Are you tired and weak? Do the linings of your lower eyelids look pale? If so, you could be anemic. But what does that mean? It means that either your red blood cells or the amount of hemoglobin (oxygen-carrying protein) in your red blood cells is low.
Iron-deficiency anemia is the most common form of anemia. In the United States, 20 percent of all women of childbearing age have iron-deficiency anemia (compared to 2 percent of adult men). The primary cause is blood lost during menstruation. But eating too few iron-rich foods or not absorbing enough iron can make the problem worse. (The recommended daily allowance for iron ranges from 6 milligrams (infants) to 30 milligrams (pregnant women). Yet one government source found that females between 12 and 50 years old, those at highest risk for iron-deficiency anemia, get about half of what they need). Pregnancy, breast-feeding a baby, and blood loss from the gastrointestinal tract (either due to ulcers or cancer) can also deplete iron stores. Older persons who have poor diets, especially when they live alone, often have iron-deficiency anemia.

Folic-acid deficiency anemia, another type of anemia, occurs when folic-acid levels are low, usually due to inadequate dietary intake or faulty absorption. The need for this vitamin more than doubles during pregnancy.

Other less common forms of anemia include pernicious anemia (inability of the body to properly absorb vitamin B12), sickle cell anemia (an inherited disorder), and thalassemia anemia (also inherited).

Alcohol, certain medicines, and some chronic diseases can also cause anemia.

Self-Care Tips

The first step in treating iron-deficiency anemia is to pinpoint the cause. If it's due to a poor diet, you're in luck: Iron deficiency anemia is not only the most common form of anemia, it's the easiest to correct if it's due to being female or taking in inadequate amounts of certain foods. Folic acid vitamin supplements may also be necessary.
You may need to:

**Eat more food that are good sources of iron. Concentrate on green, leafy vegetables, lean, red meat, beef liver, poultry, fish, wheat germ, oysters, dried fruit, and iron-fortified cereals.
**Boost your iron absorption. Foods high in vitamin C, such as citrus fruits, tomatoes, and strawberries, help your body absorb iron from food. And red meat not only supplies a good amount of iron, it also increases absorption of iron from other food sources.
**Don't drink a lot of teaÑit contains tannins, substances that can inhibit iron absorption. (Herbal tea is okay, though).
**Take an iron supplement. (Consult your physician for proper dosage). While iron is best absorbed when taken on an empty stomach, it can upset your stomach. Taking iron with meals is less upsetting to the stomach. [Note: Recent research is suggesting that high levels of iron in the blood may increase the risk for heart attacks. Do check with your doctor before taking iron supplements.]
**Avoid antacids, phosphates (which are found in soft drinks, beer, ice cream, etc.) and the food additive EDTA. These block iron absorption

Women's Health: Anemia

Are you tired and weak? Does the lining of your lower eyelids look pale?
If so, you could be anemic. But what does that mean?

It means that either your red blood cells or the amount of hemoglobin (oxygen-carrying protein) in your red blood cells is low.

There are several types of anemia:

Iron-deficiency anemia is the most common one. In the United States, 20 percent of all women of childbearing age have iron-deficiency anemia, compared to only 2 percent of adult men. The primary cause is blood lost during menstruation. But eating too few iron-rich foods or not absorbing enough iron can make the problem worse. The recommended daily allowance for iron ranges from 6 milligrams for infants, to 30 milligrams for pregnant women. Yet one government source found that females between 12 and 50 years old (those at highest risk for iron-deficiency anemia), get about half of what they need. Pregnancy, breast-feeding and blood loss from the gastrointestinal tract, either due to ulcers or cancer, can also deplete iron stores. Older women who have poor diets, especially when they live alone, often have iron-deficiency anemia.

Folic-acid deficiency anemia (megaloblastic anemia), occurs when folic-acid levels are low, usually due to inadequate dietary intake or faulty absorption. The need for this vitamin more than doubles during pregnancy. This is often not met by diets of pregnant women, so a supplement of 400 micrograms (mcg) to 1 milligram (mg) per day of folic acid is recommended throughout pregnancy. You should even take this supplement when you plan to become pregnant. Adquate folic acid should be in your system when you conceive and during the first month you are pregnant. Low folic acid intakes have been associated with low birth weight and neural tube defects, such as spina bifida in babies. Folic-acid deficiency can lead to infertility and an increased risk of infection. Also, a deficiency of this vitamin is seen frequently among elderly women, especially those who have poor diets.
Other, less common forms of anemia include:

*Pernicious anemia - the inability of the body to properly absorb vitamin B12..
*Hemolytic anemia - when red blood cells are destroyed prematurely.
*Sickle cell anemia - an inherited disorder that occurs primarily in blacks, which affects the red blood cells’ ability to carry oxygen to the body’s tissues.
*Thalassemia anemia - an inherited disorder in the synthesis of hemoglobins (substances that carry oxygen). It is also known as Mediterranean Disease.
*Aplastic anemia - a serious disease of decreased bone marrow production. Alcohol, certain drugs, large amounts of aspirin and some chronic diseases can also cause anemia.

[Note: Keep in mind that fatigue is often the first symptom of pregnancy.]

Treatment

The first step in treating anemia is to pinpoint the cause. When it results from disease, such as a peptic ulcer, you will need to follow your doctor’s advice to get the condition under control. If it’s due to a poor diet, you’re in luck: Iron deficiency anemia is not only the most common form of anemia, it’s the easiest to correct if it’s due to heavy periods or taking in inadequate amounts of certain foods. Folic acid vitamin supplements may also be necessary. See self-care procedures below.

