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Iron deficiency anaemia: Everything you need to know

What is iron deficiency anaemia?

Anaemia occurs when you have a level of red blood cells (RBCs) in your blood that is lower than normal. Iron deficiency anaemia is the most common type of anaemia, and it occurs when your body doesn’t have enough of the mineral iron. Your body needs iron to create a protein called haemoglobin. This protein is responsible for transporting oxygen to your body’s tissues, which is essential for them to function effectively. When there isn’t enough iron in your bloodstream, the rest of your body can’t get the amount of oxygen it needs.

What causes iron deficiency anaemia?

Low Iron Intake

Consuming too little iron over an extended amount of time can create a shortage in your body. Foods such as meat, eggs, and some green leafy vegetables are high in iron. Because iron is imperative during times of rapid growth and development, pregnant women and young children may require even more iron-rich foods in their diet.

Pregnancy or Blood Loss Due to Menstruation

In women of childbearing age, the most prevalent causes of iron deficiency anaemia are heavy menstrual bleeding and blood loss during childbirth.

Internal Bleeding

Specific medical conditions can cause internal bleeding that can lead to iron deficiency anaemia. Examples include a stomach ulcer, Intestinal polyps, or colon cancer. Frequent use of pain relievers, such as aspirin, can also cause bleeding in the stomach.

Inability to Absorb Iron

Certain disorders that affect the intestines can also interfere with how your body absorbs iron. Even if you get enough iron in your diet the following conditions may limit iron absorption:

  1. Celiac disease
  2. Non-celiac gluten sensitivity
  3. SIBO
  4. Achlorhydria (Low stomach acid)
  5. Parasites

What Are the Symptoms of Iron Deficiency Anaemia?

The symptoms of iron deficiency anaemia can be very mild at first, and you may not even notice them. According to the American Society of Hematology (ASH), most people don’t apprehend they have mild anaemia until they have a blood test.

The symptoms of moderate to severe iron deficiency anaemia include:

  1. general fatigue
  2. weakness
  3. pale skin
  4. shortness of breath
  5. dizziness
  6. strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  7. a tingling or crawling feeling in the legs
  8. tongue swelling or soreness
  9. cold hands and feet
  10. fast or irregular heartbeat
  11. brittle nails
  12. headaches
  13. lower back pain

How Is Iron-Deficiency Anaemia Diagnosed?

Your doctor can diagnose anaemia with blood tests including:

Complete Blood Cell (CBC) Test

A full blood cell (CBC) test is usually the first test a doctor will use. A CBC test measures the amount of all components of the blood, including:

  1. red blood cells (RBCs)
  2. white blood cells (WBCs)
  3. hemoglobin
  4. hematocrit
  5. platelets

The CBC test provides information about your blood that is helpful in diagnosing iron deficiency anaemia. This information includes:

  1. the hematocrit level, which is the percent of blood volume that is made up of RBCs
  2. the haemoglobin level
  3. the size of your RBCs

In iron deficiency anaemia, the hematocrit and haemoglobin levels are low. Also, RBCs are usually smaller in size than normal.

A CBC test is often performed as part of a routine physical examination. It’s a good indicator of a person’s overall health. It may also be performed routinely before surgery. This test is useful to diagnose this type of anaemia since most individuals who have an iron deficiency don’t realise it.
Other Tests

Anaemia can usually be confirmed with a CBC test. Your doctor might order additional blood tests to determine how severe your anaemia is and assist in identifying treatments including:

  1. Iron level in your blood
  2. Ferritin levels – Ferritin is a protein that helps with iron storage in your body. Low levels of ferritin indicate low iron storage.
  3. Total iron-binding capacity (TIBC)
  4. Transferrin – Transferrin is a protein that transports iron. A TIBC test is used to determine the amount transferrin that’s carrying iron.

What if you have symptoms of low iron, but your doctor says your test results are normal?

If you suspect low or high levels of iron, then check your ferritin test result. The ideal range of ferritin is 50 to 70 ng/ml.

What Are the Potential Health Complications of Iron Deficiency Anemia?

Most cases of iron deficiency anaemia are mild and don’t cause complications. The condition can usually be easily corrected. However, if anaemia or iron deficiency is untreated, it can lead to other health problems, including:

Rapid or Irregular Heartbeat

When you’re anaemic, your heart has to pump more blood to make up for the small amount of oxygen that can lead to irregular heartbeat. In severe cases, it can lead to heart failure or an enlarged heart.

