-IBIS-1.7.6-
tx
cardiovascular system
anemia: nutritional deficiency/blood loss
Nutrition
dietary guidelines
therapeutic foods:
» Iron-deficiency anemia:
Increase dietary sources of Iron
If Fe stores are depleted then absorption is:
35% if from heme sources (animal)
8% if from non-heme sources (grains and vegetable source)
If Fe stores are repleted then absorption is:
15% if from heme sources
3% if from non heme sources (Marz, 326, 1997.)
Note: Iron in the heme form is better absorbed but there is another factor referred to as MPF (Meat, Poultry and Fish) that also seems to enhance absorption of iron.
Beets, green vegetables, black cherries, bee pollen, sun chlorella, apricots, blackberries, apples, currants, egg, kelp, lettuce, prunes, greenbeans, spinach, huckleberries, tahini, lentils, peach, molasses, mustard greens, nettles, mulberries, parsley, liver, watercress; see also the "Iron" topic in Materia Medica for iron content of a wide range of foods.
Foods rich in Iron, folic acid, B12, Chromium and Vitamin C
» Folate-deficiency anemia:
Eat foods with high folate: Liver, asparagus, dried beans, brewers yeast, spinach, wheat bran, dark green leafy vegetables, whole wheat bread. Since heat destabilizes folate, it is good to eat foods as raw as possible.
(Marz, 328, 1997.)
Folate: Increase dietary intake
» B12-deficiency anemia:
Eat foods with B12: animal foods or brewers yeast.
» B6-responsive anemia:
Eat foods with B6: whole grain cereals and breads, vegetables, meats, and liver.
fresh juices:
blackberry and parsley
grape and parsley
blackberry
black cherry
parsley
dandelion
tomato and desiccated liver
oatstraw or tea
carrot, beet, and celery (Walker, 121.)
carrot and fennel (Walker, 121.)
carrot, asparagus, and lettuce (Walker, 121.)
carrot, beet, and cucumber (Walker, 121.)
carrot (Walker, 121.)
carrot, celery, parsley, and spinach (Walker, 121.)
spinach (Walker, 121.)
red grape and black currant (Airola, 37.)
specific recommendations:
red meat
chicken
foods rich in Iron and Vitamin A
specific remedies:
take 250 g soybean sprouts, 15 g Chinese dates, and 250 g pork bones. Add water and simmer for several hours, add salt to taste. Eat three times daily. (Chao-liang, Qing-rong, Bao-zhen, p. 72)
avoid:
Avoid coffee, black teas and EDTA additives; any of these when consumed with meals can each reduce iron absorption by up to half.
(Marz, 326, 1997; Mehta SW, et al. Nutr Res 1992;12:209-222; Morck TA, et al. Am J Clin Nutr 1983;37:416-420.)
Avoid eating foods rich in Iron with dairy or with caffeine-containing foods due to decreased absorption (Shefi)
supplements
» Iron-deficiency anemia:
Treat the underlying cause. If iron deficiency based on ferritin and MCV then give foods with high iron
Ferrous fumerate, glycerate or glycinate are the most absorbable forms of supplemental iron. Supplementation is usually at 100 mg per day for a period of three to six months. Ferrous sulfate, while commonly used, is significantly less well absorbed and well known for its tendency to cause digestive irritation, upset and/or constipation; 250-325 mg is a typical daily dose. Make sure it is taken on an empty stomach to maximize absorption if the patient can tolerate it. If not, then give with foods along with vitamin C. Prescription iron can be given as combined with certain proteins to minimize irritation to gastrointestinal tract. (Marz, 326, 1997.)
Vitamin C: 1 g per day buffered; helps keep iron reduced. Take with iron or iron liver extract (Marz, 326, 1997.)
NOTE: Response to this therapy usually takes 1-3 weeks with an increase in RBCs being the first change. Then hemoglobin levels rise, and epithelial changes are last. Iron therapy should continue for 6-12 months, even after hemoglobin levels return to normal. This allows iron reserves to be depleted (check ferritin).
Liver extract: 2-6 capsules per day in divided doses. Can also give liver extract IM or as straight iron sulfate if someone has extreme nausea or they have a digestive disorder that might hamper their absorption or tolerance to the iron orally. (Marz, 326, 1997.)
» Folate-deficiency anemia:
Folate: 1-5 mg per day. Symptomatic treatment usually is apparent before the hematologic values are back to normal.
Correct the underlying condition such as Celiac disease.
Vitamin C: Macrocytic anemia of scurvy may produce a relative folate deficiency since vitamin C is required to convert folic acid into folinic acid. (Marz, p. 328, 1997)
» B12-deficiency anemia:
Treatment for pernicious anemia: Vitamin B12: IM 1000 mcg per day for 1 week; normally it only requires about 3 mcg per day to prevent pernicious anemia. (Marz, p. 329, 1997)
Treat the underlying cause: parasites, diarrhea, irritable bowel disease, abnormal gut bacteria, etc.
Cobaltum Metallicum 3x (3 twice daily): iron deficiency anemia (Easley)
» Copper-deficiency anemia:
Copper 5 mg per day.
» B6-responsive anemia:
Vitamin B6: 100 mg three times daily. Patients respond in varying degrees. P5P may also work. (Marz, p. 330, 1997)
footnotes
Ajayi OA, Nnaji UR. Effect of ascorbic acid supplementation on haematological response and ascorbic acid status of young female adults. Ann Nutr Metab 1990;34:32-36.
Cook JD, Noble NL, Morck TA, et al. Effect of fiber on nonheme iron absorption. Gastroenterology 1983;85:1354-1358.
Hunt JR, Gallagher SK, Johnson LK. Effect of ascorbic acid on apparent iron absorption by women with low iron stores. Am J Clin Nutr 1994;59:1381-1385.
Looker AC, Dallman PR, Carroll MD, et al. Prevalence of iron deficiency in the United States. JAMA 1997;277:973-976.
Mehta SW, Pritchard ME, Stegman C. Contribution of coffee and tea to anemia among NHANES II participants. Nutr Res 1992;12:209-222.
Morck TA, Lynch SR, Cook JD. Inhibition of food iron absorption by coffee. Am J Clin Nutr 1983;37:416-420.