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Understanding Anaemia
We all know that when one is anaemic one is tired and pale and that a blood test shows low iron levels. We know that pregnant women can become anaemic, as can girls at puberty or women with very heavy menstrual blood loss. Some children who naturally seem to be pale and have dark rings under their eyes are anaemic. We also know that treatment for anaemia involves iron supplements, but what does it all mean? Holistic medicine offers much more satisfactory understanding and treatment of anaemia than does orthodox western medicine.

How can we identify and treat sub-clinical anaemia, which does not show up on standard blood tests, but which is experienced at some time by quite a large proportion of us affecting our health and quality of life?

As a consulting herbalist, I am always on the lookout for sub-clinical anaemia and its involvement in both low energy and vitality and in lowered resistance to common illnesses.

Blood tests for anaemia were one of the first uses to which blood testing was put. It was easy to measure the amount of iron in the blood and so tests were able to confirm scientifically what the Doctor already knew by observing the patient and taking their history.

Blood testing has gone on to new and better things but is still widely used in the greyhound racing industry for example where the dog which is under-performing and probably has pale gums is tested and found to be low in iron. Iron supplements are prescribed and the blood levels are confirmed by later tests as being somewhat higher. The dog is very often not performing much better, but the levels are up and the gums are less pale. All this blood testing and the assumption that low iron levels can be fixed by putting more iron in the diet has made iron tonics a standard part of greyhound diets.

Now it is true that some of us, who don't eat enough red meat or green vegetables, seem to become anaemic, but we have to ask why not everyone, with a similar diet? What about the greyhound, which always has a diet extremely high in red meat, how come it is not getting enough iron in its diet? What happens to all this iron anyway?

The blood tests and the iron tonics stopped us asking all these simple questions and prevented us from understanding what it is all about. Let us start from the beginning, and follow the iron and the red blood cells around in our systems to see what can happen.

The Bone Marrow:

Red blood cells are produced in the bone marrow, which is sort of interesting. We know that bones are hollow and need to be to maximize their strength while keeping their weight low. As a result the hollow bones provided quite a large volume within the body, which was available to be put to use. Evolution decided this would be a good space for the blood factory. The vitality and efficiency of the bone marrow can be seen as the starting point in the chain of events, which can show up, as anaemia in the body.

We also know that in some desperate blood related illnesses, bone marrow is transplanted into the sick person to help kick start aspects of their immunity, which have broken down, so there must be more to this marrow stuff than that which meets the eye.

The Spleen:

The business of taking up oxygen into the blood (which occurs in the lungs), and its release to sustain living tissue around the body is also well understood. The fact that these red blood cells wear out on a regular basis and must renewed about every twelve weeks is not so commonly known by lay-people. The process of inspection and renewal takes place mostly in the spleen, which is a large organ behind the bottom of the left side rib cage. The spleen, like the marrow, is another of those body parts which we don't pay too much attention to except that it is often damaged in seat belt injuries on the drivers side on English and Asian roads and on the passenger side, on American and European roads.

The process however of breaking down and replacing worn out red blood cells however provides the first opportunity for iron loss in our system.

The Veins:

We all know the blood is pumped through the body by the heart and then transported back through the veins when it is spent. What we don't understand so well is that the whole of the circulation system leaks. Our blood vessels are not plastic pipes, they are flesh pipes and they leak a little. The arteries are rather more robust and muscular than the veins and that is why they leak less than the veins do.

Leakage through overly fragile vein walls provides the second major opportunity to lose red blood cells and therefore reduce iron levels within the body.

The Lungs:

All of our blood is pumped through the lungs every time around and the lungs are constructed of very fragile blood vessels indeed. They have to be if the oxygen is to pass through the walls of these vessels and be taken up by the red cells in the blood. Bleeding into the lungs is not so common in humans, as it is for example in the modern racehorse, but it must be considered along with everything else.

Shallow and inefficient breathing however, is very common in humans. Since anaemia is really not primarily a problem of the red blood cells themselves but rather the amount of oxygen available to the living tissue within our bodies, some anaemia is really a breathing problem and not a blood problem at all.

