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Nutritional-deficiency anemia is a common issue that can happen if the body does not absorb enough of certain nutrients. It can result from an imbalanced diet or certain health conditions or treatments.

Nutritional deficiencies can lead to a low red blood cell count, low levels of hemoglobin in these cells, or red blood cells that do not function as they should. Anemia is a term for these issues.

Iron-deficiency anemia is the most common type, but low levels of folate or vitamin B-12 can also cause the condition, and a low vitamin C intake can contribute to it.

Anemia affects over 30% of the world's population, according to the World Health Organization (WHO). It is often more common in pregnant women and children. Anemia can cause severe medical issues and affect a person's overall health and wellbeing.

In this article, find out more about nutritional-deficiency anemia and how to treat it.

Iron-deficiency anemia can cause red blood cells to appear small, oval-shaped, and pale under a microscope. The paleness stems from low hemoglobin content.

Symptoms

a woman experiencing tinnitus due to nutritional deficiency anemia Share on Pinterest
Tinnitus is a common symptom of iron-deficiency anemia.

A person with iron-deficiency anemia may have:

  • pale skin
  • tinnitus
  • changes in the sense of taste
  • itchiness
  • a desire to eat ice
  • sores or ulcers at the corners of their mouth
  • a sore tongue
  • hair loss
  • spoon-shaped fingernails and toenails
  • difficulty swallowing
  • depression
  • missed menstruation in females during their reproductive years

Learn more about the symptoms of iron deficiency here.

Causes

Nutritional and dietary causes of iron-deficiency anemia include:

  • not consuming enough iron
  • not consuming enough vitamin C
  • having a condition that prevents the body from sufficiently absorbing nutrients

During pregnancy, the mother and fetus both need iron. If a pregnant woman does not consume enough of the nutrient, anemia can result.

Heme iron is the easiest form for the body to absorb, and it only occurs in meat. Plant-based foods contain nonheme iron, which the body does not absorb as easily. People on plant-based diets may need iron supplements to meet their needs.

Which other supplements might a vegan need? Find out here.

Vitamin C helps the body absorb iron, and consuming too little vitamin C may increase the risk of iron-deficiency anemia.

This condition can affect a person's overall health and ability to function from day to day. However, taking supplements can usually restore a person's iron levels.

Learn more about iron here.

Vitamin-deficiency anemia can develop when a person's diet contains too little vitamin B-12 or folate, which is vitamin B-9. The condition can also develop if the body is unable to absorb these vitamins effectively. It is most common in older people.

Another name for vitamin-deficiency anemia is megaloblastic anemia. It can cause red blood cells to become too large or the body to produce too few of them.

Symptoms

Symptoms include:

  • a feeling of tingling, or pins and needles
  • a sore, red tongue
  • mouth ulcers
  • muscle weakness
  • fatigue and a lack of energy
  • visual disturbances
  • depression
  • confusion and other problems with concentration, thinking, and memory

Long-term complications include:

  • infertility, which is usually reversible
  • complications during pregnancy
  • congenital disorders
  • nervous system disorders, which may be permanent
  • heart problems, including heart failure

Find out more about different kinds of anemia.

When the body is unable to absorb enough folate or vitamin B-12, possibly because the nutrients are lacking in the diet, nutritional-deficiency anemia can develop.

Some medications, such as proton pump inhibitors, can affect the way that the body absorbs vitamins. A person taking these types of drugs may develop anemia.

High alcohol consumption can also affect the way that the body absorbs folate and vitamin B-12 and may lead to anemia.

Other health issues that can trigger or worsen anemia include:

Some types of anemia do not relate to nutrition.

They include:

Aplastic anemia: This occurs when the bone marrow does not produce enough red blood cells, and treatment may involve transfusions. Certain medicines, toxins, and infectious diseases can cause aplastic anemia.

Anemia during pregnancy: During the first 6 months of pregnancy, the amount of plasma — the fluid of the blood — increases faster than the number of red blood cells. This dilution can lead to anemia.

Sickle-cell anemia: This occurs when a genetic factor causes the body to produce unusually shaped blood cells that cannot pass easily through the blood vessels.

