Iron Deficiency Anemia

Overview
Iron deficiency anemia (anemia) is fairly common in children, women of childbearing age and pregnant women. It can result from poor food intake or from the loss of large amounts of blood. Pregnant women often become anemic due to the rapidly increasing blood volume of both mother and baby.

What Causes Anemia
Diet. You could develop anemia simply because you are not getting enough iron in your diet. Anything that interferes with the absorption of nutrients (malabsorption) could also lead to anemia. Children who are growing rapidly may become anemic if they drink a lot of milk but eat little meat or other iron-rich foods.

Pregnancy. Pregnancy can also lead to iron deficiency anemia. During pregnancy, both the mother and baby are increasing their blood volume. This requires iron to make the hemoglobin. If there is not enough iron to meet this need, anemia can result.

Blood loss. Losing a lot of blood is another way that you can develop anemia, including injury to a blood vessel, heavy menstrual periods, malabsorption, or any condition that results in bleeding from the gut.

Symptoms of Anemia
If you are anemic, you might experience the following symptoms:

• Tiredness/fatigue
• Weakness
• Dizziness
• Shortness of breath
• Lowered immunity/frequent infections
• Pale skin
• Irregular heartbeat
• Pica: Eating ice, dirt or chalk
• Tingling of the hands and feet

Preventing Iron Deficiency Anemia
The most important thing that you can do to prevent iron deficiency anemia is to eat a diet that is rich in iron. Liver and red meat are good sources. You can also get iron from other animal products as well as plant sources. Eat more whole foods and less processed foods for optimum results.

Additionally, eat foods that are high in vitamin C will help to increase the amount of iron you absorb. On the other hand, drinking milk at the same meal with iron-rich foods will reduce the amount of iron absorbed, so try to drink milk or consume other calcium-rich foods at a different time.

Treatment
If you are diagnosed with iron deficiency anemia, you will need to take steps to correct the problem as quickly as possible. There are two primary approaches to treating iron deficiency anemia - diet and iron supplementation. The treatment will depend on the cause of the anemia and the severity.

Diet. If you are not getting enough iron from your diet, you will need to will need to eat more iron-rich foods. A registered dietitian can help you to identify ways to increase your intake.

Supplement. In some cases, a basic multivitamin with mineral supplement might help to improve your hemoglobin level. Your doctor may prescribe a higher dose iron supplement where diet and a basic MVI with iron is not enough. Conditions such as pregnancy, malabsorption and conditions that result in chronic blood loss typically require a high dose supplement.

Food Sources of Iron
Animal products such as liver, red meat, poultry, fish, clams and egg yolk are high in iron. But you can also get the iron you need from a diet that is rich in plant foods. Spinach and other green leafy greens, legumes, dried fruit, dried beans and peas, pumpkin seeds and molasses are all good sources. In  addition, breads and cereals that have been enriched with iron can also help to boost your iron intake.

Recommended Intake
The recommended intake of iron for women ages 19-50 is 18 milligrams. In comparison, the RDA for men of the same age is a mere 8 milligrams. The difference is due to the large loss of iron that women experience during their monthly period. Requirements at different stages in life vary.

What Next?
Eat foods that are high in iron daily to boost iron levels, increase hemoglobin level and reduce your risk of anemia.

Vitamin B6 and Your Health

Overview
Vitamin B6 (pyridoxine) is a water-soluble vitamin that is required for a wide range of metabolic processes in your body. It is important for healthy blood formation, nerve function and normal brain activity.

Functions 

Vitamin B6 plays an important role in a number of metabolic activities related to the release of energy from protein, fat and carbohydrates. It is also necessary for the production of hemoglobin - the red pigment in red blood cells. Vitamin B6 also works with folic acid and vitamin B 12 in regulating homocysteine levels in the blood. High levels of homocysteine may be a risk factor for heart disease. Another important role of vitamin B6 is in the conversion of the amino acid tryptophan to niacin and serotonin. Serotonin is a mood hormone – that makes us feel good.

