Living Vegan In Charlotte, NC

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 3

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.”

VegCharlotte Christmas

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

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?

punjabi greens and beans 2

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.

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30 Responses »

  1. This is a great post. Most doctors in India say that anyone that doesn’t eat red meat is always prone to anaemia. Since there a ton of Indians who are vegetarians, iron supplements along with orange juice was always the prescription to bring hemoglobin back to normal. And of course almost once in 2 days, people ate spinach and dates to stay on track:)

  2. Being vegan has actually been good for my anemia- mine was caused by Celiac’s Disease! I hope you get everything worked out!

  3. A very interesting post! I have to admit that when I saw the title I wondered if you were going to share that lots of vegans are anemic due to their diet (I’m SO glad that’s not what this was about!). Celeste 🙂

    • LOL! Quite the opposite! Once I started doing some digging I realized many cases of anemia are caused by other physical conditions and that a vegan diet can actually help! I think it’s the junk food vegetarians that are at the biggest risk of anemia because of their diet … they don’t get animal sources of iron, but if they depend on dairy/cheese/packaged veggie burgers etc. for their protein instead of beans/lentils/greens they are setting themselves up for anemia.

      And .. BTW … I wanted the title to be intriguing!

  4. Great post! I think it ts so very important to address health”issues”on vegan blogs. Something that is not done very often. But it can be oh so helpful to a new or aspiring vegan.

  5. I don’t know how big your fibroids are or what course of treatment you will decide on but I would like to share what my mom did. I tsbp of molasses in hot water every morning. This caused hers to reduce in size. She also did aloe vera blended with honey, I would suggest maple syrup or agave to veganize. Some people also do aloe vera blended with milk. As a girl just hitting puberty I also got a small amount of the molasses tea and the aloe vera. I took less than my mom and only about once a week instead of daily. The molasses tea suppresses appetite in some people and can cause weight loss. It just made me hungry. Molasses is also a great source of iron. Also there is inflammatory related anemia or something along those lines. My iron was the highest when I was popping ibuprofen like candy and not taking any supplements.

  6. Great advice and a few home truths for me. My caffeine intake is dreadful and I have acid reflux disease which means antacids are a regular. I will look into making some changes! I hope you are feeling better now. 😀

    • I’m feeling fine, thank you. Actually never really felt “bad” just “stressed.” I’ve had acid reflux too … worsens in times of stress … but I can already see reduced caffeine consumption helps tremendously!

  7. I enjoyed reading this post… and the iron-rich foods that you posted look very yummy (I am not a vegan, but I enjoy vegan and vegetarian meals!). Best wishes, Shanna

    • Oh, thanks, Shanna .. that makes me feel good! I realize not everyone is vegan or vegetarian, but part of my mission is to show that vegan meals can be yummy and healthful, whether you are a vegan or not! I believe i have the recipes posted for the pictures shown … channa palak, sweet potato soup, and punjabi beans and greens.

  8. Hi, I have been a vegan for around two years now and recently got some lab work done. Everything seems to be super awesome except my iron. They said it is too High. I am a 26 year old dude and pretty active. Ive been doing some research on how to lower it a bit before they do my re-test next week. Here is what I have been eating that might have caused it. Whole lot of beans, salads along with one fruit and a cup of water at every meal. I have been eating about 6 meals a day including peanut butter sandwich in the mornings and oatmeal in the evening. One green juice every day which include 2 kale leafs, hand full of spinach, small peace of ginger, green apple, one carrot, cucumber, small peace of aloe Vera, half of no pale, Chia seed, hemp seed, and wheat grass. I am going to exchange the green juice for green tea along with some other stuff. But for girls that daily green juice might higher it for sure.

  9. Oh my gosh! Thank you so much for this post. I have almost the exact experience as you…pepped up on being vegan and no idea I was anaemic because I lacked overwhelming symptoms.

    I also feel terribly nauseous on the iron tablets so I’m going to try cutting down on the coffee. Hopefully it’s as simple as that as I already eat tofu daily and also eat beans, greens and lots of fruit.

    And like you my B12 was fine. And I thought thats where there’d be a problem.

    Again, thanks for the post!

  10. great post, I have a friend that wants to tradition to a plant-based diet but she suffers from Anemia and doctor only recommendation is ‘you need to eat more red meat’ 😡 so she is afraid to do it… I will share your post with her! thanks 😀 Ana xx

    • Hope this helps her! I have so many omnivore friends who are anemic, I don’t think red meat is an issue here at all. I will say I’ve made a few more changes since I originally wrote the article. I’m eating much more fruit. And I am not only eating several servings of leafy greens per day, I am conscious about alternating the greens – as it may be easier for one’s particular body type/chemistry to absorb iron, calcium, or other nutrients from different greens. And also you should be consuming cooked greens as well as raw. Highly recommend How Not To Die by Dr. Michael McGregor – I “tweaked” my diet based on his suggestions and immediately felt more vibrant (while feeling pretty good before!)

  11. Wow! Thank you for this article! I recently had bloodwork done and was told I’m “slightly anemic” but was prescribed a 325 mg iron pill. Whoa! Not in my body! How is that okay for “slight anemia”?
    So now I’m looking at my diet. I love coffee but usually only have 1-2 cups in the morning and that’s it. Will cut it back to 1 for sure and not with my meals.
    I also was told that I have a small fibroid but it’s nothing major.
    I already know I do not want to take an iron pill so I’m going to try treating it with diet.
    I haven’t been the best vegan and could use more beans, lentils and fruit.

  12. Thanks for sharing!! Great information !

  13. I read that spinach, although it has a lot of iron, also contains oxalates that can block your absorption of iron. Also, I read that soy has phytates that can stop you from absorbing iron. Actually, I found an article that said spinach, black and green tea, wine, soy and coffee can all mess up your iron!! Eeek! Anyway, I had to quit eating/drinking all these things. It was hard at first, but I am now drinking herbal tea, as I was eating/drinking all of the above and really felt miserable/exhausted. We’ll see if it works. I am like you and don’t like taking pills except B12. Glad you are better!

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