Paleness, lack of enthusiasm or energy, headaches, loss of libido, inability to concentrate…. you may be suffering from anemia. If anemia has been in place for a long time, other disorders may appear such as shortness of breath or dizziness
Women, children and seniors are most affected
- Menstruation, which is more important under IUD, is the most common cause of ferriprive hypochrome anemia. Vigilance is also required during pregnancy and puberty (quality of dietary intake).
- You should also be wary of regular small bleeding of the nose, gums after brushing teeth
- Children living in precarious conditions are at risk of anaemia. By licking old paints, old pipes, they are sometimes victims of lead poisoning (saturnism) attacking the manufacture of red blood cells.
- In seniors, digestive hemorrhages, esophagitis or simple erosions related to medication (anti-inflammatory drugs, aspirin, anticoagulants) are the most common causes of anemia. Their sometimes insufficient dietary intakes are responsible for deficiencies in iron, vitamin B12 and B9. Long-term treatments with anti-ulcer drugs may also explain vitamin B12 deficiency.
The life of a red blood cell
The synthesis of red blood cells is controlled by erythropoietin, a hormone secreted by the kidneys. The red blood cell is made in the bone marrow along with all other blood cells. It circulates in the blood to provide the cells with the oxygen they need to function and rid them of carbon dioxide. After 120 days, the red blood cell is destroyed by the spleen.Every day, about 1% of red blood cells are renewed.
What is anemia
Anemia is a disease that affects the quantity or quality of red blood cells. It is defined as a decrease in the level of hemoglobin in red blood cells. This drop in levels leads to a decrease in the transport of oxygen within all cells in our body.
In fact, there are several types of anemia. Anemia can result from three main mechanisms:
- Blood loss: Acute or chronic bleeding;
- Decrease in red blood cell production;
- Increased red blood cell destruction (hemolysis).
Iron deficiency anemia (for lack of iron) is the most common anaemia
Classification of anaemia
Anemias are classified into 2 large groups according to the average size of red blood cells (average globular volume or GMV):
- Microcytic anemias (red blood cells smaller than normal):
- Anemia by martial deficiency (lack of iron)
- Inflammatory anemia (iron is sequestered in macrophages)
- Thalassemias (a genetic disease resulting in an abnormality of hemoglobin)
- Normal or macrocytic anemia (normal-sized or larger-than-normal red blood cells):
- Anemias by haemorrhage
- By hyper hemolysis
- Or anemias by hereditary disease (Minkowski-Chauffard spherocyticosis)
- Carential Macrocytician anemias have regenerative (folic acid or vitamin B12 disorders: Biermer’s anemia…)
Clinical signs of anaemia
- Signs common to all anemias
All anaemias manifest themselves by:
- asthenia, weakness, exaggerated fatigue
- tachycardia, palpitations
- a dyspnea of stress, a polypnea
- anomuquent skin pallor
- a heart murmur
- a dizzying sensation or ringing of the ear
- Specific signs by cause
- Iron deficiency anemia: Fragility of dphaners (brittle and concave soft nails, dry and brittle hair). In a more advanced form, dry skin, crack in the lips, signs of atrophy of the digestive lining. Tendency to infections, discrete splenomegaly, eating disorder (pica).
- Inflammatory anemia: Inflammatory syndrome (fever, sweating, altered general condition)
- Vitamin B12 deficiency anemia: atrophy of the mucous membrane that covers the tongue
- Thalassemias: The intensity of anemia varies depending on the type of abnormality. Subictère, staturo-weight delay, bone deformities, mongolian facies, hepato spleenomegaly
- Acute hemorrhagic anemia: signs of hypovolemic shock, visible hemorrhage, presence of blood in the stool…
- Hemolytic anemia: Conjunctival subictère, dark urine, splenomegaly
- Hereditary Spherocytosis: Characteristic triad: anemia, jaundice, splenomegaly- biliary lithiasis, staturo-weight delay with deformation of skull bones
Risk factors for anaemia
Some situations put you at high risk of anaemia:
- A diet deficient in iron, vitamin B9 (folic acid) or vitamin B12. Vegans are at greater risk of a lack of vitamin B12 and iron because they do not consume animal protein.
