Vegans and Anemia (The Myths, The Shocking Truth)

When I heard the words, “You’ve got severe anemia!”  the first thing I thought was “Oh, NO!  I’ve been a BAD vegan!”

‘Cause, you know that’s what we hear all the time.  B-12 deficiencies, yada yada yada.

But it turned out my B-12 levels were perfectly fine!

I had iron-deficiency anemia.  Which still left me perplexed.  Raised in the Southern US and partnered with a Punjabi Indian, I am the poster child for eating beans, lentils, and leafy greens!  All excellent sources of iron!

Chana palak. Spinach, tomatoes, and dried chickpeas. Yep, I should be meeting my iron quota.

So what went wrong?

Nothing with my being vegan.  In fact, I think being vegan actually allowed me to continuing functioning at a higher level, despite the anemia.  I didn’t fit any anemia stereotypes.  My skin is naturally fair, yet I am constantly complimented on my healthy “glow”.  I heal quickly from bruises and scratches.  My good friend K.D. teases me about being “perky.”

According to my doctor, at the time this picture was taken I should have been on a stretcher awaiting a transfusion instead of partying on into the wee hours!

Yes, I had been feeling a bit overwhelmed – but I’d been filling in for a coworker who was on a leave of absence, I was working through lunch almost every day and racking up overtime each week, I’d had seven new properties added to my portfolio, I was beaten up by a bouncer at Dandelion Market.  I didn’t question feeling a bit more tired than usual. But that seemed logical under the circumstances, and that was my only symptom.  “A bit less perky than usual.”

The culprit was – like my mother and sister, and 40% of all American women, and maybe as much as 75% of women in my age group – I’d developed fibroids.  Again, I think my vegan diet allowed me to function at a higher level than otherwise.  Sure, I’d always had a heavy “flow,” but since I never experienced any pain, cramping, backaches, PMS, or other discomfort I never thought anything about it.

Until I had that recent bloodwork.

There were a couple of other factors that came into play – diet factors not related to veganism.

One, my company does not have a water cooler.  They do, however, have a Keurig coffee machine and probably two or three dozen varieties of K-cups.  I was never a coffee drinker, but faced with toting in a day’s supply of water every day or unlimited free delicious K-cups – I started drinking more and more caffeine. Caffeine negatively affects your body’s absorption of iron from foods.

Two, I started getting a little heartburn from all the coffee (and, no doubt, the stress).  So, what did I do?  Instead of treating the cause (too much caffeine), I treated the symptom (heartburn).  Turns out antacids also interfere with iron absorption.

Since there was no useful advice forthcoming from my doctor other than “take an iron pill,” I had to do my own research and come up with my own “treatment plan.”  I’m now sharing the results of my research with you.  Please keep in mind I am not a medical professional!

FIRST, strange but true – non-vegans actually have a HIGHER risk of being anemic than vegans!  Partly because dairy blocks iron absorption.  And partly because vegans naturally eat more Vitamin C rich foods that increase iron absorption.

So, should you be diagnosed with anemia, don’t immediately assume it is just because of your diet as a vegan! Please have yourself checked out for other physical causes first.  If you are a woman, you could be anemic simply because of heavy menstruation, fibroids, or other female problems.  And vegans of both sexes should be checked to rule out other causes such as ulcers, kidney disease, and cancer.  Keep in mind there are also less scary causes of anemia … such as being a blood donor or an athlete, or just regularly doing intense exercise.

If you are a menstruating woman, have your hemoglobin and iron levels checked at your yearly physicals.  If your levels are low, ask if you should be taking an iron supplement.  If your levels are normal, or if you are a man, you don’t need to supplement – it could even be harmful!

If you take an iron supplement, take it with a glass of orange juice to increase absorption.

Eating an orange or other Vitamin-C rich food with a meal increases iron absorption greatly – some sources say up to 600%!

Some of the B vitamins are also essential to processing iron.  As vegans, I think most of us either take vegan multi-vitamin supplements with extra Bs or a B-Complex supplement.  If you don’t, you probably should.

Conversely, drinking caffeine during or after your meal decreases iron absorption from food.  This includes coffee, tea, and yes, even soft drinks!

Antacids also have an iron-negative effect.  If you regularly take one, take a moment to Google it and find out if and how it affects the absorption of iron (and possibly other vitamins).  Consider an alternate treatment, like digestive enzymes. Or, if you can, reduce or eliminate the foods that have adverse effects on you (coffee, maybe)?

There are two other things that can reduce your absorption of iron …

Dairy.  This is of no concern to vegans, but for vegetarians reading this blog, it’s one more reason you should consider giving up milk and cheese.  Dairy can decrease your absorption of iron by up to 50%!

Calcium Supplements.  Mind, I’m definitely not saying you should stop taking your calcium supplements … but, consider taking them in between meals.

What about food?

Most leafy greens are fantastic sources of iron (kale, collards, turnip greens, mustard greens, dandelion greens, chard, spinach).

Other vegetables that are high in iron include sweet potatoes, winter squashes (acorn, butternut, spaghetti), broccoli, cauliflower, brussel sprouts, asparagus, carrots, cucumber, green beans, radishes, tomatoes …

Sweet potato soup – high in Vitamin A, Vitamin C, and Iron!

Of course, beans and lentils are excellent sources of iron – and as vegans, we’re all eating lots of those – aren’t we?

Another beans and greens dish!

Fruit was the biggest surprise to me.  I had some idea that dried fruits were good sources of iron – raisins, prunes, dates, peaches, apricots.  But even fresh fruit can be a surprisingly good source – applesauce, oranges, orange juice, peaches, pears, figs, grapefruits, plums …

Bottom line … it’s really easy to be a junk-food vegetarian but not a junk food vegan.  As long as you’re eating a healthy variety of beans, greens, fruits, and vegetables, you’re probably not in any real danger of anemia.  And if you ARE diagnosed with anemia … don’t just assume it’s your vegan diet; look for underlying physical causes.

Update 9/24/14 – I stopped taking the iron recommended by my doctor because it was making me terribly nauseous and ill. ZERO symptoms from anemia versus being almost to sick to get out of bed … I instinctively felt that was not the right treatment.  Instead, I changed my diet.  I reduced my caffeine intake – eliminating my coffee to perhaps one or two Starbucks “treats” per month, and on days I wasn’t in England, having no more than one cup of tea per day.  The drastic reduction in caffeine also made my elimination of heartburn medications rather easy.  I changed the timing of my calcium pill to  not coincide with mealtimes, and finally, I became very conscientious of eating a serving of citrus fruits or juices with at least one of my meals every day (optimally two).

Result?  In one month (without taking iron pills) I was back in the “low normal” range.  A few months later, I was firmly in the “normal” range – without taking iron, eating liver, or having a hysterectomy which were all suggested treatments.

Tagged as: anemia, iron, iron deficiency diets, iron rich foods, vegan, vegans less likely to have anemia, vegans more likely to have anemia, vegetarian