What does anemia mean?

A precise definition of anemia is a lack of hemoglobin in the blood. Hemoglobin is the red pigment that carries oxygen around the body and makes the red blood cells look red. Anemia may be due to a reduced number of circulating red cells, or to a fall in the hemoglobin content of the red cells, or a combination of both. Therefore anemia must be caused by a deficiency of certain factors that are necessary for the formation of red blood cells, such as iron, folic acid, Vitamin B12, or to a dimin­ished production of red cells. The latter group includes conditions such as leukemia, bone cancer and malignancy of the blood-forming material.

What causes Anemia?

We are only discussing the iron and vitamin deficiency anemias to which women are particularly prone. All of us lose some blood and, therefore, hemoglobin each month with menstruation. During pregnancy there are changes in the way our bodies use folic acid, which is one of the B vitamins. Both folic acid and iron are needed to help the baby’s development. If your body has too little folic acid, folic acid deficiency anemia will result, and this is why folic acid and iron routinely were given to pregnant women. We only need small amounts, but we need them daily, the best source being green leafy vegetables. The latest research indicates that all women may not need these supplements when pregnant, but deficiency is so serious that all women have their blood tested rigorously throughout pregnancy.

Symptoms of Anemia

  • Paleness of the skin, conjunctivitis and the lining of the mouth
  • Shortness of breath on exertion
  • Palpitations on exertion
  • Lack of energy
  • Sore tongue
  • Lethargy and constant fatigue
  • Vitamin B12 deficiency leads to tingling and numbness in the fingers and problems with balance; in advanced form there is confusion and loss of memory

Vitamin B12 anaemia, also known as pernicious anaemia, is usually the result of some abnormality in the way our bodies absorb Vitamin B12. Most of us get enough Vitamin B12 from our diets, but if there is a lack of a certain substance in our stomachs, known as intrinsic factor, Vitamin B12 won’t be absorbed. Pernicious anemia not only affects the production of the red blood cells, but it is vital to the central nervous system.

Should I see the doctor?

If you are pale and tired, especially if you are not eating a well- balanced diet for any reason, see your doctor check for anemia.

What will the doctor do?

You will be referred for a blood test to find out what the specific deficiency is. Normal hemoglobin levels are about 14g of hemoglobin per 100ml of your blood. If your reading is below llg/100ml, your doctor will treat you for anemia, although you may need further tests to determine the precise reason for your condition. As most deficiency anemias can be cleared up by dietary means, your doctor will probably give you supplements in the form of pills or injections, depending on the severity. Severe cases may require a blood transfusion. If it discovered that you have a Vitamin B12 deficiency because of an absorption problem, you would require further tests to confirm this, and you will need Vitamin B12 supplements for life.

What can I do?

The best form of treatment for any iron and folic acid deficiency anemia is prevention. All menstruating women should eat a diet rich in iron – green leafy vegetables, fish, red meat, liver, watercress, dried fruits. The B vitamins are plentiful in brewer’s yeast, wheatgerm products, and whole grains. If you are a strict vegetarian, you may need to supplement with synthetic Vitamin B12 as the best sources found in animal products such as fish, white meats, milk, cheese, and eggs.

Iron is quite difficult for the body to absorb efficiently and taking Vitamin C at the same time increases absorption. Antacid medications, on the other hand, limit the absorption of iron. You can greatly increase the content of iron in your food by cooking in iron pots.

Women at risk

Poor eaters

Most healthy women eat a balanced diet to provide enough iron, folic acid, and Vitamin B12. However, some women who eat junk food or are on a poor diet because of econ­omic circumstances or old age, or those who adopt extreme measures to combat their com­pulsive eating (bulimia nervosa) may become anemic. All deficien­cy anemias are most common among the elderly and poor.

Menstruating women

If your periods are excessively heavy (menorrhagia), you may lose more hemoglobin than you can make up in the following three weeks, and over some time this may lead to iron-deficiency anemia. Therefore, if you have heavy periods or frequent periods, make a special effort to include a foodstuff rich in iron in your diet.

Pregnant women

Pregnancy is a time of regular blood tests to check for deficiency anemias. The increase in the volume of blood (a pregnant woman has about 1 1/2 litres (3 pints) more blood) means that more iron is needed to supply the red blood cells. Folic acid needed for the development of the baby, and iron is laid down in the fetus’ liver as a store for the first six months of life because breast milk contains only traces of iron. If you have multiple pregnancies, make sure you take folic acid supplements and eat foods rich in the vitamin; mild folic acid deficiency is three times as common among women with multiple pregnancies.

New mothers
After the birth of your baby the tiredness and lethargy that often occurs may mask a mild case of anemia. You will need to build up your strength again, so continue to keep an eye on your diet and make sure it is full of iron-rich foods.

Heavy aspirin users

Aspirin taken in large amounts can lead to irritation of the stomach lining. If this causes internal hemorrhaging which goes unnoticed, anemia may be the first symptom of this form of drug abuse, which is common among women.

With affected relatives

The tendency to have insufficient quantities of intrinsic factors is inherited so if a close relative suffers from this type of anemia, you may be at risk.


Pernicious anemia may be the result of surgery on the intestine substance in our stomachs, known as intrinsic factor; Vitamin B12 won’t absorb. Pernicious anemia not only affects the production of the red blood cells, but it is vital to the central nervous system.

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