Anaemia - iron deficiency - anaemia
t is a good idea to take a closer look at this issue. In addition, it is occurring at a time when the Western world has a diversity of food options like never before in human history. Meat consumption worldwide is increasing year on year. Overall, there has probably never been such high meat consumption in human history. And this is about the most iron-rich food we have. For the younger among us, it is hard to imagine that for our great-grandmothers and fathers there was a very simple monotonous diet in winter. Potatoes were the main meal and a compote was the dessert on Sundays. Or that there was sometimes a bad harvest, and then it became very difficult, so that there were also emigrations of an entire village. Before we get to the bottom of this paradox, let's take a look at what tasks iron has in our organism and what the effects of a deficiency are.
Definition of anaemia:
In the blood test, there is a reduction in the erythrocyte count and/or haemoglobin and haemotocrit. In this article we deal exclusively with iron deficiency anaemia. Almost all cases are iron deficiency anaemia and most of them affect women. Rare forms of anaemia are, for example, sickle cell and spherical cell anaemia, which involve an altered form of the erythrocyte. As anaemia is usually not a disease in its own right, but a secondary disease, there is infection anaemia, tumour anaemia, renal anaemia (kidney), etc.
The symptoms are mainly of a general nature and not always easy to classify. Tiredness, fatigue, lack of concentration and depressive tendencies are among the main complaints. Cracked and dry corners of the mouth, pale mucous membranes such as typically the pallor of the inner side of the lower eyelid, as well as the inner surfaces of the hands, are then already somewhat more specific and can give indications of iron deficiency. The symptoms of iron deficiency are mainly caused by the associated lack of oxygen. People tend to have palpitations and shortness of breath even at low exertion. Despite anaemia, the cells should be sufficiently nourished with oxygen, and thus the heart beats faster.
Our red blood cells, the so-called haemoglobin, consists of a protein part (globin) and the iron-containing haem. The iron content enables the oxygen in haemoglobin to be transported. It absorbs this in the lungs and is finally released to the cells in the tissue. Iron also fulfils its function as an oxygen binder in myoglobin.
Iron distribution in the body:
Most iron is found in the erythrocytes, about 75 %. 20 % of the total iron is in the tissue or cells. 5 % in myoglobin. The body's iron stores are the liver, the bone marrow and the monocyte-macrophage system.
Seems to be a clear situation. Too little iron, so add more iron. If we look at the importance of iron for our organism and the metabolic processes that are connected with it, it will hopefully become obvious to each of the dear readers what a nonsensical procedure it is when it is done in this generalised way.
Can an entire ocean fit into a bucket that has a hole in it?
I heard this question once in another context and the undeniable answer "yes" astonished me at first. It was about happiness, which we are unable to hold on to if we are not aware of our inherent true happiness. It slips away from us and we chase after new happiness and always have the feeling of being empty-handed. Let us use this image in the context of iron intake. In fact, we only take in an average of 1 mg of the daily 10-15 mg of iron from food (that's all we need). In the vast majority of people diagnosed with anaemia, the reason is not an insufficient intake of iron, but the ability to convert it. Exceptions are too much blood loss in accidents and too heavy menstrual bleeding. How do we get the approx. 1 mg? In its free form, it is mainly found in its trivalent form in food and thus cannot be absorbed. Only in its bivalent form does it become blood iron. This decisive step depends on sufficient enzymes in the stomach in the form of hydrochloric acid formation (HCL). Therefore, it is much more important, analogous to the anaemia of the human body, to get the iron going again through an improved HCL production. The amount of iron is less important. A weak enzymatic system is the hole in the bucket. The iron cannot be absorbed and thus has no value. More specifically, the basic problem is not addressed in the slightest when iron tablets are given. Moreover, the vessel (i.e. the body) is properly burdened by the iron. In its free form, iron is quite toxic for our cells. That is why the organism has developed finely tuned systems to deal with too much or too little iron. Especially with too little, because it has only very limited possibilities to excrete iron. It did not expect the invention of iron tablets and is therefore quite unprepared. Meanwhile, he has developed highly complicated mechanisms to move the iron back and forth and convert it into different forms. Ferritin (storage form) is one of the most important tools. Too little free iron does not mean too little iron in the organism. During infections, which can also go unnoticed, the iron in the blood typically decreases and the storage iron increases. It is mainly held by the macrophages, which we need for defence. If there is a further overload of iron and enough ferritin, it is stored in haemosiderin. This is another laboratory parameter, but it is rarely of relevance for diagnostics. More important is the transferrin saturation (TfS).
