Dr. A explains iron deficiency anemia: why it happens (blood loss, heavy periods, GI bleeding), how to spot it (fatigue, brain fog, pallor), and how doctors diagnose and treat it with iron supplements, dietary changes, or IV iron. Lab work takes 3 to 6 months to show improvement.
So today I want to talk about anemia and we're going to limit it because anemia is a huge topic. We're going to limit it to the most common anemia, which is iron deficiency anemia. I'm Dr. A. Welcome to this YouTube channel I use for patient education, et cetera. I've been seeing patients with cancer and chronic illness for decades at this point, and I've been teaching and researching in the integrative community for the last 30 years. I use the channel to answer a lot of questions and get into deeper discussions. So the first thing is, How common is iron deficiency anemia? Now, you certainly can have too much iron. That does happen as well. But iron deficiency anemia, it's the most common type of anemia, and it happens for any number of reasons. Now, the first thing we often hear about is reasons related to blood loss. So certainly, if you lose blood, you had surgery, or you've had some digestive system bleeding that they fixed, but now you're anemic, or you have regular menstruation, heavy menstruation, anything in that arena, you have to watch for anemia. And there's a lot of other reasons you can get iron-deficient anemia, but that's why this is the most common type of anemia, and that would be iron deficiency. So what do we look for? Well, traditionally, when you're looking at anemia, you're looking at the current amount of red blood cells, so the number, and also the amount of hemoglobin and the hematocrit relationship to each other, looking at the mass of red blood cells. You look at the indices, which start with a big M, so like MCV and all the other M numbers. Those are related to the average sizes and efficiency of the red blood cells. Then you usually look either at the iron binding concentration, like TIBC, UIBC, and you ought to be looking at ferritin, which is stored iron. One thing with ferritin is it can go up when you're inflamed, and you may not have high stored iron, but you might be inflamed. So it's a good marker, but something to look at there. And then your doctor may add other stuff on. So they might look at your reticulocyte count, which are immature red blood cells. Usually you look at the red cell distribution width, which should be a certain amount. If it goes really high, what's happening is your marrow is pumping out a lot of extra red blood cells. This happens after blood loss, stuff like that. So that's kind of how you test for it. And so they may come back and say, yes, you're anemic. Now, what would be symptoms that would make you think you're anemic? Well, one of the things would be chronic fatigue, acute fatigue, any type of fatigue. One of the first rule-outs is, does a person have some kind of anemia if they're fatigued? This comes from the fact that iron through hemoglobin binds, helps hold your oxygen, take it around your body. Oxygen goes in, helps the ATP work, and you make energy. Well, the lower the iron I have, the lower the movement of oxygen to create energy, ATP activation, et cetera. The other things that can happen are numerous. You can get some skin effects. You can have brain fog. You can have increase in memory The other thing I've seen in the neurodiverse community is it can aggravate whatever neurodiverse traits the person has. So we see a lot of children with inattention or hyperactivity. They get worse when they're anemic. Any number of— well, think about it. Your brain needs oxygen. And if we start to lower that because we lower the amount of iron and hemoglobin activity, your brain's going to be unhappy, right? Other things that you can see sometimes in the person would be very, very white. The white part of your eye just sort of blanching and getting very white. The mucous membranes in the mouth will get very pale. It doesn't matter what color your skin is, because all the mucous membranes are going to look similar because they don't have the outer, you know, layer of skin that creates the color that we see on our skin. So, mucous membrane pallor, and a large number of other things. So, how do we address it? Well, as with all things, before you supplement, you should have food that help to increase your iron stores. So, people will always say, well, do I have to eat liver? No, you don't have to eat liver. Liver has a high iron content, but green leafy Green vegetables are a wonderful source of iron, and iron in the digestive system absorbs better with vitamin C. So a lot of times if we are having somebody increase their green leafies and/or take supplements and/or eat, you know, meat with iron or whatever, we're gonna be having 'em take vitamin C with that to help the absorption. Then the next step would be supplementation. If you go to your primary care, you'll get Feosol, like ferrous sulfate, something like that. That can be helpful. It can cause You know, a lot of constipation, et cetera. I generally will give patients a hematonic complex, which is a supplement that has 2 forms of iron. So there's heme iron and non-heme iron. Heme iron absorbs without transporters. Non-heme iron, like ferrous sulfate, needs transporters to absorb. So heme iron is like you would get from foods and stuff. So it'd be put in there. Usually we have a mix there. There are supports to other part of hemoglobin formation, like vitamin B6 is often in there. And as I said, vitamin C, and you may have other stuff in a hematinic complex. I like that better than just iron tablets. If it's real bad and/or if we don't want to put iron into your GI tract, such as during cancer therapies and many other things, we will use intravenous iron. Now, intravenous iron, the old-style intravenous iron, has a lot of allergy associated with it. Most of the modern types of intravenous iron have much less allergy. I've done thousands of these infusions and generally, you know, very, very low reaction rates. You do need to go to a specialized A lot of nephrology clinics do it. Hospitals obviously do it and other places that deal with iron infusions. You just want to make sure, like any intravenous procedure, it's somebody who does iron infusions and they know about the dosing and the safety and all of that that may go along. Now, it does take some time to rebuild. So if you're going to eat the iron and that's your source, you know, you might want to recheck in 4 to 6 months. If you're going to eat the iron and you're going to take, you know, a hematitic complex, maybe check in 3 to 4 months. If you're getting iron Infusions, what we usually do is a series. We calculate the amount of iron to give, we do the IV series, give the person about 3 weeks off to let all of the numbers re-equilibrate, and then recheck them. So that could be rather quick with iron infusions. All right, I hope this answers your questions. Love you on the channel. Thanks for all the new subscribers. Like, share, subscribe, do all the stuff. We're going to post some other videos up here for you to take a look at, and I will see you all on the next video.
