Could you be anaemic? Iron Explained

Could You Be Anaemic? Iron Explained

Iron pills - the ones at the bottom are NOT vegan and contain gelatin (not stated on outside of box).  The other two are fine.  The ferrous sulphate are available over the counter in the UK.
Iron pills – the ones at the bottom (ferrous fumarate) are NOT vegan and contain gelatin (not stated on outside of box). The other two are fine. The ferrous sulphate are available over the counter in the UK.

This article outlines the problems with vegetable iron sources – and the solution (and it’s not necessarily meaty).

The science bit:

Iron is a mineral. It’s also an element, which means it’s on the Periodic Table of Chemical Elements. The fact that everything in the universe is made of chemical elements is why it makes me giggle when people come out with all that “it’s natural there’s no chemicals in this product” nonsense. Every atom is a chemical element of some sort, and every molecule is a combination of atoms – a chemical..

Iron has the chemical symbol Fe and is one of the transition metals, it’s moderately reactive, that is to say that it’s not as reactive as the group I and group II metals (zinc, magnesium, potassium, sodium, calcium… you should watch a video about some of these if you haven’t seen them react in water). It’s still fairly reactive though, when compared to copper, gold, silver, or any of the group 4 or group 0 elements (such as carbon, which is in group 4).

The nutritional bit:

We need a small amount of a lot of different metals in our body – we call these minerals, because it sounds nicer than calling them either metals or chemical elements. We need 8-18mg of iron in our bodies every day. That means eating some broccoli on Monday isn’t going to cut it by the time Tuesday rolls round, and it’ll be long used up by Thursday.

The funny thing about dietary iron is that there are two types. Iron likes to behave differently under different circumstances because it does weird stuff (copper is similar in this respect), so it actually does make a difference whether your iron came from an animal or non animal source. In biochemistry, they actually have two different names for these two sources of iron – animal-derived iron is called heme iron (which is what you have in your body after your body has processed it) and plant-derived iron is called non-heme iron. The iron you find in your blood is always heme iron.

Basically, if you eat heme iron, the animal you got it from has already done the hard job of turning the non-heme iron into heme iron, which means you can absorb more of it, and you absorb it faster, and less of it is needed or wasted. If you eat non-heme iron, you are the one who has to do the job of turning it into heme iron before it can get to your blood stream (to make hemoglobin – see how they both have the same word stem). This makes it a slower process, and means you should eat more of it, because its less absorbable.

For vegans, this can pose a problem but being aware of it means that you can easily overcome it. The solution is to just eat more iron-containing foods, such as the ones I’ve listed in my table of vegan nutrition in this article. You do need to be aware of this though, because it means the Recommended Daily Allowance / Daily Value for iron doesn’t give you a true picture of how much iron you need to consume as part of your daily vegan diet. The medical associations who made that stuff up were doing it under the assumption that you eat an “average American/British/Insert Your Country Here diet.” For most vegans, that’s not you, which means you need to fiddle those numbers a bit and get more iron than the omnivores, so you get the same amount of iron in your blood as they get in theirs.

The medical bit:

If you don’t get enough iron, you will become anaemic. Anaemia is a decrease in the amount of red blood cells, because without iron, you can’t make red blood cells. They are the ones that carry oxygen around your body to release energy (which is the whole point of breathing and the process is called respiration). If you don’t have anything to carry the oxygen, you will constantly be tired and weak, and you will probably also be thirsty and dizzy and confused. Contrary to popular belief, you won’t go pale until the anaemia has reached a very severe level, so don’t rely on that as an indicator.

The list of symptoms of anaemia are:

Weakness, fatigue, general malaise, poor concentration, poor temperature regulation (feeling too hot or too cold for no reason). Some people also get depression, shortness of breath and in some cases, palpitations or angina can be present, due to increased heart rate as the body thinks it’s been exercising (anaerobic respiration) due to the lack of oxygen getting around the body.
Eventually, anaemia can kill you. Brittany Murphy and her boyfriend both died from pneumonia, which was a complication of the severe anaemia that they both had.

