American Medical Association Family Medical Guide - American Medical Association [364]
After your anemia has cleared up, the doctor may recommend that you continue to take iron supplements for a few more months to build up your body’s iron reserves. If the cause of the anemia was a poor diet or inadequate absorption of iron, your doctor will recommend changes in your diet to increase your intake of iron. Further treatment will depend on the cause of the iron deficiency.
Preventing Iron Deficiency Anemia
To reduce your risk of iron deficiency anemia, eat plenty of iron-rich foods—such as lean red meat, fish, poultry, eggs, whole grains, dark green leafy vegetables, dried peas and beans, dried fruit, and nuts and seeds—every day. Because vitamin C makes it easier for the body to absorb iron, eat plenty of foods that are rich in vitamin C—such as oranges, grapefruit, strawberries, tomatoes, bell peppers, broccoli, and cauliflower.
Vitamin Deficiency Anemia
Your body needs an adequate supply of vitamin B12 and folic acid to produce hemoglobin-rich red blood cells, which deliver oxygen throughout the body. A diet lacking these nutrients can lead to vitamin deficiency anemia. Vitamin deficiencies usually develop slowly, over the course of months or years.
Vitamin B12 is vital to maintaining the nervous system and producing red blood cells. The body absorbs vitamin B12 from foods such as lean red meat, poultry, fish, and dairy products. A shortage of vitamin B12 can damage the brain, spinal cord, and peripheral nerves. Vitamin B12 deficiency anemia, also called pernicious anemia, is the most common type of vitamin deficiency anemia. It occurs when the body cannot absorb vitamin B12.
In healthy people, vitamin B12 is stored in the liver. If a person develops an inability to absorb vitamin B12, his or her body will gradually use up the stored vitamin B12, resulting in vitamin B12 deficiency anemia. Surgical removal of a large section of the small intestine (the part of the body where most nutrients are absorbed) and digestive system disorders such as Crohn’s disease (see page 764) may impair the body’s ability to absorb vitamin B12. Pernicious anemia rarely develops before age 40 and affects men and women in equal numbers. If you have a close relative who has pernicious anemia, you are at increased risk of developing the disorder.
Folic acid deficiency anemia usually results from inadequate intake of the vitamin in the diet. Folic acid is found in foods such as green leafy vegetables, whole grains, nuts, and fortified cereals and grains. Because the body cannot store large amounts of folic acid, folic acid deficiency anemia can develop after only a few weeks of inadequate intake.
Although folic acid deficiency anemia is now rare in the United States, it often occurs in people who drink alcohol heavily, people who may not eat a well-balanced diet (such as older people), and pregnant women (because the developing fetus requires large amounts of folic acid). Folic acid deficiency anemia during pregnancy can lead to birth defects of the brain and spine called neural tube defects (see page 398). For this reason, doctors stress that all women of childbearing age (starting in adolescence) who could become pregnant should get 400 micrograms of folic acid each day. People who have celiac disease (see page 768) are at risk of developing folic acid deficiency anemia because their body cannot absorb enough folic acid, no matter how much of the vitamin they eat in foods.
Some healthy people may have a higher-than-normal biological requirement for folic acid, and need to take in more of the vitamin than other people. Folic acid deficiency anemia also may result from long-term use of some medications, such as some antibiotics, immune-suppressing drugs, anticonvulsants, or potassium-sparing antihypertensive drugs.
Symptoms
The main symptoms of vitamin B12 deficiency anemia and folic acid deficiency anemia are abnormally pale skin, fatigue, shortness of breath, and palpitations