What is Anaemia?
Literally the word means “absence of haem”.  Haem is the part of the red blood cell that contains iron, which transports oxygen to the body tissues to be used for a number of functions, of which energy is the most noticeable.
Red blood cells live for about 100-120 days, so are continually being broken down and replaced by new ones, made in the bone marrow.  For them to be made properly, a number of ingredients are necessary, the most important of which are iron, vitamin B12 and folic acid.
A person who is anaemic doesn’t have enough red blood cells and/or not enough haemoglobin in the cell.  This reduces the ability to transport oxygen, resulting in fatigue, concentration & memory problems and in severe cases, shortness of breath.

 

What causes anaemia?

The most common cause of anaemia is iron deficiency.  This is very prevalent in young children (from 6 months of age), pubescent boys & girls and menstruating women of all ages.
Other forms are less common, but anaemia due to inadequate intake of vitamin B12 is common in vegetarians, and anaemia due to folic acid deficiency is more likely in those with low vegetable intake.

Where does iron come from?

Iron is found in high amounts in red meat – lamb, beef, veal and venison.  It is present in smaller amounts in white meats such as pork and chicken.  Vegetable sources of iron include dark green vegetables.

How is anaemia diagnosed?

A full blood count (also known as complete blood count) includes the number of red blood cells, the total haemoglobin and a calculation of the average amount of haemoglobin per blood cell.  Iron is not routinely tested, but ferritin is – this gives an indication of the amount of iron stored in the liver, muscles, spleen and bone marrow.  However, if you are acutely unwell, ferritin is not a reliable marker, as any inflammation makes it increase.

Why am I iron deficient?

The iron contained in meat is readily absorbed into the blood stream, so if you have adequate intake (see the table for the recommended intake for you), and your levels of iron are low, then it is likely that you have poor absorption or excess loss.  Both of these need to be investigated to determine the cause.  Gut problems commonly associated with poor absorption of iron – Crohn’s disease or Coeliac disease for example, or Small Intestinal Bacterial Overgrowth (SIBO), in which the bacteria in the gut are consuming the iron – are common factors.  In menstruating-age women, heavy menstrual flow (periods) is a common cause.  Blood loss due to internal bleeding, such as peptic ulcers or ulcerative colitis are other reasons for low iron.  All of these need investigation.

Where can I get iron?

Sources of highly absorbable iron include red meat and organ meat such as kidney and livers.  Egg yolks, beans (including tofu), lentils, dark green leafy vegetables (such as spinach and kale), dried prunes, dried raisins are common sources for vegetarians, but the form of iron in these foods is not as well absorbed.  Ensuring a vitamin C-containing food (such as raw capsicums, tomatoes or fresh fruit) with the meal increases your ability to absorb the iron.  Avoid drinking tea or taking calcium supplements with meals as these can interfere with absorption of iron.

How much iron do I need?
Age (years) RDI*
Iron (mg/day)
Newborns & Infants 0-6 months 0#
Infants 7-12 months 11
Children 1-3 9
4-8 10
9-13 8
Boys 14-18 11
Men 19-70+ 8
Girls 14-18 15
Pregnant women 14-50 27
Breastfeeding women 14-18 10
19-50 9
All other women 19-50 18
Over 50 8

* RDI = Recommended daily intake
# babies are born with iron stores that last until 6 months of age.  This assumes mum was iron-sufficient during pregnancy.

Where can I get folic acid?

Also, called folate, this important nutrient is found in green leafy vegetables, such as kale and spinach, dried beans, peas and nuts, as well as in foods that have been fortified – such as some breads, non-dairy milks etc.

Where can I obtain vitamin B12?

This vitamin is readily obtained from animal foods, so if you consume beef, lamb, poultry, liver, fish, eggs, milk and/or dairy products your diet will contain it.  Other sources include fortified cereals, and nutritional yeasts & yeast spreads.  If you are vitamin B12 deficient, we recommend a nutritional assessment as soon as possible as vitamin B12 is also needed for a healthy nervous system.

Can I have too much iron?

Yes – excessive iron can cause problems.  Iron is considered a “pro-oxidant” that can cause oxidative stress in the body.  Iron overload can occur, which can have detrimental effects on the liver.  Generally, it is not advised to supplement with iron unless you have a diagnosed deficiency.