Vitamin B6: Deficiency: Causes 
Vitamin B6 deficiency may result from inadequate dietary intake. This is most likely to occur in people who may have poor appetite or swallowing problems and are unable to eat enough to get the nutrition they need. People who live extensively on refined, processed foods may also be at increased risk for a vitamin B6 deficiency.

People who suffer from malabsorption, and those on certain prescription drugs, like Isoniazid, and women who use hormonal contraceptives (oral contraceptives) are also at risk for vitamin B6 deficiency.

Vitamin B6 Deficiency: Symptoms 
Symptoms of vitamin B6 deficiency may include cracked or chopped lips, sore tongue, weakness, fatigue and depression. Anemia, and neurological problems, such as numbness and tingling of the hands and feet are also signs of vitamin B6 deficiency.

Prevention and Treatment of Vitamin B6 Deficiency 
Eating a diet rich in vitamin B6 will help to reduce the risk of deficiency in people who do not have other underlying conditions. In cases where the problem stems from other medical conditions, a supplement may be necessary. 

Food Sources of Vitamin B6 

Vitamin B6 is available from a wide range of foods, including potatoes, avocados, bananas, meat, fish, poultry and nuts. It is also found in vitamin B6 fortified cereals and other foods.

Recommended Intake for Vitamin B6 
The RDA for vitamin B6, which has been established by the National Academy of Sciences is between 1.3 and 1.7 milligrams per day for American adults. Pregnant and lactating women need slightly more.

Summary 
Select a variety of whole foods daily and avoid highly processed foods in order to get the vitamin B6 you need for hundreds of metabolic processes that take place in your body every moment. Lack of this vitamin could have serious adverse effects on your mood, mental functions and your physical health.

Folic Acid

Overview

Folic acid (folate) is a water-soluble vitamin that is abundant in leafy green vegetables and other plant food. It is not present to any measureable degree in animal products.  Lack of folic acid could lead to major health problems. So, you should try to eat lots of leafy greens and other foods that are high in folic acid everyday. Folate is the natural form of the vitamin found in food. Folic acid is the synthetic form that is added to food and used in supplements.

Functions of Folic Acid

Folic acid is essential for DNA synthesis, which takes place as cells multiply. It plays a powerful role in the development of the spine and other tissues during the early part of pregnancy. This is the point at which the cells are dividing rapidly; the need for folic acid is greatest at this time. Folic acid is also for the production of healthy red blood cells.

Folic Acid Deficiency: Causes 

Folic acid deficiency can occur as a result of several conditions, including:

1. Poor dietary intake. People who eat a lot of highly processed foods and relatively few leafy vegetables or other foods that are high in folic acid are most prone to folic acid deficiency.
2. Pregnancy. The demand for folic acid is increased greatly during pregnancy. If the diet of the mother is low in folic acid, growth of the spinal column could be disrupted, resulting in serious birth defects. The mother's health could also be seriously affected.
3. Weight loss surgery or any other type of surgery that results in the removal of parts of the stomach or intestine could interfere with folic acid absorption, leading to a folic acid deficiency.
4. Other malabsorption problems like celiac disease and other conditions that lead to poor absorption.

Folic Acid Deficiency: Symptoms 

Symptoms of folic acid deficiency include anemia, nerve damage, tingling sensation or numbness in the arms and legs, fatigue, weakness, poor motor function and lack of balance. Other symptoms include memory loss, dementia, megaloblastic anemia, loss of appetite, and constipation. Medications can also interfere with the way folic acid is used in the body. A deficiency during pregnancy can lead to a condition called neural tube defect. Malabsorption due to disease or surgery of the stomach and parts of the intestine could result in a folic acid deficiency.

Prevention and Treatment of Folic Acid Deficiency

Folic acid supplements are usually prescribed for pregnant women beginning early in the pregnancy in order to avoid the problems associated with folic acid deficiency.

