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DESCRIPTION
Iron deficiency is the most frequent cause of anemia. A decreased number of circulating blood cells, or insufficient hemoglobin in the cells may result in iron deficient anemia. Anemia is a symptom of other disorders. For proper treatment, the cause must be found. The correct diagnosis is based on history, peripheral blood findings and investigations of the iron status. Anemia occurs only when iron stores are empty.
Iron deficiency anemia is a microcytic (small red blood cells), hypochromic (pale or light colored) anemia. For this reason, the anemia that occurs with iron deficiency is also called hypochronic microcytic anemia.
Normal Red Blood Cells (RBCs) seen microscopically after staining.
Micro Hypochromic Red Cells in Severe Anemia.
Size is smaller and cell is light in color.
Red blood cells show poikilo- and anisocytosis with predominance of small erythrocytes. In one third of people with the anemia is accompanied by slight leukopenia. The platelet counts may be normal, increased or decreased. Iron deficiency is documented by decreased serum iron, increased transferrin and decreased iron saturation. Ferritin below 15 ng/ml confirms the depletion of iron. Once the diagnosis of iron deficiency is established, its cause must be investigated. Pregnancy and bleeding are the most frequent conditions leading to iron deficiency. Therapy of iron deficiency involves treatment of the underlying condition as well as reestablishment of iron stores. Oral therapy is the most safe and economical method of correcting iron deficiency. Parenteral therapy should be confined to exceptional situations.
Iron deficiency anemia is the most common type of anemia throughout the world. In the United States, iron deficiency anemia occurs to a lesser extent than in developing countries because of the higher consumption of red meat and the practice of food fortification (addition of iron to foods by the manufacturer). Anemia in the United States is caused by a variety of sources, including excessive losses of iron in menstrual fluids and excessive bleeding in the gastrointestinal tract. In developing countries located in tropical climates, the most common cause of iron deficiency anemia is infestation with hookworm.
KEY TERMS USED REGARDING ANEMIA:
Hematocrit: The proportion of whole blood in the body, by volume, that is composed of red blood cells.
Hemoglobin: Hemoglobin is an iron-containing protein that resides within red blood cells. Hemoglobin accounts for about 95% of the protein in the red blood cell. Hemoglobin is the most important component of red blood cells. It is composed of a protein called heme, which binds oxygen. In the lungs, oxygen is exchanged for carbon dioxide. Abnormalities of an individual's hemoglobin value can indicate defects in red blood cell balance. Both low and high values can indicate disease states.
Protoporphyrin IX: Protoporphyrin IX is a protein. The measurement of this protein is useful for the assessment of iron status. Hemoglobin consists of a complex of a protein plus heme. Heme consists of iron plus protoporphyrin IX. Normally, during the course of red blood cell formation, protoporphyrin IX acquires iron, to generate heme, and the heme becomes incorporated into hemoglobin. However, in iron deficiency, protophoryrin IX builds up.
Recommended Dietary Allowance (RDA): The Recommended Dietary Allowances (RDAs) are quantities of nutrients of the diet that are required to maintain human health. RDAs are established by the Food and Nutrition Board of the National Academy of Sciences and may be revised every few years.
FREQUENT SIGNS & SYMPTOMS
Initially there may be no symptoms.
Signs of pronounced anemia include:
- Tiredness and weakness.
- Tongue inflammation.
- Breathlessness.
- Paleness, especially in the hands and lining of the lower eyelids.
- Fainting.
- Rapid heartbeat.
- Appetite loss.
- Cravings for ice, paint or dirt. Pica is the craving for non-food substances such as ice, starch, or clay. It is a possible cause of iron deficiency, particularly in those who eat clay or starch, which interferes with iron absorption in the stomach. To complicate matters, pica (particularly ice cravings) may also be a symptom, rather than a cause, of anemia.
- Susceptibility to infection.