Diagnosis via blood test (the three most important):
- Ferrum, the free iron.
- Ferritin, the stored iron
- Transferrin saturation (TfS)
The determination of Ferrum alone is not sufficient. The other two are needed. In addition, protein electrophoresis can provide further information (the erythrocytes are small and pale in the blood smear). Acute infections can lead to a sharp drop in free iron without there being an iron deficiency. Therefore, the ratio of these three is important to get an idea.
Back to the body's own regulatory systems:
And from then on it becomes more and more complex, and we are not yet ready to understand it in its entirety. The bone marrow probably plays a major role in fine-tuning iron levels by signalling a higher or lower need for iron to the intestine via signalling molecules. This brief treatise is only intended to give an idea of how complex and sophisticated the fine-tuning of iron balance is. And we throw iron bombs at this fine construct. The endocrinologist Ingrid Mühlhauser said very aptly about such procedures:
"There is no need to tamper with the body."
A low iron level can promote our health.
Let's go one step further to clarify our one-dimensional way of thinking, and further underline the quoted statement. So let's broaden our view by looking at ourselves as an ecosystem. Not only do we live in one, but we are one ourselves. There are more bacteria in one gram of faeces than there are people on earth, according to current scientific knowledge. This fact alone is enough to establish us as an ecosystem and needs no further argument. 99% of the microorganisms that live with us are in the gut. Our intestinal microbiota weighs up to 2 kilos. Oops, we had by no means included this incredible number of bacteria in our considerations on iron metabolism. Although they are constantly on our backs, we never think about them. "The absorption of iron is controlled in the small intestine", we had already established. And 2 kg of bacteria shouldn't be in the middle of that? That would be most surprising. They have been practising the art of communication in our intestines for about 300,000 years. We have only recently, in ancient times, practised it. Our training was probably too short, and we have already forgotten most of it, limiting ourselves more and more to sentence phrases and smileys. They already had 65 million years of preliminary study in the intestines of primates (apes are a group of primates). Just like us, iron plays a crucial role in the growth and flourishing of bacteria. Somehow we have managed to develop and maintain a friendly working relationship with this unimaginably vast preponderance of microbes; and over this enormous period of time. We are alive! Regulation over certain undesirable groups of bacteria proceeds via the deprivation of vital iron, or so it is believed at present. Regulation occurs via a curbed intake of iron from food. Iron is incorporated as storage iron (ferritin) and probably via other mechanisms that we do not yet know. We already know more about the connection between infection and iron. An increased iron content in the blood increases the susceptibility to inflammation and infection. It favours diseases like gout and rheumatism. It is now thought that this is one of the reasons for the low iron content in most pregnant women. This lowers the risk of infection during pregnancy. Isn't reproduction the central point for the organism, which it has been training and developing for about 300,000 years to ensure? Another very simple reason is that the iron content naturally (physiologically) decreases because the expectant mother gets an increased blood volume (1.5 times), but the iron remains potentially the same. We, on the other hand, look intelligently at the laboratory value and want to know better.
We are not looking at extreme cases of iron substitution, but at people with a general symptom such as fatigue. The enormously high annual iron tablet prescriptions largely concern this type of patient. It is standard practice to prescribe iron tablets for pregnant women. In this context, it is also interesting to note that sales of iron preparations are increasing rapidly worldwide. World market leader Vifor Pharma made 44 percent more profit in Switzerland in 2016 than in the previous year with intravenous drugs alone. By sending elephants into a fragile china shop as a company consultant, I am not necessarily promoting the flourishing of the business. In many cases, such actions block the self-regulation, i.e. the self-healing of the organism, to put it more objectively. I hope it has become clear what the chosen title of this section is supposed to express.