Pregnancy Complications

In severe cases of iron deficiency, a child may be born prematurely or with a low birth weight. Most pregnant women take iron supplements as part of their prenatal care to prevent this from happening.

Delayed Growth in Infants and Children

Infants and children who are severely deficient in iron may experience a delay in their growth and development. They may also be more likely to experience infections.

How Is Iron-Deficiency Anaemia Treated?

Iron Supplements

Iron tablets can help restore iron levels in your body. If possible, you should take iron pills on an empty stomach, which helps the body absorb them better. If they upset your stomach, you can take them with meals. You may need to take the supplements for several months. Iron supplements may cause constipation or stools that are black in colour. A non-constipating form of iron is iron glycinate.


Diets high that include the following foods can help treat or prevent iron deficiency:

  1. red meat
  2. dark green, leafy vegetables
  3. dried fruits
  4. nuts

Additionally, vitamin C helps your body absorb iron. If you’re taking iron tablets, I suggest taking the pills along with a source of vitamin C, like a glass of orange juice or citrus fruit.

Treating the Underlying Cause of Bleeding

If you have tried supplementing, modifying your diet and your doctor has ruled out any serious causes of anaemia such as internal bleeding then you more than likely have an absorption problem. In my clinical experience, the most common causes of poor iron absorption include:

  1. Non-celiac gluten sensitivity
  2. Intestinal Parasites
  3. SIBO

If you have any questions about this article either post them in the comments section below or email using the form on my contact page.


This article in not intended to provide medical advice, diagnosis or treatment.


Histamine Intolerance: Everything You Need To Know

Do you endure unexplained headaches or migraines? What about difficulty falling asleep? Do you react badly to mosquito bites? Do you experience irregular periods? If you said yes to any of these questions, then you could have a histamine intolerance.

What is histamine?

Histamine is a chemical associated with your immune, digestive, and central nervous systems. As a neurotransmitter, it conveys important messages from your body to your brain. It is also an ingredient of stomach acid that helps you digest food in your stomach.

You might be most intimate with histamine as it associates with the immune system. If you’ve endured seasonal allergies or food allergies, you may have noticed that antihistamine medications such as Zyrtec, Allegra or Benedryl provide quick relief of your symptoms. This process occurs because histamine’s role in the body is to cause an immediate inflammatory response. It serves as a warning to your immune system, of any potential threats.

Histamine causes your blood vessels to widen, or dilate so that your white blood cells can quickly find and attack an infection. The histamine accumulation is what gives you a headache and leaves you feeling flushed, itchy and miserable. This process is part of the body’s natural immune response, but if you don’t break down histamine correctly, you could develop what we call histamine intolerance.

Because it travels throughout your bloodstream, histamine can affect your digestive tract, lungs, skin, brain, and cardiovascular system, leading to a broad range of symptoms that can make it difficult to diagnose the underlying cause.

Typical symptoms of histamine intolerance

  1. Headaches/migraines
  2. Difficulty falling asleep, easily arousal
  3. Hypertension
  4. Vertigo or dizziness
  5. Arrhythmia, or accelerated heart rate
  6. Difficulty regulating body temperatureAnxiety
  7. Nausea, vomiting
  8. Abdominal cramps
  9. Flushing
  10. Nasal congestion, sneezing, difficulty breathing
  11. Abnormal menstrual cycle
  12. Hives
  13. Fatigue
  14. Tissue swelling

What Causes High Histamine Levels?

  1. Allergies (IgE reactions)
  2. Small Intestinal Bacterial Overgrowth (SIBO)
  3. Increased Intestinal Permeability or Leaky gut
  4. Parasites
  5. Gastrointestinal bleeding
  6. Fermented alcohol like wine, champagne, and beer
  7. Diamine Oxidase (DAO) deficiency
  8. Histamine-rich foods
  9. In addition to the histamine made in your body, there is also a mixture of foods that naturally contain histamine, create the release of histamine, or block the enzyme that breaks down histamine, Diamine Oxidase.

How do I break down histamine?

Once made, histamine is either stored or broken down by an enzyme. Histamine in the central nervous system is broken down primarily by histamine N-methyltransferase (HMT) while histamine in the digestive tract is broken down mainly by diamine oxidase (DAO). Though both enzymes play a significant role in histamine break down, the American Society for Clinical Nutrition found that DAO is the primary enzyme responsible for breaking down ingested histamine. So if you’re deficient in DAO, you likely have symptoms of histamine intolerance.

