I have iron-deficiency anemia, should I be concerned?

The red blood cells are found in the blood. About 40 - 45 percent of the blood's volume is made up of red blood cells thus making it the most abundant cell in the blood [3]. Each red blood cell has 200 million hemoglobin molecules and we have a total of 25 trillion red blood cells [4]. The iron that hemoglobin contains is recycled by the red bone marrow.

What are red blood cells (RBCs)?

Red blood cells. Image via pixabay.

Red blood cells are called erythrocytes and they are produced in the bone marrow. The soft jelly-like tissue that is found in the insides of bones is called the bone marrow. Also, there are two types of bone marrow- red and yellow. The red blood cells are produced by the red bone marrow. Additionally, not all bones produce red blood cells in adults. 

How are red blood cells produced?

Initially, red blood cells don't start off as red blood cells! Instead, they start off as blood stem cells that are produced by the bone marrow. Now, these blood stem cells are unspecialized cells which mean that they'll give rise to other blood cells as well as red blood cells.

These stem cells (the ones that will give rise to RBCs) will mature (during maturation hemoglobin will fill these cells and they'll lose their nuclei) in the bone marrow and will eventually give rise to immature red blood cells called reticulocytes. These reticulocytes will leave the bone marrow and enter the bloodstream and will circulate for a day in the blood stream and then develop into mature red blood cells. Once in the bloodstream, these biconcave disc shaped red blood cells will circulate for about 120 days.

A biconcave disc shaped red blood cell.  Image via pixabay.

What is the function of red blood cells?

Red blood cells circulate around the body through the circulatory system. The circulation of the red blood cells occurs for about 120 days and the damaged and old ones are removed from the circulation by macrophages that are located in the spleen and liver [5].

Red blood cells transport hemoglobin, but, what is hemoglobin and its function? Hemoglobin (Hb) is a protein that carries oxygen to the cells of the body (from the lungs to all parts of the body). So, therefore, red blood cells carry hemoglobin and hemoglobin carry oxygen. So in anemia, if the red blood cells are lower then the body will be getting less oxygen and similarly less hemoglobin in the red blood cells will also mean less oxygen.

The function of red blood cells is to supply the tissues and organs with oxygen. The production of red blood cells is regulated by the hormone erythropoietin (produced mainly by the kidneys) and low oxygen levels. The large number of red blood cells that are found in the blood get their color from hemoglobin and that gives blood its red color. The body uses the oxygen it receives to produce energy.

Types of anemia

There are different types of anemia. Some are:

- Iron-deficiency anemia

- Vitamin-deficiency anemia

- Pernicious anemia

- Sickle cell anemia

- Hemolytic anemia

- Aplastic anemia

- Thalassaemia

- Fanconi anemia

- Anemia as a result of pregnancy or by diseases



Iron-deficiency anemia is the most common type of anemia. As the name implies, this anemia results due to a deficiency of iron or in other words having little iron in the body. According to the Iron Disorders Institute, "iron deficiency is the most common nutritional deficiency and the leading cause of anemia in the world."

Iron absorption from the foods that we eat take place in the intestines. Iron is needed to make hemoglobin and without enough iron, the bone marrow can't make enough hemoglobin. Also if parasites are consuming the iron that you take in from your diet then that can also lead to anemia.




Some signs and symptoms are:

• fatigue (feeling tired)
• shortness of breath
• dizziness
• your skin is pale
• weakness
• tinnitus
• sore tongue
• headache
• hair loss
• frequent infections
• restless legs syndrome
• feeling itchy

Note: You are at a higher risk for iron-deficiency anemia if:

• you have heavy period
• you're a vegetarian or vegan
• you donate blood regularly

Iron-deficiency anemia can be caused by:

- The loss of blood
If blood is lost from the body then so is iron. An injury, bleeding in the body, infections, diseases or heavy menstrual bleeding can cause this type of anemia. For example, blood loss by hook worm. This parasitic worm will feed off of blood inside the gut.

- Decreased iron absorption
Disorders like coeliac disease and Crohn's disease can damage the lining of the small intestine. When this happens the absorption of iron is disrupted because there is where iron absorption takes place.

- Consumption of iron is not enough
This happens when we eat too little iron containing foods.

- Pregnancy








1. Education
Education is needed to become knowledgeable on the foods that contain iron because if you don't know them how are you going to choose wisely and consume them.

