Anemia is a very common and very important symptom. It basically signifies a low red blood cell count or a low hemoglobin level. It is a critical symptom because hemoglobin contained in the red blood cells carries oxygen from the lungs to every cell in the body. When one is anemic, one's energy level decreases and one can become easily tired. If the condition is extreme, oxygen starvation occurs with many other problems such as fainting, low resistance to infections, inadequate oxygenation of the tissues, and many others.

How blood is produced

Blood is produced in the marrow of all the long bones of the body. This may seem like an unusual place for blood formation, but the reason for it is that the bones actually protect the marrow from most contamination due to various toxins, including toxic metals. Today, however, most people have some toxic metals in the bone marrow itself. This is one reason for blood disorders.

Once the red blood cells are formed in the marrow, they circulate for about four months before they are destroyed in the spleen. Their components are then recycled to make new red and white blood cells. This is actually a fascinating process and one that can go awry due to many factors.

Anemias are often divided into two types. The first is a failure to produce enough or high enough quality red blood cells. The second is too rapid or too much destruction of red blood cells by the spleen or for some other reason. Usually this occurs when the red blood cells are not healthy and robust.


1. Iron deficiency. The bone marrow needs iron to make red blood cells. Iron plays an important role in the proper structure of the hemoglobin molecule. If iron intake is limited or inadequate due to poor dietary intake, anemia may occur as a result. This is called iron deficiency anemia. This is most common in poor nations where people do not eat meat and eggs. It also occurs during pregnancy in some cases, and in young women who have very heavy menstrual periods. It can also occur in some vegetarians who do not eat meat or eggs. Finally, it can occur due to hidden bleeding in the intestines, for example, or somewhere else, perhaps due to an ulcer, cancer or to an accident or injury.

Iron deficiency produces a microcytic, microchromic anemia, meaning that the red blood cells are too small, and they are not very red when viewed under a microscope.

In our experience, simple iron deficiency anemia is not that common in the industrialized nations, except among some vegetarians and young women with extremely heavy menstrual periods, and is easy to take care of by adding more meat and eggs to the diet, in most cases.

Copper anemia exactly mimics iron deficiency anemia, and is far more common. It causes a microcytic, microchromic anemia exactly like iron deficiency, can cause low ferritin, and it is extremely common. Doctors often give women iron for this condition, which only makes the women more ill. It is discussed below.

Iron is very toxic when in excess. Therefore, beware of taking iron or eating too much meat. In fact, iron overload is extremely common. Our bodies have trouble removing iron, so iron easily can build up in the body, where it causes or contributes to all the major diseases of our time. These include arthritis, inflammation, heart disease, diabetes and cancer.  For more on this, read Chronic Acquired Iron Toxicity on this website.

2. Copper-related anemia. This is often the most common type of anemia today due to widespread copper imbalance in the population. Many apparent iron deficiency anemias are caused by copper imbalance and require a nutritional balancing program to balance copper in the body. Signs and symptoms are those of a mild, chronic, microcytic, microchromic anemia. It occurs most often in young adult women and, at times, in children, though it can occur in anyone.

Biologically available copper is required for the conversion of iron from the ferric to the ferrous form, and back again, to produce hemoglobin. Bioavailable copper is also required to incorporate iron into the hemoglobin molecule.
While anemia due to copper imbalance appears identical on blood tests to iron deficiency anemia, the cause and correction is very different, and it will not respond well to supplemental iron. A hair mineral analysis can help distinguish the two types. Taking iron is not healthful for most people and unnecessary in most cases. In fact, taking iron supplements is very harmful for some young women. For more on this, read Copper Toxicity article on this website.

B12 deficiency. Vitamin B12 deficiency causes a macrocytic or so-called pernicious anemia. Most people lose some ability to absorb vitamin B12 from their food as they age. This is a serious problem for many over the age of 60 or perhaps younger, especially if the digestive tract is in poor condition or if one is under a lot of stress. Vitamin B12 is found mainly in animal foods, so vegetarians, especially vegans, are much more prone to this serious condition.