Not all of these symptoms will affect everybody, and the only reliable way to tell is to go to a doctor and get a blood test done. They will invariably want to put you on iron tablets, but be careful because I was given some last January that were called “Ferrous Fumarate” and they were made with gelatin, so that was a waste of money. Also be aware that in the UK those iron supplements that you get on prescription are also available over the counter, and if you pay for your prescriptions you should ask for the price because they’re usually selling for half the price of the prescription charge (and they’re not the ones you’ll find on the shelf – they’re more effective).

If you have anaemia, it’s a really good idea to take the iron tablets (I have some that are called ferrous sulphate which are vegan, but it will depend on the manufacturer as to which type are ok because different pharmacies use different brands which have different recipes, so always check). Making changes to your diet will help maintain your current iron level, but eating more iron-rich foods won’t be enough to increase your iron levels as much as is needed to overcome anaemia because you’re losing more blood cells by the minute due to the fact that you exist.

Side effects of iron tablets depend on which ones you get but I found the following side effects:

1. Standard off the shelf iron supplements – diarrhea, feeling too hot, stomach discomfort. They also don’t have enough iron in them to resolve anaemia (they have 14mg and the Ferrous Sulphate have 200mg).

2. Ferrous Fumarate – the idea made me feel sick due to the gelatin, so I didn’t actually take any.
3. Ferrous Sulphate – greenish tinge to stools, looser bowel movements, but nothing too spectacular. Sometimes they give me mild headaches.

In the long term, you are better off just eating more iron-rich foods. In the short term, get some supplements until you feel better. To prevent anaemia, always make sure you’ve eaten a bit more iron than you think you need. Remember, it’s not the general vegan diet that’s caused the anaemia, it’s your individual food choices within that vegan diet – so you have the power to fix it without necessarily having to resort to stopping veganism. Don’t deny the problem though if you have one because anaemia is really serious and totally curable.

Obviously doctors (and everyone else) are very quick to blame the vegan diet for anaemia, and for good reason, but do bear in mind that it doesn’t make you exempt from the other causes of anaemia which are more serious, so if your anaemia persists for several months while you’ve been taking supplements, go back to your doctor so he or she can thoroughly investigate the problem and make sure they didn’t overlook a serious blood disorder or something else important. If this is the case, it may be your sad duty to stop being vegan and include some meat in your diet to keep yourself alive.

If that happens, try not to be too hard on yourself. It may be that once you’ve got your iron stores high enough, you can be vegan again.

I was first diagnosed with anaemia in 2010. I spent 3 years in denial of the problem, until in late 2013 I developed a chronic blood loss problem that lasted 3 months. The blood loss caused the doctor to test for anaemia. This time, I eventually had to accept the diagnosis, from a different doctor, based on a different blood test. I was so anaemic that I had to take the iron tablets twice a day and I was also told, in no uncertain terms, that if I did not start including red meat in my diet I would never be able to function normally. For the first six months I made sure I ate red meat every second day. Then I tapered it down to about once a week. Then I left off unless I craved it, because in my experience my body tells me what it needs. Then I stopped completely, on 31st December 2014.

It’s two months since I stopped with the red meat regime and returned to being vegan. I’m now about 60-40 fruitarian to vegan, and I thoroughly researched the sources for nutrients before I considered changing my diets, which is what led to this vegan nutrition food sources table.

I do still take the Ferrous Sulphate when I need it, such as over the past week where the dizziness (technically it’s classed as vertigo, because it’s defined as “the feeling that you or your surroundings are moving” which is coupled with a feeling of disorientation and confusion, and always my first sign of anaemia, along with dry lips and skin) returned and I had to leave school early on Friday, leaving my classes in the hands of a cover teacher and losing half a day’s pay. I hate missing school for both of those reasons. So I’m back on the iron tablets again, due to the return in the last couple of weeks of the chronic blood loss problem, and I’m hoping that by catching it early this time, it will mean I don’t have to eat meat again. I’m also taking Vitamin K to help with the clotting.

https://invokedelight.wordpress.com/2015/02/20/wellness-are-you-getting-enough-vegan-nutrients/

[wellness] Are you getting enough vegan nutrients?