- The use of certain medications. For example, anti-inflammatory drugs, aspirin, anticoagulants that can cause internal bleeding. Other medications may interfere with the absorption or metabolism of folic acid. As this interaction is well known, people who need to take this type of medication also receive a prescription for folic acid supplements as a preventive treatment for anemia.
- Exposure to certain chemicals, including lead
What causes anaemia?
- Microcytic anemias
- Iron deficiency may be due to adequate intake in infants before iron-poor feeding, in pregnant or lactating women, in isolated and malnourished old men.
- It may also be related to digestive malabsorption (digestive diseases, diets or foods trapping iron)
- Iron deficiency is also found during excessive blood loss (gynecological, digestive, recurrent epistaxis, etc.).
Chronic inflammatory states:
- Infectious diseases (tb, Osler, deep suppuration, AIDS)
- Inflammatory diseases (lupus, rheumatoid arthritis, Horton’s disease, Crohn’s disease)
- Regenerative normocytic or macrocytic anemias
- Externalized or non-externalized acute hemorrhagic anemia
- Hemolytic anemia:
- Constitutional abnormalities of the red blood cell (hereditary spherical, G6PD deficiency, pyruvate kinase),
- Genetic abnormalities of hemoglobin (thalassemia, sickle cell disease)
- Infectious or parasitic (septicemias at Clostridium perfringens, Escherichia coli)
- Toxic (drugs, household or industrial toxics)
- Mechanical (heart damage or large vessels)
- Immunological (allo antibodies, auto antibodies, drugs)
- Aerative anemia in repair
- Aregtive normocytic or macrocytic anemias
Alcoholism, cirrhosis, hypothyroidism or kidney failure can cause aerative anemia.
- Spinal cord (bone marrow)
- related to a lack of folate or vitamin B12 (growth, pregnancy, cancer, alcoholism, gastrectomized, digestive tract diseases, antifolinic drugs, vegans, parasitic infections…)
- Congenital or acquired Erythroblastopenia (cancers, leukemias, ionizing radiation, drugs, toxics, viral or bacterial infections, myelofibrosis…
Complications of anaemia
Uncorrected anaemia can lead to an outbreak in the elderly
- In cases of vitamin B12 deficiency anaemia, complications can be neurological, as vitamin B12 also acts on the nerves.
- Kidney failure may occur in hemolytic anemia
Prevention of anaemia
Prevention comes first and foremost through the plate!Anemia can be prevented by adequate intakes of protein, iron, folic acid and vitamin B12
Iron is an essential trace element. It is present at 3.5 to 4g in the body.
- It is an important component of hemoglobin (heminic iron). it helps transport oxygen to the bloodstream and muscles via myoglobin.
- Non-heminic iron is stored in the liver (ferritin) or transported (transferrin).
Iron deficiencies: Very high needs during pregnancy, cannot be met by diet. Iron deficiency can occur at the end of pregnancy (30% of pregnant women develop iron deficiency anaemia), in certain socially disadvantaged segments of the population, among vegetarians as well as in the elderly who do not eat enough meat. Deficiencies are also observed in gastrectomists, in subjects who consume substances that complex iron such as coffee, tea, wine, beer, polyphenols, whole grain phytates, fibre, calcium from dairy products and zinc. Signs of deficiency range from simple fatigue, shortness of breath to exercise, sleep disturbances, repeated ENT infections (angina, ear infections…), paleness, hair loss, to real iron deficiency anemia
Children 1 to 12 years old
7 to 10 mg per day. Give growth milk for up to 3 years; in older children prepare a slice of veal liver once a week
13 mg a day. Ensure a balanced diet; iron-fortified cereals
Women of childbearing age
16 mg a day. Eat black pudding at least once a week. Eating mussels as often as possible
Up to 30 mg per day in the third trimester. Prefer oilseeds and dried fruits. Supplementation is required
Postmenopausal women and senior men
9 mg a day. Do not sulk at red meat. Rehabilitating pulses.
Heminic iron (hemoglobin and myoglobin of meats and offal shares of 150g/day) is the one that is best absorbed by the body (4 times more than non-heminic iron).
Non-heminic iron (recommended intake: 100g/day) found in plant foods is rather poorly absorbed (only 10%). It is found in cereals, broccoli, spinach, watercress, almonds, hazelnuts, dried fruit, dates, black olives, peas or beans. Citrus fruits, kiwis, strawberries, as well as Vitamin C make it possible to better assimilate plant-based iron
Foods rich in vitamin B12 are veal liver, fish (mackerel, herring), meat, milk and egg yolk.
