1.     Health article

Anaemia

“Illness is caused more by malnutrition of the mind than of the body. Doctors speak of vitamin deficiency; I will call it the deficiency of Vitamin G, and I will recommend the repetition of the name of God, with accompanying contemplation of the glory and grace of God. That is the Vitamin G. That is the medicine; regulated life and habits are two-thirds of the treatment, while the medicine is just one-third.¹“…Sri Sathya Sai Baba.

1. What is anaemia?^2-11

The human body produces three types of blood cells in the bone marrow: white blood cells (WBC) to fight infection, platelets to help the blood to clot, and red blood cells (RBC) to supply oxygen throughout the body. Haemoglobin (Hb), a complex iron-rich protein present in RBC, gives the blood its red colour and carries almost all of the oxygen in the blood.²

Anaemia is a condition when body is starved of oxygen either due to insufficient healthy RBC or inadequate Hb.^3,4,5 The normal life span of each RBC is 120 days. The body produces enough RBC each day to offset the removal of old cells by the liver or spleen.⁶ Normal RBC range per microlitre of blood is around 4.7 to 6.1 million for males and 4.2 to 5.4 million for females.⁷ Requisite Hb level should be in the normal range of 14 to 18 g/dL for men and 12 to 16 g/dL for women.⁸ These can be known through a simple blood test for complete blood count. 

2. Symptoms of anaemia^{2-5,8,10-19,21}

Symptoms may range from none to life threatening ones. People with mild to moderate anaemia may not even realise it unless a blood test is done. Some important symptoms are:

•        Paleness, especially pale conjunctiva, tongue, palms, or nails, called pallor, as well as brittle or spoon shaped nails. A hospital based diagnostic accuracy study¹⁵ has shown that pallor is a reliable sign of anaemia in children and its absence can rule out severe anaemia. 
•        Fatigue, dizziness, brain fog, or palpitations. Where the heart is under stress to pump enough oxygen to organs, symptoms would include abnormal heart rhythm, breathlessness, and chest pain. 
•        Other indicators which should not be ignored are: lack of energy even for normal activities, weight loss, forgetfulness, moodiness, headache, low BP, cramps, numbness, or coldness in the hands, legs, or feet, low body temperature, altered taste, swelling or soreness in tongue, mouth with cracks at the corners, or ringing in the ears (tinnitus). Change in colour of one’s stool, hair loss, and general feeling of being unwell may also be indicators depending on the underlying cause. 
•        Strange cravings: Anyone who has the urge to eat inappropriate or non-nutritive things (a behaviour called pica), like dirt, clay, soil, paper, paint, rubber band, wax, ice, or excess starch could be having iron deficiency. Mostly small kids, pregnant women, and those with developmental disabilities may have this symptom.^{3,10,12,14,16-18}

·       Symptoms due to vitamin B12 deficiency may include a tingling “pins and needles” sensation in the hands or feet, lost sense of touch, a wobbly gait and difficulty in walking, clumsiness and stiffness of the arms and legs, confusion, depression, loss of appetite, and dementia.^12,19

3. Causes of anaemia ^{2-5,8-10-14,20,21-24}

•        Iron and vitamin deficiency: Globally, anaemia is mostly attributed to iron deficiency. Diet low on iron, vitamin B9 (folate), and vitamin B12 is the major cause.
•        Blood loss leading to deficiency: Heavy menstruation, injury, surgery, trauma, and diseases like ulcers and cancer, and frequent blood donation may result in blood loss causing anaemia.
•        Body’s inability to absorb nutrition: Some foods and drinks, smoking, alcoholism, chronic illnesses or infections, specially parasitic and autoimmune diseases as well as some drugs, medical treatments and surgeries may prevent the body from absorbing iron and vitamins.
•        Inadequate RBC: High doses of radiation, certain chemical exposures, viruses and autoimmune disorders obstruct, and poor diet, hormonal imbalance, pregnancy, and chronic diseases slow down the production of RBC. It could also be hereditary. Research²⁰ is being done on the clock work mechanism within the body that controls the production of RBCs and how a drop in the iron content can adversely affect it.
•        Destruction of RBC: Certain health conditions and inherited disorders may cause the body to destroy RBC much faster than the rate at which they are produced in the bone marrow, for example, enlarged spleen, thalassaemia, lack of certain enzymes etc.⁴
•        Additional cause in children and women in India: Government of India, Ministry of Health and Family Welfare has²³, in addition to the already mentioned causes, attributed anaemia to iron loss due to parasite load, poor environmental sanitation, unsafe drinking water, and inadequate personal hygiene in children and women.
•        Root cause of the cause: According to Ayurveda²⁴, nutrient deficiencies arise because of the imbalance of fire element in the body (vikrita pitta) and not due to an apparent nutrient deficiency. The underlying cause for this condition is excessive consumption of sour and salty foods and excess of physical exertion.