The Ultimate Overview of Vegan Nutrition

Having had a merry old Veganuary and nearly being at the end of Vegruary, I have been giving some thought to the things I eat and the quantities in which I eat them.

I renewed my pledge to eat vegan at the beginning of this year after doing some very in-depth research into food sources for all the different nutrients and making sure that I knew a) How much of each nutrient I needed and b) Where I could reasonably be expected to get this from on a day to day basis.  I do still struggle to get enough fat, but I generally get a lot of fruit sugar which converts to fat which should help me with the chronic underweight problem I have been struggling with for the last five years.  Two months in it feels like its helping.

As a female, I need the following nutrients every day (some of these vary from time to time depending on my needs and activity levels, and the US and UK figures didn’t match most of the time either so I’ve generally gone with the US figures as they’ve sounded more reasonable for a lot of things, but in some places I either used the UK figures or went with what I know has been working for me – eg protein is 5g more than the UK Recommended Daily Allowance because that’s what I need):

50 grams of protein.  This should proportionally come from specific amino acids which I’ve listed in the chart accompanying this article.  I get mine from lots of lentils (which also count towards your five a day – yay, but are totally lacking in essential amino acid methionine – boo), nuts, seeds and tofu (which is actually more of a treat than a dietary staple these days).  When I’m training for outdoor pursuits, I need more protein as protein = muscle.  When I’m growing my hair I also need more protein as protein = hair.  Protein in fact makes most of the things in the human body so you need loads of it to fix stuff and grow stuff.  Protein is made of lots of amino acids, which are the things in protein that your body needs in different amounts, so it’s not enough to eat protein – it’s got to be the right sort.

70 grams of fat.  This comes from oils such as coconut oil, sunflower oil and vegetable oil in the vegan diet.  It can come from olive oil as well, although you shouldn’t fry with it as it requires a fairly low temperature before the molecules break down and release free radicals.  Fat is where you get your essential fatty acids, however, so you do need some in order to get those, which are also called Omega 3 and 6, although you can supplement with linseed oil or flaxseed oil. UPDATE: Also nuts are good sources of fat (sorry for omission)!

90 grams of sugar (aka carbohydrates).  This should mostly come from complex carbohydrates such as starchy foods like pasta, rice (GF), potatoes (GF), with extra healthy points if it’s wholegrain rice/pasta.  I also like amaranth (GF), quinoa (GF), pearl barley and noodles.

18g of fibre (fiber, in American).  This is easy peasy as a vegan you don’t really need to think about it (unless you’re a juicearian but I’ve made my thoughts on that very clear).  All fruits and vegetables count towards this and you don’t need to faff around with All Bran or other nonsense because it’s in the plants.  In fact, my dentist could tell I was vegan a few years back by the wear on my back teeth because of having such a high-fibre diet.  I don’t worry at all about this one because I did track it for a while but almost everything I eat counts towards my fibre intake.

I also need the following vitamins:

Vitamin A: 700 micrograms (with an upper limit of 300 micrograms because vitamin A can cause cancer in long-term high doses).

Vitamin B complex: B1 (thiamine) 1.4 milligrams (upper limit 50 milligrams); B2 (riboflavin) 0.9 milligrams; B3 (niacin) 14 milligrams; B5 (pantothenic acid) 5 milligrams; B6 1.3 mg per day; B7 (Biotin) RDA/DV currently undecided by health organizations, should be sufficient in the average vegan diet, excessive supplements can cause unpleasant side effects such as acne, greasy hair, mood swings and water retention; B9 (folic acid) 1 milligram, although when I start trying for a baby I will need more and will supplement; B12 (cyanocobalamin) (no Daily Value or Recommended Daily Allowance established).

Vitamin C: 40 milligrams per day, no upper limit.