The symptoms of iron deficiency anemia include weakness and fatigue. These symptoms result because of the lack of function of the red blood cells, and the reduced ability of the red blood cells to carry iron to exercising muscles. Iron deficiency can also affect other tissues, including the tongue and fingernails. Prolonged iron deficiency can result in changes of the tongue, and it may become smooth, shiny, and reddened. This condition is called glossitis. The fingernails may grow abnormally, and acquire a spoon-shaped appearance.
CAUSES
Decreased absorption of iron or increased need for iron.
Causes in adolescents and adults:
- Rapid growth spurts.
- Heavy menstrual bleeding.
- Pregnancy.
- Malabsorption.
- Gastrointestinal disease with bleeding, including cancer.
Iron deficiency anemia occurs when the body lacks iron to produce the hemoglobin it needs to make red blood cells. In general, there are three stages leading from iron deficiency to anemia:
- First, there is an insufficient supply of iron and iron stores are depleted in the bone marrow. This stage generally has no symptoms.
- Second, iron deficiencies develop and begin to affect hemoglobin production. (Tests, in such cases, reflect low hemoglobin and hematocrit levels.)
- Hemoglobin production declines to the point where anemia develops.
Most of the iron used in the body can be recycled from blood and reused. Nevertheless, iron deficiency can occur from a number of conditions.
Iron-Poor Diets. Lack of iron in the diet is not a common cause of iron deficiency anemia, except in infants. In fact, most Americans adults may be consuming too much iron in their diet. Most of the iron in red blood cells is recycled and reused. In general, most people need just 1 mg and menstruating women need 2 mg of extra iron each day, which a healthy diet easily provides. Iron-poor diets are only a cause of anemia in people with existing risks for iron deficiency.
Infancy is a period of increased risk for iron deficiency. The human infant is born with a built-in supply of iron, which can be tapped during periods of drinking low-iron milk or formula. Both human milk and cow milk contain rather low levels of iron (0.5-1.0 mg iron/liter). However, the iron in human milk is about 50% absorbed by the infant, while the iron of cow milk is only 10% absorbed. During the first six months of life, growth of the infant is made possible by the milk in the diet and by the infant's built-in supply. However, premature infants have a lower supply of iron and, for this reason, it is recommended that pre-term infants (beginning at 2 months of age) may be given oral supplements of 7 mg iron/day, as ferrous sulfate. Iron deficiency can be provoked where infants are fed formulas that are based on unfortified cow milk. For example, unfortified cow milk is given free of charge to mothers in Chile. This practice has the fortunate result of preventing general malnutrition, but the unfortunate result of allowing the development of mild iron deficiency.
Peptic Ulcers and Their Causes. The bacteria H. pylori are known to be primary causes of peptic ulcers, which, in turn, is an important cause of anemia in older people. Anemia in such cases may be less likely to result from bleeding ulcers but more to impaired iron or vitamin B12 absorption caused by the presence of the bacteria. The bacteria, in fact, may also bind to iron and reduce its availability in the intestine, causing iron deficiency anemia.
Bleeding Due to Other Medical Conditions. Iron deficiencies most commonly occur from internal blood loss due to other conditions that range in severity from hemorrhoids, heavy menstruation, or benign colon polyps to colon cancer. Very heavy periods (menorrhagia) are the most common causes of anemia in pre-menopausal women. Cancers of the gastrointestinal tract account for 2% of cases of iron deficiency (the rate is higher when menorrhagia is excluded).
The normal rate of blood loss in the feces is 0.5-1.0 ml per day. These losses can increase with colorectal cancer. About 60% of colorectal cancers result in further blood losses, where the extent of blood loss is 2-10 ml/day. Cancer of the colon and rectum can provoke losses of blood, resulting in iron deficiency anemia. The fecal blood test is widely used to screen for the presence of cancer of the colon or rectum. In the absence of testing, colorectal cancer may be first detected because of the resulting iron deficiency anemia.
Infection with hookworm can provoke iron deficiency and iron deficiency anemia. Hookworm. Hookworm infects about one billion people worldwide. It is a major cause of anemia in areas where it occurs. The hookworm is a parasitic worm. It thrives in warm climates, including in the southern United States.