Folates are mainly found in beetroot, cabbage, spinach, green beans, lettuce and peas, but also in carrots, cucumber, turnip, potato, veal liver, meat and fish.
Exposure to toxics
Many chemicals can impair the production of blood cells.
Take all necessary precautions if toxic products are to be handled
Breastfeeding could have a positive impact on the anaemia of the mother’s postpartum
Tips for anaemia
Spare your heart.In case of anemia, even light exercise can cause fatigue. Indeed the heart has to work much more because of the deficient transport of oxygen associated with anemia. Avoid unnecessary effort!
- Beware of impacts, cuts and injuries. In case of anemia, blood loss should be avoided as much as possible. For example, shaving with an electric razor rather than a blade, prefer soft-haired toothbrushes and refrain from contact sports.
- Prevent any risk of infection.In case of spinal cord anemia, which also affects white blood cells, you are more vulnerable to infections.Wash your hands often with antiseptic soap, avoid contact with sick people, get enough sleep, get vaccinated and undergo antibiotic therapy if necessary.
- Drink a lot.Poor hydration increases blood viscosity and can cause painful seizures or complications, especially in sickle cell anemia.
Biological assessment of anaemia
Hematological balance sheet
The dosage of red blood cell numbers, hemoglobin levels and red blood cell size (average globular volume VGM) differentiates the three major groups of anaemia
The number of hematias is normally:
- 5 (4.5 to 5.5) million/mm3 in adult humans;
- 4.5 (3.9 to 5.0) million/mm3 in adult women and children.
Blood hemoglobin (Hb) levels are normally:
- 15 (13.5 to 16) g/100 ml in adult men;
- 13.5 (11.5 to 15) g/100 ml in adult women and children.
Anemia is when hemoglobin levels are less than 13 g/dL in adult men and less than 12 g/dL in women.
In pregnant women, there is physiological hemodding, so the minimum rate is placed at 10.5 g/dL
Reticulocytes are the precursors of red blood cells. The reticulocyte level is used to determine whether the body is replenishing its hemoglobin stock. Anemia is said to be regenerative if its reticulocyte level is > 120,000/mm3
- Blood smears
Sickle cell anemia
|Type of anaemia||Medium globular volume||Reticulocyte rate|
< 80 fl
|Regenerative Normocytic or Macrocytic|
> 80 fl
|Regenerative Normocytic or Macrocytic|
> 80 fl
< 120 000/mm3
|Values in adults|
In the face of non-regenerative normo or macrocytic anemia, a myelogram should be requested. It is performed on a spinal cord puncture (bone marrow puncture).
- Biochemical balance sheet
In the face of microcytic anaemia, a martial check-up is then prescribed in order to look for iron deficiency: Ferritinemia or blood ferritin dosage (translated iron reserves), serum iron, Transferrin saturation coefficient
- In the face of non-regenerative normo or macrocytic anaemia, serum folate and vitamin B12 dosages are used to diagnose
Treating andropause with dietary supplements
Androlistica® is a dietary supplement of andropause, consisting of specific fatty acids, phytosterols, OMEGA 3 sea fish, provitamins, minerals, and antioxidants
Its naturally occurring phytosterols, provitamins, minerals and antioxidants have all been studied to protect the body from premature aging. They contribute to the urinary balance and integrity of prostate cells.
The extracts of ootes and yam oppose the oxidation of phytosterols, contributing to the preservation of cell membranes, and contribute to the proper transformation of sterols into steroids whose main expression in humans is testosterone
Tips for use: 2 to 3 capsules per day during a meal, 3 weeks per month
How to improve andropause through homeopathy
Painful erection or ejaculation, Lack of libido; with nervous irritability, coitus back pain, reassembled, retracted
Sabal serrulata composed tablets, granules or drinkable solution: 3 granules 3/day or 10 drops 3/day
Remedy against andropause by herbal medicine
The use of plants that act as a precursor to essential hormones such as testosterone, melatonin, DHEA can compensate for physiological decreases associated with andropause.