Food Sources of Folic Acid

You can get folic acid mostly from plant foods. Green leafy vegetables, broccoli, peas, legumes, orange juice and tomato juice are natural sources of folate. Other foods are fortified with the synthetic form of the vitamin. Folic acid occurs naturally in few animal products. Those animal sources include beef liver and eggs. Folic acid is available as a supplement for people who do not get enough from their diet. It is usually prescribed for pregnant women beginning early in the pregnancy.

Folic Acid Requirements

The RDA for folic acid is 400 micrograms for children ages 14 to 18 and for adults 19 years of age and over. The RDAs for children range from 150 to 300. There is a lack of sufficient scientific evidence to set standards for infants under the age of one, according to the National Research Council the group that sets the standards.

Resources
Dietary Supplement Fact Sheet: Folate
Linus Pauling Institute at Oregon State University

Folate, vitamin B12, homocysteine status and DNA damage in young Australian adults

Nutrition and Your Health: Dietary Guidelines for Americans

Dietary Reference Intakes: Vitamins

Vitamin B12 and Your Health

Overview

Vitamin B12 is a water-soluble vitamin that is found exclusively in animal products. Consequently, vegans, who do not eat any animal products, may be at risk for vitamin B12 deficiency. A number of other health problems that interfere with vitamin B12 absorption can also lead to serious health problems.

Functions of Vitamin B12 
Vitamin B12 plays a critical role in the formation of hemoglobin, the oxygen-carrying portion of the red blood cells. It is necessary for proper nerve function. Another key role of vitamin B12 is in the synthesis of DNA. Additionally, vitamin B12 helps to limit the buildup of homocysteine, a compound that is associated with heart disease.

Vitamin B12 Deficiency: Causes 
Vitamin B12 deficiency may occur as a result of several conditions, including:

1. Lack of an enzyme (intrinsic factor) that is necessary for the vitamin to be absorbed from the gut.
2. Low dietary intake. Vegans, who do not eat any animal products may be at high risk for a B12 deficiency.
3. Removal of certain parts of the small intestine or stomach, for example, in people who have undergone weight loss surgery or who required this type of surgery for other health conditions. Removal of parts of the stomach or small intestine could interfere with the ability to absorb the vitamin, thus resulting in a deficiency. 
4. Other malabsorption problems.

Vitamin B12 Deficiency: Symptoms 

Symptoms of vitamin D12 include a type of anemia called pernicious anemia, tingling sensation or numbness in the arms and legs, fatigue, weakness, poor motor function and lack of balance. Other symptoms include memory loss, dementia, megaloblastic anemia, loss of appetite, and constipation.

Treatment of Vitamin B12 Deficiency

If low dietary intake is the main cause of a vitamin B12 deficiency (as is possible with vegans and raw food loyalists), this may be corrected by eating foods that have been fortified with the vitamin. However, if the problem is related to gut problems that interfere with your ability to absorb the vitamin, B12 shots are usually required.

Food Sources of Vitamin B12 
You can get vitamin B12 from meat, eggs, poultry, shellfish and milk. Vitamin Vitamin B12 is not found in plants. Therefore, if you are a vegetarian, you will need to get your vitamin B12 from foods that are enriched with the vitamin or take a B12 supplement. 

Vitamin B12 Requirement 
The RDA for vitamin B12 has been set at 0.9 to 1.8 micrograms for children 1 to 13 years of age, depending on age. For adolescents and adults the recommended intake is 2.4 micrograms. Lower amounts are required for infants while the requirements for pregnant and breastfeeding women are 2.6 and 2.8 micrograms, respectively.

Resources

Linus Pauling Institute at Oregon State University

Folate, vitamin B12, homocysteine status and DNA damage in young Australian adults

Nutrition and Your Health: Dietary Guidelines for Americans

Dietary Reference Intakes: Vitamins