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Anemia is more common than is often realized. The good news, though, is that it's often fixable with nutrition - but just taking iron pills won't do the trick. Instead you need to look at your diet as a whole.

Anemia is one of the most prevalent deficiency diseases in America right now. It's so widespread that it's verging on a hidden epidemic, and along with low thyroid hormone counts stemming from iodine deficiency, it's one of the first places you should look if you always seem to be off-color and tired.

After all, one in ten Americans over 65 is anemic.

In a world where many deficiencies and allergies seem to be only for the health-club crowd, though, anemia is a serious illness for the seriously ill.

Cancer patients on chemo are anemic 80% of the time. 70% of people with severe chronic kidney disease are anemic. Half of nursing home residents are anemic - and if a nursing home resident is anemic, they're 50% more likely to be admitted to hospital for a fall. 

Where an elderly person presents as anemic, he or she is usually prescribed iron supplements in the form of pills. The main effects of these are to stain feces black and cause constipation. There's a disconnect between anemia's prevalence and its treatment, and that disconnect is found in diet.

Where a younger person presents as anemic... well, where does a younger person present as anemic?

Unless your doctor calls you in and tests you, you might never know.

Or you might read an article like this one online and think of taking a supplement. Since it won't have much effect on your blood iron count it will be pretty hard to tell empirically whether you're anemic or not that way. You could be anemic and not know it. 12% of US women between 12 and 49 years old are iron-deficient - and that's by the low standards that describe a person as anemic when a man has a blood hemoglobin count of 130-140g/L, or a woman has 120-130g/L. 10% of pregnant women in the US are anemic.

Hopefully, those figures are enough to convince you that anemia isn't an invented disease, or a fancy name for being tired.

Anemia is also a condition with many causes

Roughly speaking anemia is caused by three things: you aren't making enough red blood cells, you're breaking red blood cells down faster than you're making them, or you don't have enough blood. You can have anemia from traumatic injury or from any bleeding. One major cause of anemia in women is menstrual bleeding. You can also have anemia as a result of malaria or sickle-cell disease, which goes some way to explaining why a billion people in the world are anemic. But there is one cause that outstrips all the others. 

Anemia is caused by malnutrition in third-world countries. It's the result of a diet that focusses on getting enough calories to survive, with every other consideration secondary.

In the West that's not necessarily true. But it remains largely a disease of poor diet. And feeding people iron pills just doesn't work.

Why can't I just take iron pills?

The main reason iron pills don't work is because anemia isn't always caused by a lack of iron. Imagine if your car was underwater up to the windscreen. The fuel gauge reads full, you're turning the key, but it won't start. Why? OK, OK, because the sparkplugs are wet. But more importantly because the engine doesn't just need fuel. It needs air too. Taking iron doesn't solve the problem because you need other nutrients to absorb the iron ad to use it inside your body.

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