You may need to:

*Eat more foods that are good sources of iron.
*Concentrate on green, leafy vegetables, lean, red meat, beef liver, poultry, fish, wheat germ, oysters, dried fruit and iron-fortified cereals.
*Boost your iron absorption.
*Foods high in vitamin C - like citrus fruits, tomatoes and strawberries - help your body absorb iron from food.
*Red meat not only supplies a good amount of iron, it also increases absorption of iron from other food sources.
*Limit the use of tea. It contains tannins, substances that can inhibit iron absorption. Herbal tea is okay though.
*Take an iron supplement.
-Consult your physician for proper dosage.
-While iron is best absorbed when taken on an empty stomach, it can upset your stomach. Taking iron with meals is less upsetting to the stomach.
[Note: Recent research is suggesting that high levels of iron in the blood may increase the risk for heart attacks. Do check with your doctor before taking iron supplements, especially if you have already gone through menopause.]

*Avoid antacids, phosphates (which are found in soft drinks, beer, ice cream, candy bars, etc.) and the food additive EDTA. These block iron absorption.
*Increase dietary fiber to prevent constipation.
*Avoid aspirin and products with aspirin.

To get and/or make the best use of folic acid:

*Eat good food sources of folic acid daily.
-These include vegetables like asparagus, brussels sprouts, spinach, romaine lettuce, collard greens and broccoli.
-Black-eyed peas, cantaloupe, orange juice, oatmeal, whole grain cereals, wheat germ, liver and other organ meats are excellent sources also.
-Eat fresh, uncooked fruits and vegetables often. Don't overcook food. Heat destroys folic acid.
*Take a multi-vitamin supplement daily that has 100% of the RDA for folic acid.
*Don't smoke. Smoking increases vitamin needs.
*Don't drink alcoholic beverages

Dangers of Iron Supplements

Iron is unique among essential minerals, because there is no mechanism for its excretion once absorbed into the body. Whatever iron is absorbed must either be used or stored and excessive storage of iron in the body promotes the generation of free radicals. Excess dietary iron has been implicated by some scientists as a cause of cancer and heart disease. It also increases the risk of bacterial infection.
Except for the lactic acid bacteria like Lactobacilli, all microbes require iron for growth. Many of them produce special binding proteins to secure iron from their environments. Humans also produce iron-binding proteins which have as their role the capture of free iron so that microbes can't use it. An excess of iron overcomes this protective mechanism and in-creases susceptibility to bacterial infection. The amount of iron needed for optimal health reflects a delicate balance between deficiency and excess.

The best known effect of iron deficiency is anemia, which is the name given to a state in which the number of red blood cells is lower than normal. Anemia is not the same as iron deficiency, however. There are many different causes of anemia, which include folic acid deficiency, vitamin B12 deficiency, disorders of the bone marrow and conditions which increase the rate at which red blood cells are broken down in the spleen. Iron deficiency, when mild, may not produce anemia but may still cause fatigue, im-mune de-fects or fungal infections of skin. There are probably twenty million people in the U.S. who are iron deficient and half of them are not anemic. Wom-en with chronic fatigue and mild iron deficiency who are not anemic improve their energy after taking low doses of iron. Twenty milligrams per day is all that's needed, no more. Low-dose iron supplements can cure people with recurrent boils on the skin, but only if those people have mild iron deficiency. Presumably, correcting iron deficiency improves metabolism and immunity.

It is unfortunate that most commercial iron pills contain sixty to three hundred milligrams of iron, far more than are needed or than can even be absorbed from a single pill. High dose iron supplements, taken orally or by injection, increase susceptibility to bacterial infec-tion. Studies in southeast Asia and in Africa demonstrate that even low-dose iron can be harmful. When Indonesian school children who are not iron deficient take iron pills, they fail to grow normally. When iron supplements are given to Somali nomads or Masai tribes-man, their rate of infection increases, even though their iron deficiency is corrected. The high frequency of negative responses to iron supplements in Africa and Asia may reflect the interaction between iron and zinc.

Iron in food or pills interferes with zinc absorption and supplemental iron can aggravate zinc deficiency. The recommended daily allowance for zinc (RDA) is based on the assumption that forty per cent of the zinc that is swallowed is absorbed into the body. Actually, zinc absorption is only seventeen to thirty-five per cent and depends upon what is eaten along with zinc. Starch and fiber interfere with zinc absorption, as do calcium and iron. Lack of stomach acid, which may be caused by infection or acid-lowering drugs, also interferes with zinc absorption. Zinc deficiency is common in Africa and Asia, where people consume large quantities of milk, which is high in calcium and low in zinc, and of starches and fibres which inter-fere with zinc absorption. Zinc deficiency profoundly depresses immunity and administering iron to a zinc-deficient person is extremely risky. Not only does iron stimulate bacterial growth, but, by aggravat-ing zinc deficiency, it weakens the immune system of the person being supplemented.
No one should ever take iron supplements unless iron deficiency is present, with the possible exception of pregnant women. The best test for iron deficiency is a blood test called the serum ferritin level. Ferritin is a protein that carries iron, and low ferritin levels are a common sign of iron deficiency. Like all laboratory tests, the interpretation of ferritin levels is subject to interpretation. Because the body has a limited capaci-ty for iron absorption, it does not make any sense to administer more than twenty milligrams of elemental iron at a time. Iron should not be taken as part of a multivitamin or multimineral preparation. Iron interferes with the absorption of the essen-tial minerals zinc, manganese and molybdenum; it destroys vitamin E; its own absorption is blocked by calcium and magnesium. Iron is best absorbed after a meal, with a small quantity of vitamin C (between one hundred and five hundred milligrams).