Anemias and Bowel Disorders

Anemia is a common disorder for those of us without a colon, particularly if we are also missing a part of our small intestine.
Anemia occurs when a person doesn't have enough healthy red blood cells to carry adequate oxyen throughout the body. This condition can cause:

• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headaches

It's important to catch anemia early as the symptoms can worsen with prolonged anemia and there are increased risks to the heart. There are two types of anemia common for those with bowel disorders:

• Iron Deficiency Anemia

This occurs when there is a deficiency of iron. This lack of iron makes it difficult for the hemoglobin to be produced which enables red blood cells to carry oxygen. In addition to the common symptoms of anemia, a person may also experience:

• Inflammation or soreness of the tongue
• Brittle nails
• Unusual cravings such as ice, dirt or starch
• Poor appetite

For those with GI issues, simply increasing food intake of iron rich foods is not typically enough to correct the iron deficiency anemia. Iron pills and iron infusions are common to help manage iron deficiency anemia. Iron pills can be Ferrous Sulfate, Ferrous Fumarate, or Ferrous Gluconate with the latter being easier on the stomach than the former. Vitamin C (250 mg daily) can also help with iron absorption. It is important not to drink tea within two hours of taking iron supplements as the tannins in tea can interfere with iron absorption. It's important to consult your doctor regarding how much iron to take as at high doses iron is toxic.


Try incorporating these iron rich foods into your diet:

• Red meat, pork, poultry
• Seafood
• Beans, lentils and peas
• Dark green leafy vegetables
• Dried fruit
• Iron fortified cereals, breads and pasta

• Vitamin Deficiency Anemia

This occurs when the body doesn't have enough Folate, Vitamin B12 and Vitamin C that's needed to produce enough healthy red blood cells. This also is called Megalobalstic Anemias.

In addition to the common symptoms of anemia, Vitamin Deficiency Anemia can also cause:

• Weight loss
• Numbness or tingling in hands and feet
• Unsteady movements
• Personality changes
• Mental confusion or forgetfulness

It is common for those with bowel disorders to also be low on folate and Vitamin B12.


Folate is also known as B9 and is found in fruits, leafy green vegetables, nuts, and enriched grain products. Folate can also be taken as a supplement, commonly in a daily multi-vitamin.


Vitamin B12 is found in meat, shellfish, eggs, and dairy products and can be taken via an injection, oral solution or in a pill form. Cyanocobalamin is the synthetic form of Vitamin B12. Vitamin B12 also needs to be monitored as too high of a level can cause inflammation to occur.


Vitamin C can be found in broccoli, citrus fruits, strawberries, sweet peppers and tomatoes and can help with the absorption of iron.


To help manage both my iron and vitamin deficiency anemias, I take several medications:

• Ferrous Gluconate 28 mg from Puritan Pride - I take 2 pills every time I eat something but I allow a 2 hour window between consumption of tea and these pills
• B12 Microlozenge 5000 mcg from Purtain Pride - I take one pill three times a week. I take the microlozenge with food and let it melt under my tongue before swallowing for best results. I've found that if I chew it and don't take it with food then it isn't absorbed and taking it three times a week helps keep my B12 level below an inflammation level.
• Vitamin C - I cut a 500 mg tablet in half so that I'm taking the recommended 250 mg a day to help with iron absorption and thereby stretching my supply of Vitamin C. I found that 250 mg tablets are more expensive than the 500 mg tablets.
• Multi Vitamin with Folate - I take one daily to help maintain my folate level.

For your best functioning, it's a good idea to have your doctor monitor your iron levels and vitamin levels to determine if you are low on any levels and to develop a plan to treat any deficiencies.