- Plants to avoid
Be careful to avoid estrogen-like plants such as Hops (Humulus lupulus), Sage (Salvia officinalis), or Ginseng (Panax Ginseng).
In any case
- Glycine max (soy)
Its effects are manifold.
- Stabilizes bone density in both sexes after age 50.
- Has a cholesterol-lowering effect, is a precursor to nitrogen monoxide (the most powerful vasodilator known), and its richness in ARGinine precursor of NO causes a decrease in diastolic pressure.
- Slows the rise of PSA in prostate cancer and prevents prostate cancer.
- In addition, provides kidney protection in diabetics and improved cognitive function (in a group capable of making equol from daedzine) in the presence of competent gut bacteria.
- Land Tribe (Tribulus terrestris)
Specific plant also called The Maltese Cross which seems particularly interesting as it would raise testosterone levels
- Anti-oxidant plants
Rosmarinus, the Lycopene of the tomato, in association with the body’s detoxification plants likeChrysantellum americanum or other large polychrests like Carduus marianus.
- Pycnogenol extracted from grape seeds or pine bark is also a very powerful antioxidant of interest in the treatment of andropause
- Depending on the disorder
Against emotional instability, decreased muscle power, decreased resistance to stress and decreased reaction speed, Eleuterococcus senticosus associated with magnesium will improve the situation.
- Sleep disorders
Tilia Tomentosa and Eleutherococcus senticosus
Decreased libido and erectile dysfunction will be usefully compensated by the use of Sabal serrulata, selenium, zinc and VitB
How do I treat anemia naturally?
Treatment depends on the type of anemia.
It is different, and the treatments indicated for one type of anemia are sometimes contraasted for another type. Hence the value of the diagnosis and biological balance before starting any treatment for anemia
Iron deficiency anemia or anemia by martial deficiency
Dealing with the cause
This type of anemia is caused by iron deficiency.
In this case, it is imperative to find the cause of this iron deficiency or risk having anemia relapse after treatment.
Sometimes it is not always possible to correct the cause of this deficiency (abundant rules, non-operable iatale hernia…). In this case, iron is prescribed either continuously or in repeated cures several times a year.
iron fumarate (Fumafer®) ferrous ascorbate (Ascofer®), ferrous chloride (UCB iron®), sodium fedatet (Ferrostrane®), iron hydroxide polymaltosis (Maltofer®), ferrous succinate (Innofer®), ferrous sulphate (fero-Grad vitamin 500®, Tardyferon® 80, Tardyferon® B9)
|Given the multiplicity of anaemia etiologies, it is important not to engage in iron supplementation without anemia being identified by a doctor|
|Posology: 100 to 200mg/iron element day in adults. 6 to 10mg/kg/day in children and infants.|
Tips for use: Follow the recommendations outlined in: Tips for Iron Treatment
Injectable pathway: Intramuscular injectable iron is reserved for (rare) cases of malabsorptions, after failure of per bone iron. The treatment is limited to a few injections, under strict medical control. The intravenous (Venofer®) is only indicated to treat anemia of chronic kidney disease dialysis when oral treatment is insufficient or poorly tolerated.
Duration of treatment: anemia is corrected in 1 to 2 months but treatment should be extended on average 5 to 6 months until normalization of all blood parameters (hemoglobin, GMV and ferritin)
Against absolute indications
|Martial overload, normo or hypersided disease (thalassemia, refractory anemia, spinal cord disease anemia)|
- Inflammatory anemia
Whether infectious, autoimmune or neoplastic, the only treatment is that of causal disease.
In this type of anaemia, iron intake is unnecessary, even dangerous, in the absence of associated deficiency
- Megaloblastic anemia
This type of anemia is due to a disorder of the metabolism of vitamin B12 and/or folate. The treatment therefore aims to compensate for this deficiency
- By vitamin B12 deficiency:
Cobamamide (Cobanzyme), Cyanocobalamine (Vitamine B12 Gerda®, Roche®, Delagrange®, Lavoisier®), hydroxocobalamine (Dodecavit®)
Whether due to a lack of dietary intake (strict and prolonged vegan diet) or a deficiency of absorption (pernicious anemia of Biermer, gastrectomy, intestinal ailments…), the treatment is based on the parenteral administration of vitamin B12 in the form of cyanocobalamine or hydroxocobalamine. The latter is often preferred because of better liver storage.