The cornerstone of holistic therapy:
- Herbal therapy
What comes first to improve blood formation, i.e. iron metabolism, is as clear as dumpling broth to the attentive reader: regular inclusion of iron-rich vegetables in the diet, or meat from the health food shop. No, don't. Fiddlesticks! Someone hasn't been paying attention. Since in most cases it is not the lack of iron in food that is the cause, but weak enzymes in the stomach, we have to start there first. And we do that, quite simply, with a hearty breakfast. There are worse therapies, aren't there? What does hearty mean? It should be spicy. The flavours salty, sour, spicy and bitter all stimulate the hydrochloric acid of the stomach. There should be some of that in the food. Goat cheese, avocado cream with lemon, salt and pepper, a soup, a classically prepared porridge, .... and many other treats do this. The only thing that doesn't is sweet muesli, which is so popular. Sweet doesn't stimulate, it calms. We have just got up, the sun is rising or about to reach the peak of its illusory power, the day's work is about to begin or the many leisure activities are waiting for us, and we are about to take a sleeping pill. It just doesn't go together. Muesli combined with fruit then makes us even more flatulent. The shrewd reader might now say that they are a stimulant, so everything is fine. "My good friend. Let us remember in this respect that man is a social being, and naturopathy also takes this into account." Second comes the iron-rich diet. And if we then also eat a bitter component such as chicory or radicchio regularly with it, these are good conditions for the right balance in the iron household. It should be noted that the iron from animal foods is easier for us to utilise because it is fat-soluble (at least that is the usual doctrine). List of particularly iron-rich foods.
For some of us, the increase in exercise may even come before the increased intake of iron-rich foods. Exercise stimulates the peristalsis of the intestines (thus the enzymes) and also increases the number of erythrocytes. A hike in the mountains would increase the production of erythrocytes even more. Essentially, it can be said that mental, emotional relaxation is very very conducive to good digestion. Stress paralyses digestion. Here we have arrived at probably the greatest evil for health in today's society: Stress. Let's add its other siblings: Fear, anger, doubt, greed and a few others whose names I have just forgotten. If you live for a few years in a friendly relationship with this baggage (lumpenpack), the hydrochloric acid formation in the stomach gradually dries up. We are still subject to ancient archaic principles. We want to live. Everything in us cries out for it. The distinction between danger and peace was and is vital. It works quite simply. No rounds of talks with pros and cons, but a decision in a moment to one of these two possibilities. The autonomic nervous system either remains parasympathetic or switches to the sympathetic nervous system. With the first, everything is in the green. No danger, we can chill. This is the time when digestion gets the most attention. We get an appetite, can relax and go to the toilet and find other quiet places to have a nap. The sympathetic nervous system keeps us on our guard. Adrenalin is released and the lungs and heart are better supplied with blood. If necessary, we have to run away or climb a tree in the face of the wild animal. Or we sit there racking our brains over broken relationships, the power of bullying takes hold, how can we save our business, etc. Then all the energy is in our fetching coconut sitting on our shoulders. This energy is taken away from digestion. No time for the sensual. A common cause of stomach mucus inflammation (gastritis). The stomach is well protected from hydrochloric acid. However, this is not produced sufficiently in these times of need. Everything distorts the "vain coconut". This inflammation in turn increasingly slows down the all-important hydrochloric acid that promotes blood formation. And now comes another absurdity: we live in a fun society. Never before have people, at least in the western world, had so many leisure opportunities. Cinema, theatre, wellness oases, holidays, excursions by car, train, planes instead of plough horses, music while jogging or waiting in the queue at the department stores', chatting with a pearl from other lands, ... it's really fun. So much fun that we no longer even notice the enormous stress inside us. Our archaic vegetative system doesn't even check anything! It always thinks we are at war.
