We often come across the complaints of low iron or Vitamin B12 or folate deficiency among patients; it affects everyone but mostly the women in India at 53%. These nutritional deficiencies lead to lower than normal haemoglobin levels, appropriate for age and sex. Among women, for example, the anaemia is defined as a haemoglobin level below the normal range of 11.5 -13.5 gm%.
Though nutritional anaemia – deficiency of iron, folate, Vitamin B12, for example – can affect anyone, the women of reproductive age group and children up to five years are at most risk. Recurrent menstrual loss after reaching puberty, nutritionally deficient food during pregnancy and lactation, early age of childbearing, poor access to antenatal care and overall nutrition are amongst the leading causes of anaemia among women in India.
The sources of food-iron also play an essential role in the prevalence of anaemia. In India, non-haem-based or vegetarian sources such as green leafy vegetables, lentils are more accessible and commonly consumed compared to the haem-based sources including meat, eggs and fish. The haem-based food-iron is absorbed easily than the non-haem-based food-iron sources, and the Vitamin B12 and Folic acid supplied by the haem-based sources aids the formation of haemoglobin.
Signs and symptoms of anaemia
The initial symptoms of anaemia are minor, increasing the risk of prolonged exposure. The most common symptom is fatigue, weakness and poor concentration, especially after exertion, dark circles around eyes and increased hair-fall. Other common symptoms include breathlessness, palpitations, headache, pale skin, puffy swelling on feet and increased pulse rate. In the case of anaemia due to blood loss, such as heavy or prolonged menstrual flow the symptoms develop rapidly. At my clinic, I have observed that many women ignore these initial signs and symptoms, and seek my advice only when the symptoms aggravate to health complications, for example, menstrual irregularities, hair fall, oedema of feet, or a more severe breathlessness. Chronic anaemia expresses through behavioural changes including irritability, listlessness or loss of energy, anger and low feeling. Like many health issues, early detection of anaemia improves the outcome of medical interventions.
The most common and the most accessible blood-test for anaemia is the simple haemoglobin level check. Additional tests of serum ferritin level, total iron binding capacity, folic acid and vitamin B12 levels are required, if initial treatment does not yield results.
The most personalised anaemia treatment
Ferrum Phos and Ferrum Metallicum are the most commonly prescribed homoeopathic medicines for iron deficiency anaemia; these improve iron absorption and help in supplementation. Biocombination #1 is an effective homoeopathic combination used specifically for nutritional anaemia. Natrum Mur is useful in cases of anaemia in adolescent girls where the presentation is a headache and menstrual irregularities. Cinchona and Phosphoric acid are helpful in cases where the anaemia develops after exhausting diseases where there is blood loss. Thus, homoeopathy has a wide range of medicines to offer specific, personalised and the accurately personalised treatment for anaemia patients.
A 34-year-old lady visited my clinic complaining about swelling on lower limbs for several months, and headache. Her haemoglobin level was 7 gm%, and the iron stores were extremely low. She was prescribed homoeopathic medicines along with a diet chart, which met her daily requirement of iron and Vitamin B12 and folate. I examined her after three months. The swelling on feet had considerably reduced, her haemoglobin rose to 11 gm%.
Another 25-year-old young woman complained of hair-fall. She reported no weakness and fatigue. She was getting married soon; therefore, hair-fall was her only concern. When the initial treatment for hair-fall showed no improvement we tested her for haemoglobin; it was at 8 gm%. Iron-rich diet and medicines treated her anaemia, considerably reducing her hair-fall.
Besides the increased demand for iron and vitamins during pregnancy, the other cause of anaemia among women is haemodilution. The symptoms include fatigue, pallor and it puts a strain on the maternal cardiovascular system, increasing the risks during delivery and the cognitive development of the newborn. Homoeopathic medicines like Aletris and Acetic acid are useful for pregnancy-related anaemia; however, the doses are decided basis patient history and examination.
A patient in her seventh month of pregnancy complained of breathlessness and tiredness; she attributed the long-neglected weakness to weight gain. After talking to her, I learned that she ignored the iron supplements prescribed the doctor resulting in her haemoglobin levels plummeting to 10.1 gm% from 13.8 gm% in the third month. Such a sharp drop in haemoglobin levels was the reason for her health issues; I prescribed supplements along with homoeopathic medicines. A follow up after one month showed improvement in her health and delivery was without any complications.
Vitamin B12 and Folic acid that we can receive only through animal products such as milk, meat, chicken, eggs and fish are essential for the formation of haemoglobin; vegetarian and vegan diets cannot possibly supply us with enough of these essentials putting us at higher risk of developing anaemia.
A 43-year-old woman visiting my clinic complained of dark circles around her eyes, irritability, lethargy, and tingling in feet. Her haemoglobin levels were much low at 9 gm%. Moreover, she told me that haemoglobin levels have always been low throughout her life. With such a prolonged anaemia, she had become used to the symptoms without realising that her behavioural traits were due to anaemia. Also, her strictly vegetarian diet led to Vitamin B12 deficiency along with iron deficiency. She was advised to improve her milk intake, besides some homoeopathic medicines to improve her B12 absorption. A follow up revealed not the only improvement in haemoglobin levels, but also her irritability had reduced.
Eat right to keep anaemia away
A balanced, iron- and Vitamin B12-rich diet is the most critical aspect of anaemia-management. A nutritious diet does not necessarily mean expensive food products; affordable and readily available foods like jaggery, curry leaves, beetroot, pumpkin, sweet potato are a good source of iron. Eggs at least twice a week will help to meet the dietary requirements to keep anaemia at bay. Other iron-rich dietary sources include green leafy vegetables; dry fruits like dates, raisins; fresh fruits like a pomegranate; legumes and pulses such as rajma, dried peas, chickpeas. Folic acid is found in all green leafy vegetables, beans, peas and lentils besides citrus fruits. Amongst dry fruits walnuts are a good source of folic acid.
Women often focus on the nutrition and the health of family members and ignore the health symptoms they suffer. This leads to the neglect of their health, complicating simple and easily curable health issues like anaemia. I think one saying is very accurate of anaemia: prevention is the best, but the cure is simpler too.
References
- The burden of iron deficiency anaemia among Indian women by Rajesh Kumar, Wafaei Fawzi, Anamita Barik and A Chowdhury.
- Principles and practice of Medicine by Sir Stanley Davidson.
- A Lady’s manual for Homoeopathic therapeutics by E Ruddock.
- A select Homoeopathic Materia Medica by Tarkas P and Ajit Kulkarni.
- Efficacy of Ferrum Phos in iron deficiency anaemia single-blind randomised placebo control trial by Dr M.L. Dhawale Memorial Homoeopathic Institute