Anemia

Background

Anemia is a condition in which the blood lacks enough healthy red blood cells (cells that carry oxygen to your body). It is easily diagnosed by a blood test called a hematocrit (part of a routine blood count).

The tricky, but important, part is determining the cause of the low blood count and correcting it when possible.

Causes

Although there are many potential causes of anemia, the more common causes are:

Iron deficiency

This can be determined with a blood test called a "Ferritin Level" test. The problem? The normal range is insanely inappropriate and misses about 90% of cases. If the ferritin level is under 60, I recommend treatment for low iron — and if chronic illness is present, iron treatment should be given if ferritin is under 100. Most doctors (and lab reports) consider anything over 12 to be normal, not realizing that using this "normal" level simply says you’re not in the lowest 2% of the population (see The Problem with Lab Testing).

Vitamin B12 deficiency

B12 deficiency is usually a result of poor absorption (called pernicious anemia, where B12 injections are recommended), poor stomach acid, or being vegan.

Other nutritional deficiencies

Other deficiencies, such as deficiencies in folate, vitamin B6, copper, and others, can cause anemia.  For these, simply taking a high-potency multivitamin works better than testing.

Low thyroid or testosterone

If this is the cause of anemia, the levels will usually be so low that the abnormality will show up in tests. Treating a low normal testosterone, though, will help raise the blood count, and can be helpful for anemia.

Chronic illness

This can suppress blood cell production.

Genetic blood conditions

Blood loss often from heavy menses or gut bleeding

Treatments

Most physicians are familiar with what tests to perform, but often not as familiar with how to interpret the results.  I will focus here on what to do that your physician may not be aware of.

Recommended Supplements

Multivitamin powders

Overall nutritional support is essential, and a good multivitamin powder is a simple way to provide it.  This will take care of many often missed nutritional deficiencies (low B6, copper, zinc, B vitamins, etc).

Iron and vitamin C

If the blood test for iron (called a "ferritin" test) is under 100, and anemia is present, take iron 25 mg with vitamin C 50 mg 1-2 tablets daily till the ferritin is over 100 (the ferritin test is considered "normal" if over 12, missing about 90% of those with iron deficiency).

Other Therapies & Advice 

Optimize testosterone levels with bioidentical natural testosterone

Men should optimize testosterone levels to bring their total testosterone level above 500.

Treat underlying inflammation

Treat underlying inflammatory conditions and illnesses.

Treat Bleeding

Heavy menses can be caused by low thyroid or low iron, even if lab tests are "normal," so I optimize these. Your doctor can check for blood in the stool and it is very reasonable to consider a colonoscopy, especially if you over 45 years old!