What is the "poor" in anemia? Can eating red dates make up for it?

Chen Miao

In life, people often say that they suffer from anemia. In fact, it is not an independent disease, but a clinical symptom. Similar to fever and cough, anemia is just the tip of the iceberg of many diseases in the human body.

What is anemia?

One is the reduction of red blood cell production. If the human body lacks the raw materials needed for hematopoiesis, such as iron, vitamin B12, folic acid, etc., it will cause iron deficiency anemia and megaloblastic anemia. Adults mainly produce blood in the bone marrow. When suffering from bone marrow diseases, hematopoiesis is abnormal and anemia will occur due to the reduction of red blood cells, such as aplastic anemia, myelodysplastic syndrome, leukemia, myelofibrosis, etc.

The second is excessive loss of red blood cells. Some patients lose too much red blood cells due to heavy bleeding, such as heavy bleeding caused by trauma, bleeding caused by gastrointestinal ulcers or tumors, hemorrhoidal bleeding, excessive menstrual flow causing blood loss, and excessive blood loss during childbirth.

The third is excessive destruction of red blood cells. Various reasons lead to the destruction of red blood cells, shortening their lifespan and causing hemolytic anemia.

How to determine whether you have anemia

Anemia refers to a clinical syndrome caused by a decrease in the volume of peripheral red blood cells, which is lower than the lower limit of normal values, and hemoglobin (Hb) cannot transport enough oxygen to human tissues. It is generally believed that anemia can be diagnosed when Hb is less than 120g/L in adult males and less than 110g/L in adult females.

If you feel tired, weak, have palpitations, dizziness, shortness of breath after activity, or have decreased ability to move around than before, you need to consider the possibility of anemia.

The most common nutritional anemia can be identified by checking serum ferritin, vitamin B12, and folic acid. Other commonly used tests to determine the cause of anemia include reticulocytes, blood cell morphology, liver and kidney function, fecal occult blood, and bone marrow examination.

Who are the most susceptible groups to iron deficiency anemia?

Iron deficiency anemia is the most common, and its high-risk groups include: children, the prevalence of iron deficiency anemia in children aged 0-14 in my country is as high as 19.9%; women, the proportion of women aged 18-49 in my country whose iron intake is lower than the recommended amount is as high as 72.2%, and women are at risk of iron deficiency due to blood loss during menstruation; vegetarians, this group of people's diet is mainly plant-based, and the absorption rate of plant-based iron is very low, mostly below 10%. In addition, the elderly and pregnant women are also high-risk groups for anemia and need regular physical examinations.

It should be noted that coffee contains caffeine and other substances that can inhibit the body's absorption of iron ions; and the tannic acid contained in strong tea easily combines with iron to form insoluble substances. Long-term and large-scale drinking of these drinks can easily cause iron loss.

Can asymptomatic anemia be ignored?

Anemia can cause hypoxia in the body. Over a long period of time, the body will gradually adapt and develop tolerance. Especially for young people, they may not feel any obvious discomfort at first, but in fact anemia can still cause symptoms such as memory loss and lack of concentration, and they will feel flustered and short of breath after a little activity. Long-term anemia can also cause some chronic damage. For example, in order to compensate for the hypoxia caused by anemia, the heart needs to increase blood pumping, which can cause an increased heart rate, myocardial thickening and heart enlargement. Therefore, patients with anemia should seek medical attention as soon as possible to find out the cause and correct the anemia.

What to do if iron deficiency anemia recurs after stopping medication

Iron deficiency anemia can be quickly cured by iron supplementation. However, the cause of iron deficiency is often that women lose a lot of blood during menstruation, and the iron intake and absorption from the diet is relatively insufficient. Therefore, after iron supplementation is stopped, menstrual blood loss continues and anemia will recur. Women with uterine fibroids and adenomyosis will not easily recur anemia if their menstrual volume decreases after gynecological treatment, or if they reduce their menstrual volume through medication, placement of the Mirena ring, etc. If the menstrual volume still cannot be reduced, the patient needs to continue iron supplementation and take an iron pill every other day or every two days until menopause.

Is dietary supplement effective for anemia?

Ordinary people attach great importance to dietary supplements, which needs to be viewed on a case-by-case basis. Mild iron deficiency anemia can be improved through diet, such as eating more red meat, animal liver, animal blood, etc., which are rich in iron and easy to absorb. However, some red foods, such as red dates, red beans, brown sugar, peanut skins, and iron pan cooking have little effect on iron supplementation. Drinking strong tea or coffee after a meal will also affect the absorption of iron. When moderate to severe anemia occurs, patients need to supplement iron through oral iron supplements or intravenous iron infusions under the guidance of a doctor. In short, if anemia is not caused by nutritional deficiency, dietary supplements are often ineffective, and appropriate drug treatment is required for the cause.

(The author is the chief physician of the Department of Hematology at Peking Union Medical College Hospital)