What Does it Mean to be Anemic?

I always thought anemic meant low iron. If someone was anemic it meant they needed to eat more red meat, or they had a condition that caused them to lose too much blood. I was also taught in nutrition classes that the best way to raise iron stores is to eat liver and other organ meats, that the iron found in other sources wasn’t a good way to get iron.  BUT… that’s not necessarily true.

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to the body tissues.”


This can be due to low B12, low B9, low iron, chronic illness, intestinal permeability (leaky gut), IBS/IBD, Crohn’s disease, celiac, and many other conditions.  Not all of these are remedied by eating red meat, and most should not! They are also not all due to low iron.

Someone can be classified as anemic when any of their vitamins or minerals are low, and not all doctor’s know that certain basic lab markers can be an indicator for low vitamins and minerals.  It is actually VERY common for someone to be anemic, even those who eat a lot of red meat.  A diet of processed foods and fast food does not provide all of the vitamins and minerals needed to create and grow healthy red blood cells. Many foods are fortified to make up for nutrients lost in processing, but those that are added back are only part of those that are lost.

Take vitamin C.  (not literally!)

Vitamin C is essential for absorbing iron. Iron is essential for making hemoglobin which is essential for making red blood cells.  Without enough vitamin C, we’re not going to have enough healthy red blood cells, as well as many other functions in the body. Lab markers for iron, hemoglobin, and RBC, MCV, … could all be related to vitamin C.  Many people take supplemental vitamin C.  BUT, supplements of vitamin C are created through processing and heating. It is usually combined with other chemicals then added to a shelf stable liquid for drops, a capsule made of gelatin or cellulose, a tablet made with filters and usually bleached or colored, or powdered and combined with buffering agents. This is NOT natural!  If I feel like I need more vitamin C, I can eat raw fruits and vegetables. (This is not to say that supplements won’t help someone who is very anemic.  Supplements can be helpful). Most of us think of oranges, but kiwi, tomatoes, peppers, and greens are excellent sources for vitamin C.  When you eat a food for vitamin C, you’re getting the vitamin C packaged with other nutrients including fiber to feed the beneficial microbes in your intestine, other vitamins, water for hydration, and other nutrients that we may not even understand, yet.  Your body’s cells recognize the form of vitamin C being delivered in its natural form, and it knows how to process, deliver, and use it.  We also need vitamin C to absorb iron and zinc.  We may be taking in enough of those minerals, but we are also taking in items that block the absorption OR are missing nutrients that help us absorb and use those nutrients.

Let’s look at supplements.  

Different forms of supplements have to be acted on by different actions in the body.  The capsule or tablet may need to be broken down, the chemical structure may need to be separated into smaller parts. The chemical may need to be combined with something else to be usable.  

Here are some forms to consider:

  • Liquid form
    • usually easier to absorb (under the tongue)
    • usually less “other” ingredients
    • Powdered form
      • can be a good choice depending on the structure of the chemical
    • Capsule
      • usually powdered and just enclosed in gelatin or cellulose capsule
      • -READ THE INGREDIENTS! Sometimes it contains more than the supplement 
    • Tablet
      • usually more difficult to break apart and lots of fillers.  These sometimes contain dyes.  WHY?!

From the vitamin C example, 

            Vitamin C in an orange is ascorbic acid which is very unstable and is oxidized by air.  You want to eat foods really fresh and raw to get the most vitamin C. Cooking, heating, and exposing these foods to light depletes the vitamin C.  How long has that produce been sitting in transportation vehicles and on supermarket shelves?  Supplements can be made to be the same chemically, but they don’t come packed with other nutrients which may be what we need to absorb and get the most benefit found in its natural state.  