Hookworm (Ancyclostoma caninum)
Seen here on the lining of the intestine.
(Centers for Disease Control & Prevention)
The hookworm enters the body through the skin, as through bare feet. The hookworm then migrates to the small intestines where it attaches itself to the villi (small sausage-shaped structures in the intestines that are used for the absorption of all nutrients). The hookworm provokes damage to the villi, resulting in blood loss, and they produce anti-coagulants which promote continued bleeding. Each worm can provoke the loss of up to 0.25 ml of blood per day.
Bleeding and blood losses through gastrointestinal tract can be provoked by colorectal cancer and hookworms, as mentioned above, but also by hemorrhoids, anal fissures, irritable bowel syndrome, aspirin-induced bleeding, blood clotting disorders, and diverticulosis (a condition caused by an abnormal opening from the intestine or bladder). Several genetic diseases exist which lead to bleeding disorders, and these include hemophilia A, hemophilia B, and von Willebrand's disease. Of these, only von Willebrand's disease leads to gastrointestinal bleeding.
Medications (NSAIDs). Aspirin and drugs such as ibuprofen and naproxen are called nonsteroidal anti-inflammatory drugs (NSAIDs). About 70% of long-term users of these medications have some sign of gastrointestinal bleeding, although it is rarely significant enough to cause anemia. Two laboratory studies suggest that aspirin, but not other NSAIDs, may stimulate the production of ferritin, a blood protein that binds iron. Since low ferritin levels indicate iron deficiencies, this effect could mask the true cause of anemia. However, a clinical study found that aspirin users actually have low ferritin levels, possibly because of gastrointestinal bleeding. More research is needed.
Impaired Absorption of Iron. Certain intestinal diseases (e.g., inflammatory bowel disease, celiac disease) or surgical procedures that affect the gastrointestinal tract can impair the ability of the intestine to absorb iron. (Such conditions also often impair folic acid absorption as well.)
Genetic Causes. Some people are born with iron deficiency. Certain cases may be due to a mutation of the Nramp2 gene, which regulates a protein responsible for delivering iron to the cells.
RISK INCREASES WITH
Adults over 60, especially those who have poor nutrition.
Illness, such as an ulcer, diverticulitis, colitis, hemorrhoids, or gastrointestinal tumors.
PREVENTIVE MEASURES
Maintain an adequate iron intake through a well-balanced diet or iron supplements.
Correction of gynecologic or other problems causing excess blood loss.
In the healthy population, all of the mineral deficiencies can be prevented by the consumption of inorganic nutrients at levels defined by the RDA. Iron deficiency anemia in infants and young children can be prevented by breast-feeding the infant for human milk and the use of fortified foods. If a baby or young child is not breast-fed, liquid cow milk-based infant formulas are generally supplemented with iron (12 mg/L). The iron in liquid formulas is added as ferrous sulfate or ferrous gluconate. Commercial infant cereals are also fortified with iron, and here small particles of elemental iron are added. The levels used are about 0.5 gram iron/kg dry cereal. This amount of iron is about 10-fold greater than that of the iron naturally present in the cereal.
EXPECTED OUTCOME
Usually curable with iron supplements if the underlying cause can be identified and cured.
The prognosis for treating and curing iron deficiency anemia is excellent. Perhaps the main problem is failure to take iron supplements. In cases of pregnant women, the health care worker may recommend taking 100-200 mg iron/day. This dose is rather high, and can lead to nausea, diarrhea, or abdominal pain in 10-20 % of women taking this dose. The reason for using this high dose is to effect a rapid cure for anemia, where the anemia is detected at a mid-point during the pregnancy. The above problems of side-effects and noncompliance can be avoided by taking iron doses (100-200 mg) only once a week, where supplements are initiated some time prior to conception, or continuously throughout the fertile period of life. The problem of compliance is not an issue where infusions are used, however a fraction of patients treated with iron infusions experience side-effects, such as flushing, headache, nausea, anaphylaxis, or seizures. A number of studies have shown that iron deficiency anemia in infancy can result in reduced intelligence, where intelligence was measured in early childhood. It is not certain if iron supplementation of children with reduced intelligence, due to iron-deficiency anemia in infancy, has any influence in allowing a "catch-up" in intellectual development.
