a few cups of mixed nuts are placed on a rimmed baking sheet to be toasted in the oven.

A case of mysterious anaemia

Janelle drooped in for her appointment. There was no other way of describing her dispirited entry. She lost no time in coming to the point of her consultation.

“I seem to have no interest in food — nothing tempts me. Constipation is making my life extremely uncomfortable. I try not to take laxatives too often, but all the natural things like slippery elm, chia seeds, flax seeds, aloe vera and herbal compounds have made no difference. I think I must have swallowed every probiotic brand in town, but nothing seems to provide an answer. My husband is complaining that I’m becoming too irritable to be around.”

Janelle also mentioned that headaches and dizzy spells were a common problem as well as difficulty concentrating on her work or tasks at hand.

On examination, both her hands and feet felt like blocks of ice. Janelle’s skin tone was verging on slightly mud-coloured; lips were bloodless and pale and nailbeds were almost white and showed a brittle tendency. Her eyes were puffy and she had surprisingly firm legs with abnormally shiny skin.

“I seem to have no interest in food — nothing tempts me.

“All your signs and symptoms seem to point strongly in the direction of anaemia,” I told her. “Have you had any blood tests?”

Yes, Janelle had brought a file of haematology results covering the past two years. Folic acid and vitamin B12 were well within normal range. Her GP had prescribed an iron tonic, but Janelle found it exacerbated her constipation to the point that she developed a painful anal fissure. (As most people are aware, the most common cause of anaemia is a deficiency in iron, the mineral that makes haemoglobin, which attaches to oxygen and carries it round the body.)

When questioned regarding abnormal blood loss, Janelle said her periods lasted three to four days with no blood clots or heavy bleeding; she was not using an intra-uterine contraceptive device and she took no aspirin or anti-inflammatory medications.

As far as eating habits were concerned, Janelle described sensible, well-balanced meals with a sound basis of healthy protein, nuts and seeds, some organic cereals and fresh vegetables and fruits. There had to be a missing factor which, so far, was proving elusive.

The missing link

Sometimes an in-depth look at inherited weaknesses can shed light on a puzzling situation. Janelle was quite familiar with her ancestral frailties: arthritis, hardening of the arteries, macular degeneration and cataracts, varicose veins, strokes and chemical sensitivities. These all had a common link in nutritional terms.

As mentioned earlier, red blood cells have a most important job — one that is unique to them. That job is carrying oxygen-rich haemoglobin to every cell in the body. Deprived of life-sustaining oxygen, our cells would “starve” and disintegrate.

Now, red cells are not immortal. They have an average life span of about 120 days, after which they die and their haemoglobin is lost. Needless to say, not all red cells break down at the same time and our body has the innate capacity to replace deficient cells as fast as they are being broken down.

Unfortunately, this happy balance of supply and demand can sometimes go awry. Red blood cells may expire before their natural time span is up and bone marrow can lose its ability to reproduce them fast enough. In other words, the problem is not one of adequate cell quantity, but reduced cell longevity. There may be more than enough iron for the body to manufacture haemoglobin, but if haemoglobin-carrying cells expire prematurely, the outcome will not be conducive to the maintenance of energy and good health.

It had occurred to me that all Janelle’s ancestral weaknesses appeared to be associated with the biochemistry of the tocopherol family. In the case of a vitamin E deficiency, red blood cells are known to be abnormally fragile in their response to hydrogen peroxide, and hydrogen peroxide is generated through the action of the enzyme superoxide dismutase, an enzyme found in the body’s cytoplasm as well as in mitochondria.

Vitamin E deficiency anaemia is much more widespread than generally suspected. The vitamin is one of our body’s essential antioxidants, protecting cells by preventing the formation of hydrogen peroxide when vitamin E reserves are insufficient. Essential fatty acids — especially linoleic acid — combine with oxygen to form hydrogen peroxide: a known destroyer of red blood cells. It is also possible that specific intracellular enzymes, supporting membrane integrity, are more easily oxidised if vitamin E is in short supply.

Janelle was, therefore, advised to add organic cold-pressed apricot oil and hazelnuts to her diet and given a supplement that encompassed all the known components of the vitamin E group. Such a simple solution for a seemingly complex set of signs and symptoms.

Karin Cutter

Karin Cutter

Karin Cutter ran a naturopathic clinic in Port Macquarie, NSW, Australia.

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