Many people are anemic from a lack of B vitamins.  We don’t eat “B vitamins,” we eat foods that contain the chemicals that our body needs.  Thiamine, vitamin B1,  is found in many plant and animal foods from brown rice, legumes, asparagus, peas, sunflower seeds, most nuts, broccoli, sea vegetables, to eggs contain thiamine.  In plants, it is in a free form that is more easily absorbed than that in animal foods. In animal foods, it has phosphorus attached to it.  We must have the right “tools” in the digestive tract to remove that phosphorus, so we can use the thiamin. All forms have to be transformed in the body to be stored. Coffee, black tea, blueberries, brussels sprouts, and red cabbage can all decrease our body’s absorption of thiamine. Some of these are “healthy” foods?!  But, when we eat these foods with vitamin C, it actually helps us absorb the thiamine.  This is why we want to eat raw foods with our cooked foods.  If I eat cooked brown rice with brussels sprouts, I may not absorb the thiamine. Add a salad with raw red bell pepper and tomatoes, and I will absorb it better and get the added benefits of the salad.  Other things that can prevent absorption and use of thiamine are gluten, processed foods, alcohol, sugar, stress, table salt, water that contains sodium fluoride (tap water), zinc supplements, and excess vitamin D. Signs that I’m not absorbing thiamine include headaches, nausea, fatigue, irritability, depression, brain fog, loss of appetite, and muscle cramps.  Now these symptoms can be from MANY other things, as well!  But thiamin is something to consider if you have several of these.  

Should you take Thiamin as a supplement?

That depends on how deficient you actually are.  It may be better to find ways to eat to boost your levels.  Supplements can interact with other medicines, so do your own due diligence before buying that next bottle, even those over the counter.  Thiamin can interact with some heart meds and diuretics and even with some herbs.

In assessing anemia, it’s important to look at the big picture.  Some labs may look like someone is deficient in one thing, where it could be the vitamin, mineral, or enzyme that’s required to absorb or use that item.  Some nutrients are more difficult to extract from foods than others, and some nutrients require things like good amounts of stomach acid and bile to be extracted and absorbed.  We need the right digestive enzymes to break apart some chemicals for better absorption.  

It is a better idea, to eat a VARIETY of fruits, vegetables, beans, nuts, and seeds.  This is an excellent way to get all of the different nutrients. Eat the Rianbow!  Every day, no every MEAL, look at your plate.  Do you have different colors on your plate? Make it a goal to get in all of the colors every day and to vary the shades of those colors each week.  For example, if you are bought a lot of spinach this week, swap that for romaine next week.  If you bought a lot of red bell peppers this week, swap those for yellow and orange next week, and get a different red fruit or vegetable for your “Red.”

Over the next few weeks, I’ll share more about vitamins and minerals and what to look at when you are considering or evaluating your supplements.


As for our iron I mentioned above, the iron in animal products is heme-iron, and it is absorbed better than non-heme iron.  Eating foods high in iron with vitamin C-rich foods enhances its absorption.  The body was not made to handle high amounts of heme iron, and it does not have a mechanism for elimination.  Signs of iron deficiency include pale nails, inflamed tongue, constipation, headaches, dizziness, restless legs, and depression. These are very similar to other things.  Never assume an iron deficiency, and do NOT take iron supplements without a medical  evaluation. Excess iron can be lethal! High iron is also associated with cardiovascular disease, cancer, diabetes, Alzheimer’s, Parkinson’s, and hemochromatosis. If you are concerned about your iron, consider foods first.  Foods like spinach, soy beans, lentils, garbanzo beans, lima beans, olives, collards, bok choy, asparagus, leeks, chili peppers, and other beans, peas, and seeds all contain iron.  Eat them with fresh squeezed lemon juice over the top, a side of kiwi fruit, a raw green salad with raw red bell peppers and tomatoes.

2 responses to “What Does it Mean to be Anemic?”

  1. […] C, and vitamin B1, about supplements, and briefly about iron.  If you missed part 1, click here.This week, we will discuss what is needed for healthy red blood cells and what symptoms could be a […]


  2. […] we need to really be sure to take if we get “It.” Most of those were already mentioned in Part 1:What Does It Mean to be Anemic?, Part 2: Anemia: Let’s Talk Vitamins (and Iron) , and Part 3: What Other Vitamins […]


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: