Nutrients are necessary to prevent and treat anemia - vitamin B12, folic acid and iron

Nutrients are Necessary To Prevent and Treat Anemia

Our blood contains two components -- plasma, the fluid that carries blood cells around the body, and the cells themselves. The three types of blood cells are platelets, which help the blood clot; white blood cells, which fight infections; and red blood cells, which carry oxygen to all the organs and tisuses of the body.

Anemia develops when the number of red blood cells decreases, or there is a disturbance in the ability of the red blood cell to carry oxygen. It can have a profoundly debilitating effect on the body, and can even lead to death if untreated.

The red blood cell (RBC) is a microscopic disc-shaped cell. In fact, it is so small that under normal conditions, 5 million RBCs can occupy a space of only 1 square millimeter. Our bodies contain billions of RBCs.

The RBC can carry oxygen because it contains hemoglobin, a complex protein molecule containing iron that is capable of binding oxygen to itself. As blood circulates through the lungs, the hemoglobin extracts and binds with the oxygen made available by the lungs. As the RBC travels through the body with its carge of oxygen, the hemoglobin releases the oxygen to supply the needs of the various organs and tissues.

The RBC, now depleted of its oxygen, is carried in the bloodstream back to the lungs, where its supply to oxygen is replenished. Then the process begins anew, repeating continuously for a life-time.

Red blood cells have a lifespan of about 120 days. The liver destroys the aged RBC, salvaging the hemoglobin and using it to manufacture bilirubin, an important component of bile. The bone marrow manufactures new RBCs to replace the old ones. Up to 50,000 or more new cells per cubic millimeter are produced every day.

There are many means of determining the status of our red blood cells, but the two most common measurements are the total red blood count and the hemoglobin level. The normal red blood count for a male is 4.5 to 5.0 million cells per cubic millimeter (million/cu mm), and for a female is 4.0 to 4.5 million/cu mm. The normal hemoglobin is 14.5 to 15 grams per 100 milliliters. While these figures will vary, anemia is considered to be present when the RBC count is below 4.0 million and the hemoglobin is less than 12.5 grams.

Causes of Anemia

Many factors can upset the balance between red blood cell loss and red blood cell production, leading to an anemic condition. Generally speaking, anemia can result from one of three causes: decreased blood formation, excessive blood loss or increased blood destruction.

Decreased blood formation is caused by fluctuation in glandular hormone levels as well as vitamin and mineral depletion, especially of iron (vital for hemoglobin synthesis), vitamin B12, folic acid and amino acids, all required for RBC synthesis.

Excessive blood loss, whether from a hemorrhage caused by a ruptured blood vessel or bleeding ulcer, leaves the body unable to compensate for the acute loss of both red blood cells and plasma. As a result, the victim suffers both from the effects of oxygen deprivation and from a loss of circulating blood volume, conditions that can cause shock and even death unless blood and fluids are replaced and bleeding is controlled. If chronic blood loss is relatively slow and occurs over a rpolonged period of time, RBCs can be replaced if the bone marrow is functioning well in manufacturing new RBC's. But when loss overbalances regeneration, anemia can develop in some cases.

Increased RBC destruction or hemolytic anemia, can be acquired or hereditary. Acquired hemolytic anemia occurs when bone marrow is unable to compensate for the loss RBCs and is caused by a variety of environmental agents including certain medications, bacterial infections, chemical agents (such as coal tar products), parasites, snake venom and certain poisonous plants.

Hereditary hemolytic anemia is related to genetic abnormalities of either the RBC or its hemoglobin. The most common of these disorders is sickle cell anemia, which is caused by an inherited abnormality in the structure of hemoglobin that makes the RBC assume a sickle shape and become susceptible to destruction.

Symptoms of Anemia

Certain symptoms are characteristic of anemia regardless of its cause. Any severe anemia will cause symptoms like weakness, dizziness, headache, roaring or ringing in the ears, fatigue, drowsines, irritability and even psychotic behavior, because of a reduction in the oxygen-carrying capacity of the blood. Shortness of breath, palpitations and rapid heart action are common. Loss of appetite, nausea and a change in bowel habits also may occur.

Treatment

The cause of the anemic condition should be diagnosed before beginning an effective program of therapy. Deterimining the cause is relatively easy with today's sophisticated testing procedures.

Treatment, of course, depends on cause. In some instances, such as in the case of sickle cell anemia, no cure is known.

Many forms of anemia, however, can be effectively treated with nutrient therapy. Pernicious anemia, caused by a vitamin B12 deficiency, is one example.

Vitamin B12 is especially important, because it plays such a crucial role in the development of the RBC. In order for this vitamin to be absorbed from the intestinal tract, it must be bound to a substance secreted by the stomach called the intrinsic factor. Pernicious anemia is a relatively rare disorder caused by a congenital defect of the stomach leading to the absence of the intrinsic factor. Vitamin B12 injections effectively treat victims of this disorder. Oral vitamin B12 is present in most vitamin B complex or multivitamin preparations in amounts averaging 25 micrograms ([micrograms]) per tablet.

Folic acid (or folacin) is a complex chemical necessary for the synthesis of DNA which, together with vitamin B12, regulates the formation of normal red blood cells in the bone marrow. A daily allowance of 400 [micrograms] is recommended for adults, increasing to 800 [micrograms] during pregnancy and lactation. Supplementation of 15 milligrams (mg) per day usually will correct anemia, with a follow-up regimen of 5 mg per day. Folic acid is widely distributed in lean beef, leafy green vegetables, whole-grain cereals and yeast.

Patients suffering iron deficiency anemia respond well to increased iron intake through diet and supplements. In temperate climates, the RDA for iron in a normal man or postmenopausal woman is 10 mg per day. For menstruating women, the RDA is 18 mg per day, and for pregnant women, 30 to 60 mg is recommended.

Iron content is highest in lean meats, poultry and fish, legumes, dried fruits and cereals. Since only about 5 to 10 percent of ingested iron is absorbed, iron supplementation is necessary. The most common compound is ferrous sulphate, but preparations of ferrous gluconate, ferrous fumarate and ferrous carbonate also are available. Vitamin C supplements also help the body absorb iron.

A combination of proper diet and use of the correct supplements can reduce, if not eliminate, any risk of developing anemia. Your local health food store is sure to have the supplements you need to keep your red blood cells healthy.

Ralph M. Myerson, M.D., is a clinical professor of medicine at the Medical College of Pennsylvania, Philadelphia, and a contributing writer for Better Nutrition.

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