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Anaemia affects many of us and the symptoms are all too common. If you're concerned you might be anaemic, read on to discover the common causes and signs.
Always tired, can't be bothered to do things? Maybe you often feel faint, suffer with headaches and breathlessness. Many of these symptoms are indicators of several conditions, so it's important to be on the look out for some more unusual signs of anaemia as well.
What is anaemia?
'Anaemia is a condition where you don’t have enough healthy red blood cells to carry oxygen all around your body,' says Doctor Aragona Giuseppe, GP and medical advisor at Prescription Doctor (opens in new tab). 'The most common cause of anaemia is low levels of iron in the body, this is otherwise known as iron-deficiency anaemia and is quite common. Your body needs enough iron to make haemoglobin, which is the substance that is fundamental in ensuring oxygen is moving around the bodily tissues."
According to the World Health Organisation, anaemia caused by iron deficiency is most common. Women and teenage girls with heavy periods, are at a higher risk of this anaemic due to the high amount of blood loss they experience each month, so it's important to up the intake of iron-rich foods around this time.
Children who were born underweight or prematurely - and who aren't getting enough iron in their formula milk or through breastfeeding - can also be at risk. As can vegetarians and vegans, who may not be getting sufficient iron after cutting high-iron animal products from their diet. People who routinely donate blood, also have a higher chance of being anaemic.
It's not only physical symptoms that are signs of anaemia, the way you feel will tell you a lot about whether you have the condition. 'Most people who are anaemic will feel weak, suffer with extreme fatigue (opens in new tab), have pale skin, chest pain an increased heartbeat or shortness in breath,' says Dr Giuseppe. 'They may suffer with headaches, dizziness or a feeling of light-headedness. Cold feet and hands are also common signs as well as brittle nails or a sore tongue.'
Anaemia signs and symptoms
- Extreme fatigue
- Headache, dizziness or lightheadedness
- Chest pain, fast heartbeat or shortness of breath
- Pale or yellow skin
- Brittle, cracked nails and hair loss (opens in new tab)
- Pica (cravings for things that aren't food, like ice and dirt, are very common signs of anaemia)
- Sore or swollen tongue
- Restless leg syndrom (opens in new tab)e
- Cold hands and feet
- Poor appetite, especially in infants and children with iron deficiency anaemia
These are all signs or anaemia that you'll be sure to notice quickly and it's important to act fast. Especially as things like swollen tongues and hair loss can be signs of more dangerous health conditions.
But how serious is anaemia? 'If anaemia is left untreated it can cause serious health complications due to not having enough oxygen in the body which can ultimately damage your organs,' says Dr Giuseppe. 'When a person has anaemia, the heart works harder to make up for the lack of red blood cells and haemoglobin, this can essentially harm the heart and cause potential heart complications and possibly hearth failure.' So it is crucial that if you are experiencing symptoms you speak to your GP.
Common causes of anaemic
Red blood cells carry oxygen from your lungs to every part of the body, but when there aren't enough red cells the body doesn't get the oxygen it needs - this is the cause of anaemia. If you're being affected by the common causes listed below, you should speak to your GP about anaemia.
1. Heavy periods
There are actually seven different types of anaemia, but of all of them, Iron Deficiency Anaemia (IDA) is the most common. It is most often caused by excessive blood loss due to heavy menstruation (opens in new tab). A huge 57,234 patients were admitted to hospital in 2013 suffering from IDA, costing the NHS a staggering £55.5 million. According to the Ferronomics Report by Vifor Pharma, published in June 2014, many of these admissions are avoidable.
Doctors are now being urged to treat all patients with iron replacement therapy first and if they do not respond to treatment to then refer them for further investigation for conditions like Coeliac and Inflammatory Bowel disorders. The hope is that this will dramatically reduce the number of hospital admissions and see patients diagnosed correctly and treated appropriately.
2. Antacids for chronic indigestion
Antacids used to stop the pain and discomfort of indigestion can often interfere with the body's absorption of iron and lead to gradually worsening anaemia. The level of iron in the blood falls and then you start to use up the iron stores.
3. Constipation treatment
Few people realise that constipation (opens in new tab) is a frequent cause of anaemia, not because of the condition, but as a result of the treatment. Everyone knows that fibre-rich diet (opens in new tab) can ease the problem, but the type of fibre you choose is critical.
There's a lot of hype about bran and high-bran cereals, but for some people wheat bran actually irritates the bowel lining, and it also reduces the amount of iron that is absorbed from other foods.
If you don't think it's helping you, opt for smooth sources of fibre like oats, brown rice and root vegetables. A common consequence of constipation is the development of piles, which may cause blood loss.