Other Blood Vessels

We have fragile blood vessels in our noses to pre-heat the air coming into the lungs to avoid freezing them. We have fragile blood vessels in the bowel to assist in the reclamation of fluid from faeces. We have fragile blood vessels in the kidneys to assist in the removal of toxins and acids. We have blood vessels feeding the musculature of the stomach and digestive system generally, which can be exposed through ulceration or weakened through the use of aspirin.

We must consider the health and wellbeing of all of these vessels when looking to understand the thing called anaemia.

Other organs:

Bleeding from the kidneys is not as common in humans as it is in racing greyhounds where it can be due to over stimulation of the adrenal glands and aggravated by the abuse of electrolytes and diuretics. Bleeding originating in the liver or the spleen or the pancreas is also rare and only usually occur following motor car accidents. Bleeding from arteries especially from an aneurism in the chest or abdomen will often kill you. Bleeding in the brain causes stroke.

In any particular case showing symptoms of anaemia, especially ones which come about quickly, we should be on the lookout for any possible source of bleeding however improbable. Rapid diagnosis and appropriate intervention may be life saving.

Iron Loss:

The body in staying alive, does not use up iron, it is recycled, as we have seen. The spleen digests and breaks down depleted red blood cells releasing iron to be re-used to make new ones.

Permanent iron loss can only occur through:
  • Menstrual bleeding in females.
  • Extra high demand for iron as in the case of a pregnancy.
  • Leaking blood vessels due to fragility as in veins where the blood is taken into the lymphatic vessels and discharged through the bowel.
  • Bruising as a result of fragility, ageing or drugs like steroids and aspirin. The blood lost is ultimately picked up by the lymphatics, as in the case above, and discharged through the bowel.
  • Breaking fragile blood vessels as in nosebleeds or bleeding into the bowel from haemorrhoids, ulcers or cancers.
  • Bleeding into the stomach or digestive system as in a perforated stomach or duodenal ulcer.
  • Internal and external wounds as in impact damage to internal tissues or puncture wounds.


Blood Testing:

Treating a low iron reading found in a blood test without considering all of the above is obviously nonsense. All those Vets and all those laboratories routinely testing blood from racing greyhounds and racehorses and prescribing iron tonics to those with low readings are mostly wasting money, time and resources.

Most doctors treating humans still look at their patients, still ask questions about all aspects of their health and history and are quite capable of considering all of these factors. Most of these doctors also know that the dream of managing health through tests is nonsense, will never be possible and that most moves in this direction, while good for business is not especially good for patients.

Specific blood tests prescribed by experienced diagnosticians, to rule out specific serious conditions is really as far as blood testing need be taken and, if used this way would reduce blood testing and the resultant cost of these services, to a tiny fraction of current usage.

We may effectively analyse the exhaust gas from our automobiles and use the results to find out which particular part of the system is malfunctioning. We may be able to correct a performance problem so detected, by changing the specifications of the fuel.

What happens to gasoline when fed into an internal combustion engine however is vastly different from what happens to food or supplements when put into the mouth. The absorption or otherwise of iron from supplements and the use to which it is put, is affected by a myriad of physical, metabolic and emotional factors which will never be fully available to the 'scientific method' and neither should it be.

Some very severely anaemic people are primarily this way due to the effect of their emotions and attitudes on spleen function, and not at all to do with iron in their diets. This whole subject of the effect of emotions on health will be elaborated in several articles to follow.

Identification and Treatment of Anaemia:

Now that we have all the information to hand and we have an understanding of the factors which can be involved, identification and treatment is simple.

  • An anaemic patient may present simply with low energy. Everything is normal but they are unable to sustain an effort for very long or never ever feel they have enough energy even though they wish to do more.
  • They may present with poor resistance to common colds and flu. They catch all the infections, which their children bring home from school and take longer than they should to get over such things. I always ask my patients how their resistance is.
  • An anaemic patient may simply feel the cold. I observe how people are dressed and how they are holding themselves if it is cool. One of the questions I ask every single patient is 'Do you feel the cold?"
  • Anaemic patients never look red cheeked and healthy. They are pale, their skin often looks fragile and they often have dark smudges under their eyes especially the young.
  • I ask all patients about their circulation, do they have varicose veins, do either of their parents? Do they bruise easily and to bruises hang around for weeks before fading?
  • I observe how my patients are sitting and breathing. Lots of the pale ones are breathing from the top of their lungs only. Little light shallow breaths.


