure that iron intake is adequate. Dried fruits such as apricots, figs, dates and raisins are excellent and can be added to the morning cereal.
Vegetarians or those who don't like to eat a lot of meat should ensure they consume plenty of fresh greens each day, as well as adding watercress and parsley to salads.
Eat brown bread and brown rice rather than their refined white counterparts. Tea inhibits iron absorption, so it's advisable to keep its intake to a minimum and not consume with a meal if you have any tendency to be anaemic.
Inorganic iron supplements are not as well absorbed by the body and tend to cause constipation. The herbal practitioner can choose from a range of iron-rich plants that will also maintain healthy bowel function.
I would use herbs such as dandelion and yellow dock root. These plants have high mineral contents, in addition to improving liver and bowel function. Raspberry leaf is high in iron and is excellent for women during pregnancy.
One plant abundant in Ireland is nettle, an excellent source of iron and vitamin C, also important for iron absorption. The tradition of making a tonic with spring nettles was to replenish many of the minerals not available to the body during the winter months.
If heavy bleeding during periods is at the root of the anaemia, the herbalist will concentrate on regulating the monthly cycle. When more serious problems have been ruled out, herbal remedies such as shepherd's purse, yarrow and lady's mantle can regulate menstruation and reduce heavy flow.
An iron-rich tonic can be made by infusing 50 grams of young nettle tops and 30 grams of chopped apricots in 750 millilitres of red wine for two weeks. Strain, bottle and take half a wineglassful before a meal - a pleasant way of taking one's medicine for a change!
Helen McCormack, medical herbalist
The Irish Association of Medical Herbalists can be contacted at 061-924268