Anemia: Types and Nutritional Treatment

Quick Answer

Anemia is a deficiency in red blood cells or hemoglobin. Most common types: iron deficiency, B12 deficiency, and folate deficiency. Treatment depends on type: iron-rich foods (meat, leafy greens), B12 sources (meat, animal products), and folate (green vegetables, legumes). Accurate diagnosis is essential before treatment.

Introduction: What is Anemia and Why Does It Occur?

Anemia is a condition in which the number of healthy red blood cells or the amount of hemoglobin - the protein that carries oxygen - in the blood decreases. The result: body organs don't get enough oxygen, causing fatigue, dizziness, shortness of breath, and other symptoms.

Anemia is not a single disease, but a group of conditions each with different causes and treatments. Nutrition plays a pivotal role in prevention and treatment for most types.

Main Types of Anemia

1. Iron Deficiency Anemia (Most Common)

Causes:

• Diet poor in iron
• Blood loss (heavy periods, ulcer, hemorrhoids)
• Pregnancy and breastfeeding
• Poor iron absorption (intestinal diseases)
• Rapid growth (children, teenagers)

Symptoms:

• Severe fatigue and exhaustion
• Pale face and nails
• Cold hands and feet
• Brittle nails and hair loss
• Craving for strange things (ice, dirt)
• Tongue inflammation and cracks in mouth corners

2. Vitamin B12 Deficiency Anemia

Causes:

• Strict vegetarian diet
• Lack of intrinsic factor (pernicious anemia)
• Stomach or intestinal diseases
• Stomach surgeries
• Some medications (metformin, antacids)

Symptoms:

• Fatigue and general weakness
• Numbness and tingling in hands and feet
• Difficulty walking and balancing
• Memory and concentration problems
• Red and glossy tongue
• Depression and mood changes

3. Folate Deficiency Anemia

Causes:

• Diet poor in vegetables
• Pregnancy (doubled needs)
• Alcohol addiction
• Some medications (anti-epileptics)
• Intestinal diseases preventing absorption

Symptoms:

• Fatigue and weakness
• Pallor
• Shortness of breath
• Irritability and concentration problems
• Diarrhea and loss of appetite

4. Other Types

• Sickle cell anemia: Hereditary, requires specialized medical follow-up
• Thalassemia: Hereditary, common in Mediterranean and Middle East
• Hemolytic anemia: Early breakdown of red blood cells
• Anemia of chronic disease: Associated with cancer, kidney disease, chronic inflammation

Diagnosis: Necessary Tests

Don't self-treat without tests! Accurate diagnosis determines treatment:

• Complete Blood Count (CBC): Measures hemoglobin, cell size, cell count
• Iron stores (ferritin): Detects iron deficiency even before anemia appears
• Serum iron and iron binding capacity: More precise iron status assessment
• Vitamin B12 and folate: Direct blood tests
• Additional tests: Depending on condition (intrinsic factor test, genetic tests)

Treatment of Iron Deficiency Anemia

Iron-Rich Foods

There are two types of iron:

1. Heme iron (from animal sources - better absorbed):

• Liver (highest source): 100g = 18 mg iron
• Red meat: 100g = 2.5 mg
• Chicken and turkey (dark meat): 100g = 1.5 mg
• Fish (sardines, tuna): 100g = 2 mg
• Oysters and shrimp: 100g = 3 mg

2. Non-heme iron (from plant sources - lower absorption):

• Cooked spinach: 1 cup = 6 mg
• Lentils: 1 cooked cup = 6.5 mg
• White beans: 1 cup = 5 mg
• Chickpeas: 1 cup = 4.5 mg
• Quinoa: 1 cup = 2.8 mg
• Sweet potato: 1 large = 2 mg
• Dried apricots: half cup = 2 mg
• Raisins: half cup = 1.5 mg

Enhancing Iron Absorption

Consume vitamin C with iron:

• Orange or lemon juice with meals
• Red or green peppers
• Fresh tomatoes
• Strawberries and kiwi

Vitamin C increases plant iron absorption by 3-4 times!

Avoid absorption inhibitors:

• Tea and coffee: Drink them at least two hours after meals
• Dairy products: Calcium prevents iron absorption - consume separately
• Whole grains and legumes: Soaking and cooking well reduces phytates that inhibit absorption

Iron Supplements

If deficiency is severe, doctor may prescribe supplements:

• Dose: Usually 100-200 mg elemental iron daily
• Timing: On empty stomach is best, or with vitamin C
• Side effects: Constipation, nausea, dark stool (normal)
• Duration: 3-6 months to replenish stores

Tips to reduce side effects:

• Start with low dose and increase gradually
• Take with little food if necessary
• Drink plenty of water
• Increase fiber to prevent constipation

Treatment of B12 Deficiency Anemia

Foods Rich in Vitamin B12

B12 is found only in animal sources:

• Liver (highest source): 100g = 80 mcg
• Clams: 100g = 20 mcg
• Sardines: 100g = 8 mcg
• Salmon and tuna: 100g = 3 mcg
• Beef: 100g = 2.5 mcg
• Eggs: 1 large = 0.6 mcg
• Milk: 1 cup = 1.2 mcg
• Cheese: 100g = 1-2 mcg

For vegetarians:

• Fortified soy milk
• Fortified breakfast cereals
• Fortified nutritional yeast
• B12 supplements are necessary!

B12 Supplements

Depending on condition:

• Mild deficiency: 1000 mcg tablets daily
• Severe deficiency or malabsorption: B12 injections monthly
• Vegetarians: Daily supplement 10-25 mcg or weekly 2000

Treatment of Folate Deficiency Anemia

Foods Rich in Folate

• Cooked spinach: 1 cup = 260 mcg
• Liver: 100g = 290 mcg
• Lentils: 1 cup = 360 mcg
• Black beans: 1 cup = 256 mcg
• Asparagus: 4 spears = 89 mcg
• Broccoli: 1 cup = 104 mcg
• Avocado: 1 medium = 120 mcg
• Orange: 1 large = 55 mcg
• Fortified bread: 1 slice = 40 mcg

Note: Cooking destroys 50-90% of folate. Eat some vegetables raw or lightly cooked.

Supplements for Pregnant and Planning Pregnancy

• 400-800 mcg daily one month before conception
• Continue throughout pregnancy to prevent neural tube defects

Meal Plan for Treating Anemia

Breakfast (Options)

Option 1:

• Boiled eggs (2) + fortified whole wheat bread
• Cooked spinach with tomatoes
• Fresh orange juice

Option 2:

• Iron-fortified breakfast cereal + milk
• Sliced banana and strawberries
• Handful of almonds

Lunch (Options)

Option 1:

• Grilled liver (100g) + onions and peppers
• Rice or potatoes
• Green salad with lemon

Option 2:

• Grilled salmon
• Lightly cooked broccoli and carrots
• Baked sweet potato

Dinner (Options)

Option 1:

• Lentil soup with lemon
• Whole wheat bread
• Spinach and tomato salad

Option 2:

• Beef with vegetables
• Quinoa or bulgur
• Yogurt with fruits

Snacks

• Dried apricots and raisins
• Hummus with tahini
• Raw nuts
• Apple with peanut butter

Practical Tips for Daily Life

1. Cook in iron pots: Increases iron content in food by 15%, especially acidic foods.
2. Don't skip meals: Your body needs regular nutrient supply.
3. Vary sources: Don't rely on one food - vary to ensure better absorption.
4. Patience required: Hemoglobin rises slowly (0.5-1 point weekly).
5. Follow up with doctor: Regular tests every 4-8 weeks until recovery.

Special Cases

Anemia in Pregnancy

Iron needs double:

• Iron: 27 mg daily
• Folate: 600-800 mcg
• B12: 2.6 mcg
• Supplements under medical supervision necessary

Anemia in Children

• Breastfeeding + additional iron from 4-6 months
• Iron-rich foods when introducing solid food
• Avoid cow's milk before one year (prevents iron absorption)

Anemia in Vegetarians

• Focus on plant iron + vitamin C
• B12 supplements mandatory
• Legumes and whole grains daily

When to See Doctor Immediately?

• Severe fatigue not improving with rest
• Shortness of breath with minimal effort
• Frequent dizziness and fainting
• Chest pain or palpitations
• Obvious bleeding (heavy periods, black stool)
• No improvement after 2-3 months of treatment

Conclusion: The Healing Journey Starts from Your Plate

Anemia is a common condition but treatable. Most cases respond excellently to proper nutrition and appropriate supplements. The key is accurate diagnosis, treatment adherence, and regular follow-up.

Remember: every meal rich in iron and vitamins is a step toward better energy, higher concentration, and stronger health.

Frequently Asked QuestionsHow long until anemia improves?

With appropriate treatment, symptoms start improving within 1-2 weeks. Hemoglobin returns to normal within 6-8 weeks. But replenishing iron stores requires 3-6 months of continuing treatment.Can I rely on food alone without supplements?

In mild cases, yes. But moderate to severe deficiency requires supplements because food alone won't compensate the deficiency fast enough. Consult your doctor to determine need.Why doesn't anemia improve despite taking iron?

Possible reasons: ongoing undetected bleeding, malabsorption, taking iron incorrectly (with tea/milk), wrong type (not iron deficiency but B12), or underlying chronic disease. See your doctor for reassessment.Are tea and coffee completely forbidden?

Not forbidden, but should be consumed away from iron-rich meals (at least two hours). You can drink them between meals without worry.Is anemia dangerous if untreated?

Yes, severe untreated anemia can cause: heart problems, dangerous pregnancy complications, growth delay in children, weak immunity, and neurological problems (especially B12 deficiency).Should I take iron supplements for life?

Not necessarily. After correcting deficiency and replenishing stores, you can rely on food to maintain levels. But some cases (heavy periods, repeated pregnancy, vegetarians) may need simple maintenance dose.Is spinach the best iron source?

No, this is a myth. Spinach contains good iron but also contains oxalates that prevent its absorption. Liver and red meat are much better. Spinach is beneficial but not the best.

Medical Disclaimer

This article is for educational purposes only and does not replace specialized medical consultation. Anemia has multiple causes requiring accurate diagnosis with laboratory tests. Do not start taking iron or any vitamin supplements without consulting a doctor, as iron excess is dangerous. Some types of anemia are hereditary or caused by serious diseases requiring specialized treatment. See a doctor for appropriate diagnosis and treatment.

Need a Dietary Plan to Treat Anemia?

Dr. Mai Obeid - Clinical Dietitian

For appointments and inquiries: +961 81 337 132