If my patients present with a specific history, or medical diagnosis or treatment for a blood disorder I ask about their treatment history and their experience with it. In some cases I will send them back to their Doctor with a suggestion that they order a specific test like for example occult faecal blood (non visible blood in the stools). This test will check for blood loss into the intestines or bowel which could be a result of ulceration or cancer.

The main herbs used in mixes I prescribe for anaemic patients:

In patients with specific and identified blood disorders I often treat them by supporting normal spleen and bone marrow functioning with Comfrey and with Yarrow. This combination in company with appropriate constitutional herbs regularly reverse conditions which the patients have been told are incurable.

I support normal balances between red and white blood cell production with Red Clover and Echinacea always paired and in the inverse proportions to which imbalance is found. Red Clover stimulates red blood cell production and Echinacea stimulates white blood cell production.

Not all herbs are safe in the hands of amateurs, please note the following cautions relating to Red Clover and Echinacea:

The popularity of Red Clover recently is risky for any of those who may be carrying lots of cysts of encapsulated toxins within their systems as this herb can release all these cysts back into the bloodstream suddenly causing a toxic crisis. Please note also a serious caution on the popular use of Echinacea, which is that it should never ever be used in a case of childhood Leukaemia where it can further elevate white cell counts.

If iron tonics are required I never prescribe commercial tonics only ever natural high sources of iron. Nettle is one, which can be given in extract form. Rosehips are one of the best tonics around being high in Iron, and having useful quantities of Copper and Cobalt also, which facilitate iron absorption. Often Yarrow as a bone marrow tonic is called for and Rue supports the strengthening of fragile blood vessel walls and can be the key to turning a whole class of anaemia cases around. I sometimes partner Nettle with Sage when there is a problem with the blood supply to the brain. I often bring in Prickly Ash where the peripheral blood supply to the extremities is a problem as is often the case in the elderly or the ex-smoking group. Elecampane is a herb which will support the muscular recovery to damaged or lazy lungs and Cactus and Hawthorne work together to strengthen the heart and support stronger and more regular beats.

As you can see there are many simple herbs which can work around any particular set of circumstances involved in cases of low blood oxygen (usually called anaemia).

Simple and (mostly) safe self-prescriptions:

Most of us can safely take a herbal tea made from 80% Nettle and 20% Sage to support iron levels in the blood generally and to the brain in particular. This is suitable for self-administration with the only exception that it could be dangerous given to someone with a history of, or prone to stroke. For all the others this invigorating aid to memory function is safe the only side effect possibly being a temporary headache due to all this extra oxygen in the brain, upon first exposure.

A drink I call 'Rocket Fuel' is safe for everyone from small babies to the elderly to take and is extraordinarily effective in dealing with a whole range of anaemia factors. It is prepared from cold Rosehips tea to which has been added a little Black Current fruit juice cordial. This tasty drink, used in place of all other soft drinks or cordials, for children will dramatically boost blood iron levels, immunity, kidney function and vein wall strength due to the unique combination of properties of these two herbs.

Buckwheat flour used in a pancake mix will strengthen blood vessel walls and this herb is the commercial source of Rutin first identified in the herb Rue and mentioned above. Rutin is also found in Black Currants and will support recovery from all problems due to vein wall fragility, from nose bleeds to stroke.

Please don't attempt to make up more complex herbal treatments for self- administration, as there are some cautions with a number of them mentioned above.

The present article has dealt only with the physical factors involved in low iron levels. As mentioned, there are many emotional and circumstantial factors which come into play as well and none of us can easily appreciate what these may be in our own case.

A professional herbalist, who can look at all the factors in your case much more objectively than you can yourself, should be consulted.

Robert McDowell
Herbalist
June 2001



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