Saturday, March 14, 2020

Anemia & Diabetes: A Vicious Circle


Dr. Julian Whitaker

01/15/2020

If you’re feeling weak and easily fatigued for no good reason, ask your doctor about testing for anemia. Although these symptoms could have any number of causes, anemia is a fairly common one. This is especially true for women who are pregnant or of childbearing age, vegetarians, Blacks, Hispanics, and people over age 65, as these groups have an above-average risk of developing anemia.
There’s another high-risk group that’s often overlooked, despite the fact that it comprises 30 million Americans—people with diabetes. Anemia affects 25 percent of those with diabetes, compared to just 5–6 percent of the general population, and oftentimes it’s undiagnosed.

ABCs of Anemia

Anemia is a condition in which the number of healthy red blood cells is too low to deliver adequate oxygen to the tissues. Common causes include:
  • Iron deficiency. Iron is an essential element in hemoglobin, the protein that transports oxygen in red blood cells.
  • Blood loss. This includes monthly menstrual cycles, which is why younger women are at increased risk.
  • Vitamin B12/folate deficiencies. These vitamins are required for the production of red blood cells. Deficiencies are most common in older people who have trouble absorbing B12 from food.
  • Inherited conditions. Genetic disorders such as sickle cell anemia and thalassemia result in fragile red blood cells.
  • Destruction of red blood cells. Hemolytic anemia occurs when red blood cells are destroyed faster than they are made.
  • Inadequate or faulty production of red blood cells. This is a rare but very serious condition called aplastic anemia.
Although any of these factors can contribute to anemia, research suggests that a primary link between diabetes and anemia is diabetic kidney disease.

Diabetes, Anemia & Your Kidneys

Iron, vitamin B12, and folate aren’t the only prerequisites for red blood cell production. Erythropoietin (EPO), a hormone made in the kidneys, is also required. If EPO output falters, the bone marrow cannot manufacture enough red blood cells to meet the body’s demands, and anemia develops.
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