POSSIBLE COMPLICATIONS
Failure to diagnose a bleeding malignancy.
Angina pectoris (pain or pressure beneath the breastbone caused by inadequate blood supply to the heart) or congestive heart failure (pumping action of heart is insufficient) may develop as a result of marked iron deficiency.
TREATMENT
GENERAL MEASURES
The most important part of treatment for iron-deficiency anemia is to correct the underlying cause. Iron deficiency can be treated well with iron supplements and/or nutritional therapy. Avoid risk of infection.
Iron deficiency anemia in infants is defined as a hemoglobin level below 109 mg/ml of whole blood, and a hematocrit of under 33%. Anemia in adult males is defined as a hemoglobin under 130 mg/ml and a hematocrit of under 38%. Anemia in adult females is defined as hemoglobin under 120 mg/ml and a hematocrit of under 32%. Anemia in pregnant women is defined as hemoglobin of under 110 mg/ml and hematocrit of under 31%.
When an abnormally high presence of blood is found in the feces during a fecal occult blood test, the health care provider needs to examine the gastrointestinal tract to determine the cause of bleeding. Here, the diagnosis for iron deficiency anemia includes the examination using a sigmoidoscope. The sigmoidoscope is an instrument that consists of a flexible tube that permits examination of the colon to a distance of 60 cm. A barium enema, with an x ray, may also be used to detect abnormalities that can cause bleeding.
The diagnosis of iron deficiency anemia should include a test for oral iron absorption, where evidence suggests that oral iron supplements fail in treating anemia. The oral iron absorption test is conducted by eating 64 mg iron (325 mg ferrous sulfate) in a single dose. Blood samples are then taken after 2 hours and 4 hours. The iron content of the blood serum is then measured. The concentration of iron should rise by an increment of about 22 micromolar, where iron absorption is normal. Lesser increases in concentration mean that iron absorption is abnormal, and that therapy should involve injections or infusions of iron.
Additional information is available from: The National Heart, Lung & Blood Institute (NHLBI)
Communications & Public Information Branch
National Institutes of Health
Building 31, Room 41-21
9000 Rockville Pike, Bethesda, MD 20892
The National Heart, Lung & Blood Institute (NHLBI)
NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
301-592-8573 phone
240-629-3255 TTY
301-592-8563 Fax
Website: www.nhlbi.nih.gov
MEDICATION
Iron supplements are usually prescribed:
- Take iron on an empty stomach (at least 1/2 hour before meals) for best absorption. If it upsets your stomach, you may take it with a small amount of food (except milk).
- If you take other medications, wait at least 2 hours after taking iron before taking them. Antacids and tetracyclines especially interfere with iron absorption.
- Iron supplements may cause black bowel movements, diarrhea or constipation.
- Continue iron supplements until 2 to 3 months after blood tests return to normal.
- Too much iron is dangerous. A bottle of iron tablets can poison a child. Keep iron supplements out of the reach of children.
Oral iron supplements (pills) may contain various iron salts. These iron salts include ferrous sulfate, ferrous gluconate, or ferrous fumarate. Injections and infusions of iron can be carried out with a preparation called iron dextran. In people with poor iron absorption (by the gut), therapy with injection or infusion is preferable over oral supplements. Treatment of iron deficiency anemia sometimes requires more than therapy with iron. Where iron deficiency was provoked by hemorrhoids, surgery may prove essential to prevent recurrent iron deficiency anemia. Where iron deficiency is provoked by bleeding due to aspirin treatment, aspirin should be discontinued. Where iron deficiency is provoked by hookworm infections, therapy for this parasite should be used, along with protection of the feet by wearing shoes whenever walking in hookworm-infested soil.
ACTIVITY
No restrictions. You may need to pace activities until symptoms of fatigue are gone. Be sure to rest often while recovering.
DIET
Limit milk to 1 pint a day. It interferes with iron absorption.