4. Risks and caution^{2,3,5,10-14,17,22-29}

Anaemia is not a disease and is manageable without any complications. If ignored, it can lead to health problems. Children and teens with poor diet habits, women, elderly, and people with chronic diseases are at risk. In case of chronic anaemia, the body may adjust to low
oxygen level and one may not feel the difference unless it becomes severe.²² In such cases one may need a blood transfusion or even a bone marrow transplant. Lack of oxygen in the blood for long can damage the heart, brain, and other organs in the body and may even cause death. Anaemia can affect animals too.

Anaemia should not be medically treated without ascertaining its cause.¹⁷ If iron tablets are being taken they should be strictly monitored under a doctor’s prescription. Iron in excess can get deposited into organs and affect the liver, heart, and pancreas. Blood donation with necessary precautions can prevent it.^{3,11,17,24-29}

5. Prevention and cure of anaemia ^{2,3,5,13,14,23,24,30-54}

Start on a holistic diet: A balanced diet of about 500 grams of fruits and green vegetables per day (raw and steamed/cooked) as well as some sprouted and/or cooked whole grains, would provide the requisite nutrients in an easily absorbable state.³⁰ One has to listen to one’s own body as to what keeps it fresh, agile, and healthy and choose the best food combinations from what is available or can be grown. Eating less or in moderation and chewing well will help in better assimilation and so will eating with awareness and gratitude.

Sources of iron and vitamins B9, B12 and C as well as some home tips are given below:

1. Iron^{2,3,5,13,14,23,24,32-39}: Some of the best plant sources of iron are

(a) fruits like apple, pomegranate, banana, peach, and water melon. 

(b) dry fruits like dates, apricots, figs, and raisins; nuts like pistachios, hazelnuts, almonds, and cashew; and seeds of pumpkin/squash, sesame, hemp, flax, sunflower, chia, and fenugreek. 

(c) dark green leafy vegetables like spinach, kale, leaves of fenugreek, mustard, drumstick, Colocasia, turnip, mint, and curry tree leaves; broccoli (raw or lightly steamed), Brussels sprouts, cauliflower; and other vegetables like pumpkin, beetroot, green plantain, unpeeled steamed potatoes, and sun-dried tomatoes. 

(e) whole grains like quinoa, brown rice, oatmeal, amaranth, soya beans and its products, legumes/beans, peas, lentils, and chickpeas. In particular, finger millet and pearl millet which are considered superior to wheat and rice. 

Take iron with care^3,5,23: Iron gets absorbed properly when it is taken in combination with vitamin B and C rich foods and when whole grains/nuts are soaked/fermented/germinated. Many of the sources of iron listed above have vitamins B & C too. Combine wisely and avoid some foods namely, dairy, calcium supplements, antacids, coffee, tea, sugar, chocolate, soda, bran, and eggs that can interfere with or block iron absorption. 