Posology: In general, 1000 g/day is given for 7 days to replenish liver reserves and obtain a normal blood level of 120 to 700pmol/l. Life-long maintenance treatment (monthly and then quarterly injections) is necessary if the cause of the deficiency cannot be cured. Per bone treatment is possible in intake deficiencies. It should be maintained until tissue reserves are replenished and blood levels of vitamin B12 normalized
Side effects: pain at the injection site, the usual red-brown coloration of the urine and the occurrence of acne in the case of prolonged treatment. Risk of allergic reaction (pruritus, hives…)
iron addition at the beginning of treatment at the 200mg/d dose is often necessary because rapid regeneration of red blood cells rapidly depletes the body’s iron reserves.
Etiological treatment: where possible, the diet is corrected. Malabsorption is also treated with intestinal tetracycline disinfection in cases of bacterial hail outbreak.
Against absolute indications
|malignant tumour due to its effects on tissue growth rapidly renewing|
By folate deficiencyStacque acid (Spéciafoldine®), calcium Folinate (Lederfoline®, Folinoral®, Perfolate®)
Oral folic acid: 5 to 15mg/d in adults.
Hematological normalization and correction of anemia appears after 2 to 3 months. If the cause is not normalized, the substitute treatment is maintained at a rate of 2 to 5mg of folic acid per week
Drug interactions: folates may reduce antiepileptic activity
Against absolute indications
|isolated use in vitamin B12 deficiencies (aggravated neurological signs)|
- Spinal cord insufficiency anemia
In the face of drug toxicity, treatment is essentially based on the temporary or definitive removal of the drug responsible (for example, chemotherapy).
In other cases, treatments are more specific and are prescribed on a case-by-case basis based on age, etiology of aplasia and severity. Thus, androgenic therapy aims to stimulate the synthesis of erythropoietin and the differentiation of red blood cells. A bone marrow transplant is also possible
- Hemolytic anemia
Hemolytic anemias may require blood transfusions or spleen surgery due to a malformation of hematics.
- In the case of autoimmune anemias, treatment is essential by the avoidance of triggers. Corticosteroid therapy at the rate of 1 to 1.5mg/kg/d of prednisone is indicated as a first-line. It is maintained until normal hemoglobin levels are obtained. The doses are then gradually reduced until the shutdown. In case of cortico-resistance or cortico-intolerance, the remedy is splenectomy. Immunosuppressants (azathioprime, cyclophosphamide and chlorambucil) are the last alternative for refractory patients. Treatment with intravenous gammaglobulins may also be prescribed.
- Anemia due to kidney failure
In the case of kidney failure, anemia is caused by the decrease in erythropoietin secretion. Erythropoietin is a hormone that acts as a factor in the growth of red blood cells on the bone marrow.
- Erythropoietin (EPO)Eprex®, NeoRecormon®, Aranesp®
The administration is done preferentially by sub-skin. The initial dosage is 20 to 50 IU/kg 3 times a week except Aranesp® (once a week). We then gradually increase in levels from 20 to 25 IU/kg
Side effects: high blood pressure dose dependent, flu-like-in-flu syndrome and rare cases of thrombosis
Precautions of use:
- iron reserves are assessed before and during treatment to eventually introduce supplementation as there is resistance to EPO in case of martial deficiency.
- Some patients develop resistance to EPO after several months of treatment through the development of anti-EPO antibodies. In this case, the only possible alternative is blood transfusion.
Against absolute indications
Pregnancy, non-controlled hypertension, patients who cannot receive appropriate thrombotic anti-thrombotic prophylaxis
Preventive treatment of iatrogenic anaemia (drugs)
- Depending on the clinical context, these treatments are removed as much as possible
- If these medications cannot be discontinued, preventive treatment is used to prevent these anemias with folinic acid or calcium folinate.
Drugs that can cause anaemia
Some treatments may lead to megaloblastic anemias: Dihydrofolate-reductase inhibitors: pyrimethamine, trimethoprim, methotrexate, sulfasalazine, triameramine, phenytoin, barbiturates
Women with abundant periods
For women with heavy periods, hormonal treatment can help (contraceptive pill, progestin IUD, danazol, etc.).
