If you’ve told your doctor you’ve felt low energy and more tired than usual they probably screened you for anemia. If you were diagnosed with anemia and it was due to iron deficiency they may have prescribed iron pills, which helped bring your blood work back into normal limits so you were no longer anemic…but what if you still felt tired when all your blood work was normal?
If that sounds familiar, this short video will help you understand why and what you can do about it.
https://youtu.be/8jL7cOpgPW4
What is Anemia?
Anemia is a condition in which there is not enough red blood cells or hemoglobin in the blood.
Red Blood Cells (RBCs)
From last week’s video, you’ll remember that RBCs are important because they carry oxygen around the body – and all of our organs, from our brain to our hearts need oxygen to function.
- Red blood cell (RBC) count: the number of red blood cells in your blood sample
Hemoglobin (Hb)
- Hemoglobin: the protein in red blood cells that allows it to carry oxygen around the body. Hemoglobin contains iron as part of its structure, which helps hemoglobin bind oxygen.
To screen for anemia, hemoglobin and RBC count are measured as part a complete blood count (CBC for short) which also provides important information like:
- Hematocrit (Hct): the proportion of your blood that is actually made of red blood cells
- White blood cell count: to check for infection
- Platelet count: to check for clotting ability
In the case of anemia, we focus on hemoglobin, hematocrit and RBC count which will all likely be below the normal range. The CBC is ordered on your annual blood work – so no excuses ladies – go out and book your annual physical with your MD &/or ND.
Common signs of anemia include:
- General fatigue
- Low energy
- Weakness
- Dizziness/feeling lightheaded
- Pale complexion
- Headaches
If you watched last week’s video on iron, these symptoms should sound familiar!
Is your hemoglobin “normal” or optimal?
Now the normal ranges of CBC values, including hemoglobin, hematocrit and RBC count vary slightly from lab to lab so I won’t go through those here. But one thing I check for all of my patients is that their lab values aren’t just within the normal range – but are optimal. This means they’re not just above the lower end of normal. I check to make sure their values are about mid-range. I also compare their values to previous years so I can analyze any trends that may show a decrease early enough that we can prevent anemia if necessary. At the end of the day, if the values are low normal and you’re still feeling very fatigued, it’s worth investigating possible causes of anemia.
Why is my CBC normal but I still feel super tired?
Some common causes of anemia include the following (not an exhaustive list!):
- Decreased RBC production
- Iron, B12 or folate deficiency
- Low intake: No red meat or other foods rich in iron? Vegetarian? Vegan?
- Reduced absorption of minerals and/or vitamins (also known as malabsorption)
- Digestive conditions, for example, Celiac disease, Crohn’s disease
- Medications: proton-pump inhibitors e.g. pantoprazole) for heartburn (GERD = gastroesophageal reflux disorder)
- Chronic kidney disease
- Iron, B12 or folate deficiency
- Increased RBC loss
- Heavy periods for menstruating women
- Bleeding stomach ulcers
- Bleeding anywhere in the body
The bottom line
If you experience borderline or recurrent anemia, talk to your naturopathic doctor or medical doctor about further investigation and treatment for the above causes.
Join me next week for an important discussion about testing that all women need to know about if they are interested in a healthy weight, metabolism & hormones.