 

2. Folate (vitamin B9)^2,3,43-46: Naturally present in fruits, vegetables, whole grains, seeds and nuts, it is nontoxic. It does not get stored in the body, but can be easily replenished every day. Any excess gets eliminated naturally. Folate builds RBC, boosts immunity and brain power, aids in absorption of vitamin B12, and promotes healthy pregnancy. The best time of the day to take vitamin B is in the morning hours as it tends to increase energy.⁴⁶

Foods rich in folate: The foods listed under Sources for iron are rich in folate too. However, some of the richest sources are avocado, prunes, asparagus, corns, celery, okra, and carrots. Folate in synthetic form (folic acid) is found in breads, pastas, and cereals.^2,3,43,44

3. Vitamin B12^2,3,47: is said to be found in its natural state only in animal based foods. It is contained to some extent in dairy products like milk, curd, yogurt, and butter milk, and fermented soya products like miso and tempeh. For better absorption and storage of vitamin B12, take them with foods with vitamin B6 contained in spinach, walnuts, avocados, brown rice, and ginger. 

Cooked rice when allowed to ferment overnight by putting enough water in it and then taken, mixed with yogurt and a little salt to taste, can be an excellent source of vitamin B12.^48,49

In India, fermented foods⁵⁰ like idlis (made from a batter of boiled rice/millet and black gram) and Dhokla (made from chick pea powder) are believed to contain vitamin B12, though it is a subject of debate whether it is adequate. A study⁵¹ on idlis has revealed that vitamin B12 got produced during fermentation.

4. Vitamin C rich foods^5,40-42: Indian gooseberry(amla), guava, citrus fruits like oranges and lemons, kiwi and other berries, blackcurrant, grapefruit, papaya, banana, watermelon, red and green bell peppers, cabbage, and coriander leaves, in addition to the fruits, green vegetables and whole grains (already listed above). Also include pineapple, mango, parsley, sweet and white potatoes and other tubers, and tomatoes (after removing seeds as they are not digested easily and can turn to stone gradually in the digestive canal³¹). Munch a few tulsi leaves every day.²⁴

Take vitamin C also with care⁴²: Human body neither makes vitamin C nor stores it. So overdose cannot be a concern, especially when it is consumed from fresh fruits and vegetables. However, it is important not to exceed the upper limit of 2 g per day, to avoid stomach upsets, if one is taking supplements. Cooking, storing, microwaving, or steaming can reduce the vitamin C content of foods. However vitamin C in amla remains almost intact on cooking.

5. Home tips:^24,32,52

*Honey mixed with luke warm water everyday would raise the RBC count as well as the level of Hb. Honey should not be mixed with hot water or cooked as it may turn poisonous. Also it is not suitable for children under the age of one.³²

*Follow the age old technique of consuming food from iron utensils. One may cook in cast iron pots and pans so that the food would absorb the iron and it will be potent for an anaemic patient.^13,24 Jaggery (dark looking) contains easily absorbable iron as it comes from the iron pots in which sugar cane juice is boiled to make jaggery.⁵²

*Have vitamin G¹ every moment! Be Glad, Be full of Gratitude, and Be with God within!

Sai Vibrionics: the wonder remedies blessed by Sri Sathya Sai Baba can offer not only relief from anaemic condition but also prevent it from manifesting at a physical level by rooting it out at the ethereal level of the body. Practitioners may refer to ‘108 Common Combos’ or ‘Vibrionics 2016’ book.

References and Links:

1. http://www.sssbpt.info/ssspeaks/volume05/sss05-39.pdf

2. https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360

3. https://www.speakingtree.in/blog/a-visual-guide-to-anemia

4. https://www.health24.com/Medical/Anaemia/Anaemia-20130216-3

5. https://draxe.com/anemia-symptoms/; https://draxe.com/vitamin-c-foods/

6. https://www.labce.com/spg469710_normal_red_blood_cell_rbc_characteristics.aspx

7. https://medlineplus.gov/ency/article/003644.htm 

8. Taber’s Cyclopaedic Medical Dictionary, Edition 20, pages 105, 966,1141.

9.  http://www.who.int/vmnis/indicators/haemoglobin.pdf

10. https://www.healthline.com/nutrition/iron-deficiency-signs-symptoms

11. https://blogs.mercola.com/sites/vitalvotes/archive/2007/06/25/How-do-You-Know-if-You-Are-Anemic.aspx