Anemia caused by chemotherapy
Anemia most often occurs after several chemotherapy treatments (especially platinum salts)
- If the hemoglobin level is less than 12g/l; anemia is prevented by administration of recombinant erythropoietin (alpha darpoietin: Arasnep®, alpha epoietin: Eprex®, epoietin beta: Neo-Recormon®) in sub-skin previously associated with a correction of an iron or folate deficiency
- If the level of hemoglobin is less than 8g/l, a transfusion of globular nerves is initiated even if the latter should be avoided as much as possible because the effectiveness of erythropoietins is clearly demonstrated.
Tips for iron treatment
When should I take the iron?
Take the iron preferably on an empty head or half an hour before meals by splitting the catch during the day.
- Avoid foods that trap iron:
- Foods rich in phytates (rhubarb). Wholemeal bread contains a high proportion of pythic acid that can form insoluble (unsolved) complexes with iron
- Phosphate-rich foods (milk feeding). Avoid the simultaneous consumption of dairy products that reduce iron absorption by 30 to 50%.
- Tanins (tea): limit tea consumption to 2 to 3 cups per day.
- Improve iron absorption:
Iron absorption is promoted by vitamin C. Swallow the iron with a glass of orange or grapefruit juice
Beware, some medications reduce the absorption of iron.
Iron should be taken at least 3 hours from cyclines, fluoroquinolones, penicillamine, gastrointestinal topicals, thyroxine and biphosphonates.
- Duration of treatment
Iron improves the state of fatigue quickly in 1 or 2 months, but the absorption of iron is limited daily, 5 to 6 months are needed to replenish stocks. The effectiveness of the treatment is controlled after 3 months by a blood test
- What to do in case of intolerance?
Iron sometimes causes symptoms of transient intolerance; nausea, diarrhea or constipation. Splitting daily intakes limits these side effects.
Anemias in dietary supplements
Don’t try to treat yourself with iron supplements or multivitamins that contain iron supplements. This could mask a much more serious disease and delay diagnosis.
- Vitamins and trace elements recommended
ACTYFERIL® is a dietary supplement made from iron, copper, vitamins B6 and B9.
- Iron contributes to the normal formation of red blood cells and hemoglobin and to the normal transport of oxygen in the body.
- Iron and vitamins B6 and B9 help fight fatigue.
- But copper contributes to the normal transport of iron in the body.Vitamin C: Vitamin C can be absorbed by iron. Only take if your doctor has prescribed iron treatment.Prefer the natural vitamin C that is acerilaVitamins C and acerola: 3 oaks Acerola 500, 3 organic oaks Acerola 1000, Acerola 1000 Arkopharma®, Acerol C vitamin C, Acerola Arkogélules®, Acerola Bio 500, Acerola Plus 500, DAYANG® Acerola 1000, Vitascorbol® 500,Vitascorbol® 1g
Treating anemia through homeopathy
Don’t try to treat yourself with homeopathy without being followed by your doctor.
Homeopathy is an additional aid, it often helps to better tolerate iron treatment (often poorly tolerated), but can in no way replace conventional treatments!
In case of chilliness or mild anaemia: Graphites 9CH
- Blood loss, anemia and general repercussions (fatigue): China rubra, Phosphoricum acidum, Ferrum metallicum 5CH 3 granules 2 times a day
- Zincum metallicum anemias sometimes masked by a state of great fatigue.
- Plumbum metallicum anemias may be accompanied by weight loss.
- Natrum muriaticum: anemias, especially in lean and chilly people
- Kalium carbonicum: chilly subject, anaemic with edema and osteoarthritis. Anemia
Anemia and oligotherapy
Don’t try to treat yourself with oligotherapy without being followed by your doctor. Oligotherapy is an additional aid, but in no way can replace conventional treatments!
Cobalt: Cobalt is an essential trace element. It is present in the structure of cyanocobalamine orvitamin B12 involved in hemoglobin erythropoiesis and biosynthesis. It is indicated in the Anemia of the pregnant woman
What to avoid
Zinc in large quantities: Excessive dose of zinc can cause anemia
Pharmacy Tip: When to see a doctor?
In case of: paleness, lack of enthusiasm or energy, headache, loss of libido, inability to concentrate
If you have a chronic illness that can cause anemia, it is important to have proper medical follow-up and blood tests from time to time. Talk to your doctor about it.
- In case of shortness of breath or dizziness