Medicinal plant therapy - phytotherapy:
In most cases, we exert the greatest effect by using medicinal plants for internal intake on a daily basis. They have a greater stimulant effect than the food plants, which in turn are more substitutive. There we are again at the main starting point, and this time I won't make a quiz question out of it. We want to activate and improve the gastric metabolism through regular administration. Because only when there is enough hydrochloric acid can the proteins be completely broken down and the iron be converted into the blood pigment. The medicinal herb therapist or Ayurvedic doctor sees himself in front of a richly laid table from which he can relax and choose. It is primarily bitter plants, especially the aromatic bitter substances, that are very beneficial to us here.
common mugwort, lovage root, oregano, savory, boar's-foot herb, .... In dandelion we have a bitter plant that is also rich in iron. It is one of the most iron-rich plants we have in our latitudes. Artichoke leaves: it is perhaps the thistle richest in iron and, through its bitter substances, promotes blood formation and stimulates bile production. Nettle: like dandelion, it is one of the most iron-rich plants and is also rich in manganese, which plays an important role in blood formation.
The pillars of a holistic approach to therapy:
- We should think of liver metabolism because bile is the most iron-rich fluid in the body. If the liver produces enough bile, a good part of the bile remains and is reintegrated into the liver metabolism and can be supplied to the bone marrow for blood formation. The storage iron ferritin is formed in the liver. Liver plants for improved bile formation: Boldo leaves, turmeric (curcuma), Benedict thistle, artichoke leaves, milk thistle leaves.
- Furthermore, we should therapeutically include the spleen. Liver and spleen are closely connected. The spleen undertakes, among other things, the blood moulting. Obsolete erythrocytes are sorted out. The blood pigment bilirubin is produced. This is finally bound to a protein (albumin), as it is toxic, and transported to the liver. A well-functioning spleen facilitates the work of the liver. The spleen is involved not only in blood purification but also in blood formation. The liver in turn gives the spleen the impulse for blood formation. Most liver plants also promote the spleen. Typical spleen plants are: Grindelia and plants from the ferns, lichens and algae.
- The presence of the following trace elements is necessary: copper, manganese, cobalt, zinc, molybdenum. If these are insufficiently present, iron supplements are of almost no use. Often constipation is the result.
- Include the renal metabolism: The formation of new erythrocytes is stimulated, among other things, by the hormone erythropoietin (EPO for short). In cases of anaemia, this messenger substance is released in the kidney and leads to an increased formation of red blood cells in the bone marrow. If the kidneys are impaired, this hormone is no longer produced in sufficient quantities. Kidney metabolism stimulating: dandelion, lovage, juniper most strongly (do not administer these in the case of kidney inflammation, i.e. glomerulonephritis).
The expert chooses the appropriate components from those listed. A part of the herbal reception (combination of several plants) should always take into account the acute symptoms and also include the constitutional context.
Tannin-containing plants slow down iron absorption: e.g. black tea, coffee and other tannin-containing teas.
Anaemia from an Ayurvedic point of view:
In the approx. 2500 year old Ayurvedic textbook "Charaka-Samhita", the cause of anaemia is explained as follows:
"Due to a weakened Agni (digestive fire), more Ama (undigested) is produced. This results in Rasa Dhatu (plasma tissue) not being well nourished and then in turn Rakta Dhatu (blood tissue) is not well nourished. "
The digestive fire (Agni) mentioned above can be equated with the formation of hydrochloric acids, which has been mentioned a lot in this article. In Ayurveda it is called Jathara Agni. It is one of the 40 main types of Agni and is of central importance for our health.
If we look a little further than the mere laboratory figures, we also come across complex interrelationships in this topic that can cause astonishment and admiration when looked at more closely. The complexity should not frighten us, because we can counter it with the simplest plants. Plants that we should walk past almost every day, not just sitting at the computer, and also frequently step on regardless. Mrs. Nettle and Mr. Dandelion send their regards. Since iron deficiency in most cases has nothing to do with too little iron, it is contraindicated to administer such supplements, because they only cause more problems for the organism. If you would like a herbal mixture that is better suited to you than the nettle-dandelion combination, which takes into account your individuality and other complaints as well as the time of year, then it is best to consult an alternative practitioner.
Your therapist should fulfil three requirements:
- Good knowledge of the mentioned field forest meadow plants.
- Knowledge of the explained interrelationships of iron metabolism.
- An eye for the individual.
These three prerequisites for a non-medical practitioner are truly not witchcraft, but the simplest, most solid craft. Whereas the administration of iron tablets, without even the slightest glimpse of a connection, nor sufficient diagnostics, is truly bungling.