12. https://www.webmd.com/a-to-z-guides/understanding-anemia-symptoms#1

13. https://www.drweil.com/health-wellness/body-mind-spirit/heart/anemia/

14. https://www.nhsinform.scot/illnesses-and-conditions/nutritional/iron-deficiency-anaemia

15. Pallor detects anaemia in kids: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797134/

16. Study on pica: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850349/

17. https://articles.mercola.com/sites/articles/archive/2016/11/05/craving-ice-iron-deficiency.aspx

18. https://kidshealth.org/en/parents/pica.html

19. https://www.healthline.com/health/pernicious-anemia

20. https://www.sciencedaily.com/releases/2018/01/180122110806.htm

21. http://www.journalijar.com/article/6859/prevalence-of-anemia-in-men-due-to-various-causes-in-kancheepuram-  district/

22. https://www.medicinenet.com/anemia/article.htm#what_are_the_signs_and_symptoms_of_anemia

23. http://www.pbnrhm.org/docs/iron_plus_guidelines.pdf

24. https://www.artofliving.org/in-en/ayurveda/ayurvedic-treatments/6-home-remedies-anemia

25. http://www.sankalpindia.net/book/haemoglobin-test

26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503668/

27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128151/

28. http://indianbloodbank.com/donors-guidelines.html

29. http://www.hsa.gov.sg/content/hsa/en/Blood_Services/Blood_Donation/Can_I_Donate/iron-and-blood-donation/new-hemoglobin-criteriaformaleblooddonors.html

 

Prevention and Cure

30. Eating Wisely and Well by Ramesh Bijlani (from Integral yoga of Sri Aurobindo and Mother), Rupa Publications 2012, Chapter 5, page 48-55

31. Sathya Sai Baba Speaks on Food, Sri Sathya Sai Sadhana Trust Publication, Dec.2016 edition, page 65; http://www.saibaba.ws/teachings/foodforhealthy.htm  

32. https://www.slideshare.net/BhimUpadhyaya/food-body-by-sadhguru

33. https://food.ndtv.com/food-drinks/fruits-for-anaemia-load-up-on-these-6-fruits-to-boost-your-haemoglobin-1761166;

      https://food.ndtv.com/health/anemia-diet-9-ways-to-include-iron-rich-foods-in-your-meals-1273991

34. https://www.healthline.com/nutrition/iron-rich-plant-foods#section3

35. https://www.medindia.net/patients/lifestyleandwellness/curry-leaves-health-benefits.htm

36. https://www.myfooddata.com/articles/vegetarian-iron-foods.php

37. https://www.africrops.com/africrops-moringa-a-solution-to-iron-deficiency/

38. http://www.academicjournals.org/journal/IJMMS/article-full-text-pdf/86F279D77

39. https://ods.od.nih.gov/factsheets/iron-consumer/

40. https://www.banyanbotanicals.com/info/ayurvedic-living/living-ayurveda/herbs/amalaki-amla/

41. https://www.globalhealingcenter.com/natural-health/foods-high-in-vitamin-c/

42. Vitamin C utilisation: https://medlineplus.gov/ency/article/002404.htm

43. https://www.myfooddata.com/articles/foods-high-in-folate-vitamin-B9.php

44. https://www.globalhealingcenter.com/natural-health/folic-acid-foods/

45. https://articles.mercola.com/sites/articles/archive/2007/01/16/get-your-folic-acid-from-whole-food-sources-not-multi-vitamins.aspx

46. Best time to take vitamin B: https://www.medicalnewstoday.com/articles/319556.php

47. https://www.livestrong.com/article/245167-how-to-prevent-vitamin-b12-deficiency/

48. Fermented rice food: http://sssbpt.info/ssspeaks/volume09/sss09-21.pdf

49. http://www.drvasudev.com/Vitamin-B12-&-vegans.asp

50. https://food.ndtv.com/opinions/magical-benefits-of-fermented-foods-like-yogurt-idli-or-dhokla-1285304

51. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551127/

52. www.ihatepsm.com/blog/jaggery-gud