Hemolytic anemia: This involves an infection, heart problem, or autoimmune disease destroying red blood cells.

Other factors that can lead to anemia include kidney disease, cancer, and chemotherapy.

Anyone who notices symptoms of anemia should consult a doctor, who will consider the symptoms and ask about:

  • the person's diet
  • existing conditions
  • ongoing medications
  • personal and family medical histories

A blood test can often identify the cause of the symptoms.

Some underlying health conditions can cause anemia, and the doctor may order further tests to rule these out or confirm a diagnosis. Treating the condition may resolve the anemia.

To treat nutritional-deficiency anemia, a doctor will recommend having a varied diet that contains plenty of mineral-rich and fortified foods. They may also recommend supplements, if appropriate.

According to the Dietary Guidelines for Americans 2015–2020, people should consume the following amounts of iron, folate, and B-12 each day. Iron is given in milligrams (mg), while the vitamins are in micrograms (mcg).

Iron (mg)B-12 (mcg)Folate (mcg DFE)
Males 19–50 years82.4400
Females 19-50 years182.4400

"DFE" refers to dietary folate equivalent. Scientists use this term because the body absorbs folic acid and folate differently.

Food sources of iron, B-12, and folate

Below are some dietary sources of iron:

SourceAmount of iron (mg)
Dark chocolate, 3 ounces7
Pan-fried beef liver, 3 ounces5
Braised beef, 3 ounces2
1 hard-boiled egg1
Tofu, firm, 1/2 cup3
White beans, canned, 1 cup8
Spinach, boiled and drained, 1/2 cup3

Dietary sources of B-12 include:

Food itemAmount of B-12 (mcg)
Beef liver, cooked, 3 ounces70.7
Salmon, cooked, 3 ounces4.8
Broiled beef, 3 ounces1.4
1 hard-boiled egg0.6
1 hard-boiled egg0.9
Low-fat milk, 1 cup1.2

Dietary sources of folate include:

Food itemAmount of folate (mcg DFE)
Beef liver, 3 ounces215
Boiled spinach, ½ cup131
White rice, ½ cup54
Avocado, ½ cup59
1 medium banana24
Milk, 1% fat, 1 cup12

Fortified cereals can be good sources of nutrients, though amounts vary by product.

Vitamin C helps the body absorb iron. Healthful sources include:

  • red peppers
  • oranges
  • strawberries
  • broccoli

In some people, anemia requires medical treatment, such as a blood transfusion. However, dietary changes and supplementation resolve the issue in most people.

Medical treatment

If dietary changes do not improve a person's anemia, the doctor may recommend supplements.

Most people take these by mouth, but a person with a severe deficiency may need to receive the nutrients intravenously. In very severe cases, a blood transfusion is necessary.

Iron: Take these supplements with orange juice, as the vitamin C in the juice will help the body absorb the mineral. Iron supplements can cause side effects such as constipation, diarrhea, abdominal pain, nausea, heartburn, and black feces.

Vitamin B-12: A person with a deficiency may need a monthly injection, though taking supplements orally may be sufficient.

Folate: A person may need to take folic acid supplements for 4 months, and they are available in pill form.

Doctors often prescribe iron and folic acid supplements during pregnancy. A healthcare professional can recommend specific dosages.

When a health issue is preventing the body from absorbing nutrients, a person may need to take supplements for life.

Anyone considering taking a supplement should speak to a doctor first. Some supplements can interact with medications or have other adverse effects.

Nutritional-deficiency anemia is a common problem. It can occur when the body is not absorbing enough iron, folate, or vitamin B-12 from the diet.

The issue may be that the diet is insufficient or that an underlying medical condition or treatment is interfering with the body's ability to absorb these nutrients.

Having a healthful and varied diet can usually provide enough nutrients to prevent anemia.

Shop for supplements

Supplements are available for purchase online.

Q:

Should all vegans and vegetarians take iron supplements?

A:

It is not necessary for all vegans and vegetarians to take iron tablets if their iron levels are normal.

It is possible to get enough iron from foods in both of those diets, and the tables above have some examples. If a person believes that they may have low iron levels and anemia, a doctor can help determine whether iron supplements or other interventions are necessary.

Kevin Martinez, M.D. Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.