Fibre is also really important to avoid other conditions like diverticulitis (opens in new tab), which is often the result of a low fibre diet (opens in new tab). In this instance, smooth fibre sources are also a good go-to as they don't irritate your intestine.
4. Ulcer or hiatus hernia
The drugs used for ulcers and a hiatus hernia - usually Tagamet, Zantac and Omeprazole - can reduce the amount of iron you get into the body. Don't just take iron supplements though, as they can interfere with the benefits of the drugs themselves.
5. Lots of tea and coffee
Drink too much tea and coffee too often and the risk of anaemia increases. General advice is not to drink tea or coffee at mealtimes or for half an hour afterwards. This is because the polyphenols in tea and coffee reduce the amount of iron that can be absorbed from food. The more you drink, the lower your iron stores and though this may not cause anaemia directly, there is a more serious problem if you have any of the other risk factors.
6. Arthritis drugs
Non Steroidal Anti Inflammatory Drugs (NSAIDs) are widely prescribed or bought over the counter for the relief of chronic joint and muscle pain.
Unfortunately, long-term use can damage the lining of the stomach causing small, but persistent blood loss. This may result in anaemia.
7. Some supplements
Some supplements reduce the ability to absorb and store iron. Zinc and iron can interfere with each other and large doses of zinc taken on an empty stomach can significantly reduce iron absorption, and vice versa. Calcium supplements can do the same, so make sure you take calcium and zinc at bed time, as far away from iron rich foods as possible.
Soy is another problem, as the protein and calcium it contains binds with iron from other non-meat foods. But vitamins A, B2, C and beta-carotene can all help to boost your iron levels.
It's not a good idea to start taking iron supplements unless you know the cause of the problem. Extra iron may improve the symptoms but could leave underlying problems to get worse and can also mask the symptoms and lead to unreliable results of blood tests.
You could also have a serious bowel problem such as Crohn's, coeliac or as we've mentioned, diverticulitis. So see your GP for a proper diagnosis.
Anaemia foods: which foods are highest in iron?
'Many types of anaemia cannot be prevented,' says nutritionist, Simone Thomas (simonethomaswellness.com). 'But you can avoid iron deficiency anaemia and vitamin deficiency anaemias by eating a diet that includes a variety of vitamins and minerals.' Iron (opens in new tab) is especially important for those with anaemia as it is helps make red blood cells which carry oxygen around the body.
Food surveys show 46 percent of teenage girls and 23 percent of adult women in the UK have iron intakes below the Lower Reference Nutrient Intake. The same surveys also show that many women fail to meet the recommended dietary target of iron intake in their diets of 14.8mg. So how can you get more in your diet?
Iron-rich foods include:
- Grilled fillet steak — (2.3mg)
- Fried calf liver (12.2mg)
- Mussels (6.8mg)
- Kale (1.7mg)
- Dried figs (4.2mg)
- Soya beans (2.3mg)
- Cooked red lentils (2.4mg)
- Oats (4.72mg)
- Cooked Quinoa (1.5mg)
- Eggs (1.9mg)
- Brazil nuts (2.5mg)
- Canned Chick peas (1.0mg)
- Canned Red kidney beans (1.5mg)
- Curry powder (two tsp = 6g) (58.3mg)
- Dried oregano (two tsp = 2g) (44.0mg)
- Fortified breakfast cereals (bran flakes) (24.3mg)
Foods that are high in vitamin C will enhance your body's ability to absorb iron, if enjoyed at the same time. So, you could consider drinking a glass of orange juice with your meals or adding other foods high in vitamin C to your diet - including citrus fruits, tomatoes, melon and brocolli.
Foods you should avoid
If you're anaemic, there are certain types of food you should avoid as these can disrupt the body's ability to absorb iron. In turn, this will help you prevent your anaemia from getting worse. These foods are:
'These product excess amounts of calcium which can interfere with iron absorption,' says Simone. Foods high in calcium include milk, cheese, yogurts, nuts and bananas.
Tannins, which are present in foods such as tea and coffee, dark chocolate and grapes can also interfere with iron absorption.
This includes legumes, brown rice, wholegrain wheat and nuts. Phytates usually bind with iron in the digestive tract and prevent its absorption.
This is found in wheat, rye and barley, and may damage the intestinal wall, preventing iron and folic acid absorption which are required to produce red blood cells.
These significantly inhibit the body's ability to absorb iron and can be found in foods like cocoa, coffee, apples, spices and walnuts.
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Rose Goodman joined Future Publishing in 2020 and writes across print titles and websites such as Woman&Home, GoodtoKnow and MyImperfectLife.
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