Vitamin D: This utterly depends, see my article on Vitamin D.  I aim for 10 micrograms which is what the US dietary guidelines state, even though the UK ones say 5 micrograms is sufficient.  Since I’ve increased my vitamin D intake, I have noticed a whole raft of problems such as fatigue and irritability have gone away and I’m more cheerful, energetic, and getting things done.

Vitamin E: 15 milligrams per day.  I don’t worry too much about Vitamin E because my skin tells me when I need to eat more Vitamin E, by drying out.  Then I crack out the avocados.

Vitamin K: 90 micrograms per day.  I regularly exceed  this though, and I make sure to never take Vitamin K and Vitamin E at the same time of day (I usually wait at least four hours between eating a meal with one and the other), because they fight each other for absorption and your body will preferentially absorb the Vitamin E, making you think you’ve got enough K when you haven’t.

And the following minerals:

Calcium: 700 milligrams per day.  Soymilk is fortified and tofu often is too.

Copper: 2 milligrams per day.  Should be easily available in the food I eat.

Iron: 18 milligrams per day because I’m female.  Men only need 8 milligrams.  Don’t ask me why.  The NHS also says women un the UK only need 14.8mg but that just goes to explain this anaemia epidemic they keep pretending isn’t happening, so they can sell you iron supplements which are pressed with pig gelatin (EWWWW.  Sidenote – the two supplements are ferrous fumarate and ferrous sulphate; ferrous fumarate are gelatinous and very non vegan and non halal and non kosher, ferrous sulphate are vegan, both can be bought over the counter at pharmacies without a prescription in the UK, they both provide the same amount of ABSORBABLE iron).

Magnesium: (this is a DIFFERENT mineral to manganese – look them up on the periodic table if you don’t believe me, Manganese is Mn in the transition metals and magnesium is Mg in group 2): 270 milligrams per day (UK) or 310 milligrams per day (US).  I go for the US figure.  This is easily acquired through vegan food.

Manganese: (this is a DIFFERENT mineral to magnesium – look them up on the periodic table if you don’t believe me, Manganese is Mn in the transition metals and magnesium is Mg in group 2).  This is very easily acquired through vegan foods so be careful not to overdo it.  I need 2 milligrams per day, but am safe up to 11 milligrams.  I did look into this and found that, in spite of what the NHS website says (it says the upper limit is 4mg), there are apparently no adverse effects shown from excessive manganese and the tolerable upper limit was set artificially on flawed data from a narrow demographic and small sample size anyway, and also it’s impossible to get less than about 6mg from the vegan diet because it’s in nearly everything we eat.

Potassium: 3500 milligrams per day.  Don’t overdo it.  It’s the same potassium that they drop into water and that burns with a lilac flame (remember high school science??), and turns the water alkaline, so be careful.  I will get an article written on the whole pH alkaline diet fad that has been circulating, but I need to look into a few more things before it will be ready.

Phosphorous: 550 milligrams per day (UK) or 1000mg (US).

There are other minerals but generally even most of the ones I’ve mentioned here will take care of themselves.

Here is my table of all the sources of these nutrients.  I tried to get up to 10 sources, but where there are less, it’s usually because there are poorer sources but you’d have to eat a lot of them.  For Vitamin D, the sources listed are all there are (unless you want to waste huge amounts of money on algae, which hasn’t been proven to have absorbable Vitamin D in it anyway).  Remember D2 is abundant in the vegan diet, but D3 is not, the daily value doesn’t distinguish between the two.

Click to enlarge.
Click to enlarge. Click again on enlarged picture to zoom so it’s readable.

Obviously this isn’t a complete essay on the entirety of vegan nutrition, and your mileage may vary based on age and gender, but this table is the culmination of my research in this area so far, and I thought it might provide a helpful starting point for people who are struggling or who are wondering why they are craving chocolate all the time (see the amount of nutrients in cocoa powder to find out).  I will continue to research this area and write more articles on it.  Happy Vegebruary!