Vitamin B12 deficiency anemia can cause permanent brain damage with symptoms of confusion, memory loss, dementia and even death. It is often missed by doctors in its early stages. A mild B12 anemia may also occur in vegetarians, or others who do not eat much meat or eggs.

Lead and other toxic metals. Lead poisoning is well known for causing a type of anemia that can be fatal. Hidden lead toxicity may be responsible for anemias of chronic disease. This is seen commonly with cancer and other degenerative diseases. Elevated lead is often not revealed on any tests until it is eliminated from the body using a nutritional balancing program or some other method. Lead is often hidden because it is deposited deep within bone marrow and other inaccessible areas of the body.

Toxic metals such as cadmium, mercury and others may also affect the bone marrow and interfere with zinc or copper metabolism. This occasionally causes unusual types of anemias and other blood problems.


Vitamin C deficiency may interfere with iron absorption.

Vitamin E deficiency affects the stability of the red blood cell membranes. Low vitamin E also causes a macrocytic anemia with shortened lifespans of the red blood cells.

Copper deficiency can impair iron absorption and incorporation of iron into hemoglobin. This is essentially identical with the copper-induced anemia described above but is due to a frank copper deficiency instead of bounavaliabe copper.

Zinc deficiency can cause a higher copper, which, in turn, interferes with iron metabolism.

Vitamin B6 deficiency can inhibit synthesis of the heme portion of the hemoglobin molecule.

Vitamin B2 or B5 deficiencies, while rare, may cause anemias.

Rarely, excess zinc intake can interfere with iron absorption and cause a copper deficiency. It also decreases copper and iron levels in the liver. This can affect the incorporation and release of iron from liver ferritin. It may also increase the fragility of red blood cells.

Folic acid deficiency, can cause a macrocytic, macrochromic anemia similar to B12 deficiency anemia.


Drug-caused anemia. This is another extremely common type of anemia due to internal bleeding, usually from the stomach. It is most commonly seen in older people who use non-steroidal anti-inflammatory drugs for pain such as aspirin, ibuprofen, Tylenol, Aleve and the others. These drugs damage the stomach lining and cause chronic internal bleeding in thousands upon thousands of people. Stopping the drugs is usually sufficient to correct the cause of the anemia. We would suggest always avoiding long-term use of these drugs for this very reason, as often the bleeding is hard to detect until the anemia is far advanced.

Chronic infections. These may cause anemia by an interesting mechanism. The body may sequester iron to keep it out of the blood stream during some infections because iron tends to favor the growth of certain bacteria in the body.  One must correct the infection and the anemia most often subsides.

Other infective organisms such as beta-hemolytic strep may destroy red blood cells.

Cancers. Cancers develop extensive networks of blood vessels and these sometimes rupture, causing internal bleeding. This will result in an anemic condition, at times with no other symptoms at all.

Anemia related to kidney disease. The kidneys release a hormone called the erythropoietin that helps the bone marrow make red blood cells. In people with chronic (long-standing) kidney disease, the production of this hormone is diminished, and this in turn diminishes the production of red blood cells, causing anemia. This is called anemia related to chronic kidney disease.

Parasitic infection. In some areas of the world, leeches, other blood-sucking parasites, and worms that may live inside the body can siphon off enough blood to cause anemia. This is rare in developed nations, however.

Chemical poisoning. Pesticide exposure or something else will occasionally cause unusual blood disorders of many kinds. In general, the chemical poisons the bone marrow in some way and this impairs proper blood formation. However, other mechanisms may be present as well, such as weakening the red blood cells and hastening their destruction.

Sickle cell anemia and thalasemias. These are more genetically-related anemias found respectively in negro populations and Southern European populations. They are due to enzyme deficiencies.

Tests and diagnosis:

Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of your blood. For anemia, your doctor will be interested in the levels of the red blood cells contained in the blood (hematocrit) and the hemoglobin in your blood. Normal adult hematocrit values vary from one medical practice to another but are generally between 38.8 and 50 percent for men and 34.9 and 44.5 percent for women. Normal adult hemoglobin values are generally 13.5 to 17.5 grams per deciliter for men and 12 to 15.5 grams per deciliter for women.


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