Anemia is broadly understood as a deficiency of red blood cells. The chief role of red blood cells is to grab oxygen from the lungs and deliver it to every nook and cranny in the body. This ensures the survival of our cells.
When the body is anemic, we feel tired and lethargic. Every tissue in the body needs a steady supply of oxygen in order to have fuel and to function properly. Oxygen is one of the ways that we produce energy.
When we talk about anemia, we are really talking about oxygen not getting to where it needs to be.
Because iron supplements are routinely given to those with anemia, many people believe that anemia translates into iron deficiency.
Iron is found in hemoglobin, a transport system within each red blood cell. Oxygen binds to the iron in red blood cells. This is why many of us take iron when we find out that we are anemic. However, taking an iron supplement or even eating extra iron-rich foods assumes that anemia is the result of low iron levels.
Anemia and Its Relationship with the Gut
Anemia is the result of a deficiency in red blood cells and can lead to exhaustion. To get to the root cause of anemia, it’s critical to focus on stomach and gut health to naturally support healthy red blood cell levels.
Anemia is complex, and there is no one mechanism behind it. In order to properly address anemia, it’s essential to understand what is causing it in the first place. The multiple reasons behind anemia can be divided into 4 categories:
- The body fails to produce enough red blood cells or hemoglobin.
- The body destroys too many red blood cells.
- Loss of blood from trauma, menstrual disorders like heavy bleeding or endometriosis, and chronic inflammatory disorders.
- Fluid overload from excessive sodium intake or pregnancy.
When the body fails to produce fully mature red blood cells, this can be due to a number of reasons, including nutrient deficiency. And we are not only talking about iron!
When the body does not have enough vitamin B12, it’s unable to manufacture healthy red blood cells.
And while it’s not often talked about, B12 deficiency is fairly common. For example, one study found that 40% of people between the ages of 26 and 83 have low levels of B12. (1)
When we look at the possible underlying causes of a B12 deficiency, this percentage is a little less surprising.
You may be deficient in B12 if you:
- Are vegan or vegetarian
- Suffer from low stomach acid
- Take an antacid medication
- Drink alcohol regularly
- Suffer from “leaky gut”
- Are prone to gut infections, cramping, and bloating
- Struggle with irritable bowel disease (IBD), ulcerative colitis, or Crohn’s disease
One of the main factors contributing to B12 deficiency is poor gut health.
This means that even if you eat meat, which contains B12, several times a day, you may not be digesting it well enough to absorb the B12 that your body needs to produce red blood cells.
B12 is important for other reasons besides the production of red blood cells. For example, it also helps to make the myelin sheath that surrounds portions of the nerve cells. This is one reason why B12 deficiency is associated with memory loss and psychiatric disorders.
Anemia of Chronic Disease
Sometimes we have plenty of iron, but we still do not have enough red blood cells or hemoglobin. This is the case in anemia of chronic disease.
Anemia of chronic disease is sometimes easy for a physician to miss. This is because on a lab panel, all the classic markers indicating iron-deficiency anemia are there: low red blood cells (RBCs), low hemoglobin, and low iron.
This is why it’s essential to check ferritin levels if you know that you are anemic. Especially if you are fighting an infection, or if you have an immune system disorder.
Ferritin is a storage form of iron. This means that oxygen cannot bind to it. When ferritin levels are elevated, the body may in fact have enough iron – only the iron is inactive and unavailable.
More importantly, ferritin is involved in the inflammatory response. This means that when ferritin levels are elevated, it indicates that there is inflammation occurring somewhere in the body. Elevated ferritin tells us that the body is storing iron in order to protect and limit infection. Like us, infectious bugs, bacteria, and parasites need iron to proliferate and grow!
Anemia of chronic disease can often happen in those with an autoimmune condition or with a low-grade gut infection. If you are anemic with high levels of ferritin, an iron supplement can simply make matters worse.
If Iron Supplements Aren’t Working for You…
In the case of anemia from vitamin B12 deficiency or anemia of chronic disease, gut health is the top priority.
If lab tests confirm that levels of vitamin B12 are low or that ferritin levels are askew, iron supplements may not necessarily improve anemia. Worse, they may even feed an infection in the body.
1. If you have anemia, focus on the stomach:
When correcting digestion and its relationship to anemia, it’s critical to begin in the stomach.
Remember, anemia from vitamin B12 deficiency is commonly found in those with too little stomach acid, heartburn, and those who are on antacid medication.
An HCl (hydrochloric acid) supplement that is equipped with enzymes to break down protein can ease the digestive burden on the stomach and help to restore the proper pH of gastric juices. This is an important first step in correcting poor absorption of vitamin B12.
2. If you have anemia, focus on the gut:
If ferritin levels are high, this means that the body is stockpiling inactive iron as a protective mechanism. While elevated ferritin indicates that the body has plenty of iron, it also tells us that the body is inflamed and that it may be fighting off an infection.
Meanwhile, when levels of both iron and ferritin are low, this may indicate poor absorption and possibly an imbalanced inner ecosystem. This is why those with gut disorders are also frequently anemic.
Whether ferritin levels are elevated or low, cover your bases and make sure that your gut is in a state of perfect health. By introducing fermented foods into the diet on a daily basis, you can gently heal the gut and promote a beneficial inner ecosystem. Fermented foods and probiotic beverages are predigested, full of enzymes, and brimming with friendly bacteria.
When anemia follows poor absorption or inflammation, this is a significant first step in supporting optimal levels of red blood cells.