2. Consume iron in your diet. This can be achieved by:

- consuming iron containing foods

This also means to:

- consume foods that were enriched with iron
The nutrients lost during the manufacturing process are added back to the foods.

Example:
Whole wheat vs white flour
The iron (other nutrients also) lost during the manufacturing process of white flour is added back.


- consume foods that were fortified with iron
Vitamins or minerals (micronutrients) are added to foods in the fortification of foods. These vitamins or minerals were not found naturally in these foods.



Some iron containing foods are:

• organ meats (cow liver, chicken liver, kidneys, heart, gizzard)

Liver. Image via pixabay.

• beef, chicken, pork, turkey, fish

Beef. Image via pixabay.

• seafood (sardines, oysters, clams, mackerel, prawns, mussels)

Oysters. Image via pixabay.

• tofu

Image via pixabay.

• dark green leafy vegetables (e.g. callaloo, spinach)

Image via pixabay.

• blackstrapp molasses

• dark chocolate

Image via pixabay.

• legumes (lentils, beans like kidney beans, lima beans, soybeans, cannellini beans, black beans, chickpeas, black-eyed peas) 

Beans. Image via pixabay.

• pistachios

Image via pixabay.

• spirulina

Image via pixabay.

• pumpkin seeds

Image via pixabay.

• sesame seeds

Image via pixabay.

• whole grains (whole wheat, oats, brown rice, whole grain barley, quinoa)

Image via pixabay.

• potatoes

Image via pixabay.

• beets

Image via pixabay.

• iron fortified cereals, pastas and breads

Pasta. Image via pixabay.

• dried fruits such as raisins and apricots

Raisins. Image via pixabay.

- Consume foods that enhance iron absorption
Vitamin C increases iron absorption. So consume things like orange juice and so on.

- Stay away from foods that make it harder for your body to absorb iron
Foods like:

• walnuts
• almonds
• coffee
• tea
• dairy
• eggs

- Always make sure that you consume iron containing foods each day to meet your daily requirements.
- If you're a vegetarian or a vegan then you should find great alternatives for iron to replace meat.




One recipe that I'm going share with you is a Caribbean liver and gizzard recipe. You can serve/eat this how you like. A delicious way to eat this is the liver and gizzard served on top of brown rice with lentils. A salad on the side with a cold glass of lime aid. This salad is a simple cucumber, tomato, and lettuce raw salad.

Lots of people don't like eating liver simply because they don't like the taste but this recipe is pretty delicious. I prefer the taste of chicken liver as opposed to cow liver and so in this recipe, I'm going to use chicken liver along with chicken and gizzards. The brown sugar used in this recipe will give it a delicious sweet taste.


Ingredients

- 1/2 pound of chicken
- 1 pound of a combination of chicken liver and gizzards
- 2 Tbsp of olive oil
- 2 onions, coarsely chopped
- 8 cloves of garlic, pressed with a garlic press
- 1 Tsp of fresh ginger, grated
- 1 1/2 tsp tomato paste
- 1 1/2 Tbsp of brown sugar
- salt and black pepper to taste/ to your liking
- 1 chili diced (optional)
- chicken seasoning to your liking (use your favorite kind)
- a handful of coarsely chopped, parsley
- green onions, chopped


Instructions

1. Wash your chicken, liver, and gizzard (not applicable if they came washed).
2. Cut your chicken, liver, and gizzard into smaller pieces and season with salt, pepper and chicken seasoning to your liking.
3. Place some oil in a pan and add the brown sugar. Let this cook until all the sugar has melted.
4. Once all the sugar has melted add the chicken, liver, gizzard, and onions into the pan and stir until they are coated with the sugary oil. Let it cook for about a minute. 
5. Add the tomato paste, garlic and ginger and stir once again.
6. Let it cook until cooked. But 2 minutes before it is finished cooking add the parsley and chili and stir.
7. Once finish add the green onions and stir and it's ready to eat.

Note: You can use liver only in this recipe and omit the chicken and gizzard.


Dhal Recipe

I have a dhal recipe that I have posted a while ago. You can read that recipe here.



Ingredients

- 2 tomatoes, chopped
- 1 cucumber, chopped
- lettuce, chopped
- 2 Tbsp of olive oil
- salt and black pepper to taste








Ingredients

- limes, juiced
- water
- sweetener




If poor diet is causing iron-deficiency anemia then you need to start eating iron-rich foods.

Reference

1. Dean L. Blood Groups and Red Cell Antigens [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 2005. Chapter 1, Blood and the cells it contains. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2263/