Causes of Low DAO

  1. Gluten sensitivity
  2. Intestinal Permeability
  3. SIBO
  4. DAO-blocking foods: alcohol, energy drinks, and tea
  5. Genetic mutations (common in people of Asian-descent)
  6. Gut Inflammation from Crohn’s, ulcerative colitis, and inflammatory bowel disease.
  7. Medications: Non-steroidal anti-inflammatory drugs (ibuprofen, aspirin), Antidepressants (Cymbalta, Effexor, Prozac, Zoloft), Immune modulators (Humira, Enbrel, Plaquenil), Antiarrhythmics including Propranolol, Metoprolol, Cardizem, and Norvasc, Antihistamines including Allegra, Zyrtec, and Benadryl, and Histamine (H2) blockers including Tagamet, Pepcid, and Zantac.

Although histamine blockers, a class of acid-reducing drugs, seem like they would prevent histamine intolerance, these medications can deplete DAO levels in your body.

Testing for Histamine Intolerance


Remove the above high histamine foods for 30 days and reintroduce them one at a time.

Click here to download a free copy of my Histamine Intolerance Food List

Blood Testing

You can ask your doctor to test for histamine and DAO levels. A high ratio of histamine to DAO means that you are ingesting too much histamine and that you don’t have sufficient DAO to break it down.
Trial of DAO

If testing is unavailable to you, you could only try a diet low in histamine and add DAO supplementation at each meal. If your symptoms resolve, you could have reduced DAO.

How to Treat Histamine Intolerance?

  1. Remove the high histamine foods for 1-3 months.
  2. Add in a supplement of DAO by taking two pills at each meal. Most importantly, find the root cause of the histamine intolerance. If you’re on a medication that is causing the intolerance, working, with your physician, to wean off of these medications is essential. The main reasons I see in my practice are SIBO and gluten intolerance, which cause a leaky gut.
  3. If you currently have histamine intolerance, you may not have to avoid these foods permanently. It can be a short-term answer until your histamine or DAO levels revert to their optimal ranges. Depending on your personal circumstances, you may discover that you tolerate some foods better than others, so I encourage you to stay positive as you learn priceless information about your body!

If you have any questions about this article either post them in the comments section below or email using the form on my contact page.


This article in not intended to provide medical advice, diagnosis or treatment.

signs of sibo

SIBO: Everything you need to know

Have you ever consumed some food or drink and within a few hours seen that your belly is so bloated that you can’t fasten your pants? It’s not unusual for my clients to inform me that they get up with a flat tummy and by the close of the day they look seven months pregnant. Even if you haven’t endured abdominal swelling to such an extreme, any amount of bloating is not healthy, and it is a mark of intestinal inflammation. If you’re producing gas and bloating frequently, you could have food sensitivities and a gut infection, such as SIBO.

What is SIBO?

SIBO or Small Intestinal Bacterial Overgrowth happens when the bacteria in our gut get out of balance and overgrow. Most of your friendly bacteria should reside in your large intestine. When you have SIBO, these bacteria overgrow into your small intestine. This overgrowth occurs when you have a slowing down peristalsis through the digestive tract.

What causes weak peristalsis?

  1. Intestinal wall nerve damage, For example, diabetes mellitus and scleroderma can both affect the muscles in the gut.
  2. Scarring from surgeries or Crohn’s disease.
  3. Diverticulitis, which are tiny pouches that can form in the wall of the small intestine.
  4. Medications such as antibiotics, acid-blocking drugs, and steroids.
  5. A diet high in sugar processed carbohydrates and alcohol.

17 Signs Of Small Intestinal Bacterial Overgrowth (SIBO)

  1. Abdominal bloating
  2. Belching,
  3. Flatulence
  4. Abdominal pain or cramps
  5. Constipation and or Diarrhea.
  6. Heartburn
  7. Nausea
  8. Food Sensitivities
  9. Headaches
  10. Joint Pain
  11. Fatigue
  12. Eczema or rashes
  13. Asthma
  14. Depression
  15. Fatty stools – stools that float
  16. Iron Deficiency Anaemia or B12 deficiency that does not resolve with supplementation
  17. Weight Loss

How to test for SIBO

The gold standard test for testing SIBO is a lactulose breath test. This test is not readily available in Canada but can be obtained from labs in the US such as Genova Diagnostics.

If you have any questions about this article either post them in the comments section below or email using the form on my contact page.


This article in not intended to provide medical advice, diagnosis or treatment.