Increase dietary fiber to prevent constipation.
Decreased iron intake is a contributing factor in iron deficiency and iron deficiency anemia. The iron content of cabbage, for example, is about 1.6 mg/kg food, while that of spinach (33 mg/kg), lima beans (15 mg/kg), potato (14 mg/kg), tomato (3 mg/kg), apples (1.5 mg/kg), raisins (20 mg/kg), whole wheat bread (43 mg/kg), eggs (20 mg/kg), canned tuna (13 mg/kg), chicken (11 mg/kg), beef (28 mg/kg), corn oil (0.6 mg/kg), and peanut butter (6.0 mg/kg), are indicated. One can see that apples, tomatoes, and vegetable oil are relatively low in iron, while whole wheat bread and beef are relatively high in iron. The assessment of whether a food is low or high in iron can also be made by comparing the amount of that food eaten per day with the recommended dietary allowance (RDA) for iron. The RDA for iron for the adult male is 10 mg/day, while that for the adult woman is 15 mg/day. The RDA during pregnancy is 30 mg/day. The RDA for infants of 0-0.5 years of age is 6 mg/day, while that for infants of 0.5-1.0 years of age is 10 mg/day. The RDA values are based on the assumption that the consumer eats a mixture of plant and animal foods.
The above list of iron values alone may be deceptive, since the availability of iron in fruits, vegetables, and grains is very low, while that the availability from meat is much higher. The availability of iron in plants ranges from only 1-10%, while that in meat, fish, chicken, and liver is 20-30%. The term availability means the percent of dietary iron that is absorbed via the gastrointestinal tract to the bloodstream. Non-absorbed iron is lost in the feces.
Interactions between various foods can influence the absorption of dietary iron. Vitamin C can increase the absorption of dietary iron. Orange juice is a rich source of vitamin C. Thus, if a plant food, such as rice, is consumed with orange juice, then the orange juice can enhance the absorption of the iron of the rice. Vitamin C is also added to infant formulas, and the increased use of formulas fortified with both iron and vitamin C have led to a marked decline in anemia in infants and young children in the United States (Dallman, 1989). In contrast, if rice is consumed with tea, certain chemicals in the tea (tannins) can reduce the absorption of the iron. Phytic acid is a chemical that naturally occurs in legumes, cereals, and nuts. Phytic acid, which can account for 1-5% of the weight of these foods, is a potent inhibitor of iron absorption. The increased availability of the iron in meat products is partly due to the fact that heme-iron is absorbed to a greater extent than free iron salts, and to a greater extent than iron in the phytic acid/iron complex. Nearly all of the iron in plants is non-heme-iron. Much of the iron in meat is non-heme-iron as well. The non-heme-iron in meat, fish, chicken and liver may be about 20% available. The heme-iron of meat may be close to 30% available. The most available source of iron is human milk (50% availability).
See these links for more information:
MoonDragon's Nutrition Information Index
Nutritional therapy information and dietary guidelines including food charts.
Nutritional therapy information and juicing with raw foods to maintain nutrient content often lost during cooking. Recipes for various health-related issues are included.
HOLISTIC, NUTRITIONAL & HERBAL RECOMMENDATIONS
See either one of these pages for more information regarding nutritional therapy suggestions:
For information about nutritional therapies, juicing and making fresh drinks using fruits, vegetables, herbs and other healthy ingredients, check out the pages located at:
Nutrients Supplement Suggested Dosage Comments Essential Raw liver extract 500 mg twice daily. Contains all the elements needed for red blood cell production. Use liver from organically raised beef. Consider injections (under a health care provider's supervision). Blackstrap molasses Adults: 1 tablespoon twice daily.
Children: 1 teaspoon twice daily.See above under Holistic Recommendations. Folic acid 800 mcg twice daily. Needed for red blood cell formation. Biotin 300 mcg daily. Needed for red blood cell formation. Iron As prescribed by a health care provider. Take with 100 mg vitamin C for better absorption. To restore iron. Use ferrous gluconate form. Caution: Do not take iron unless anemia is diagnosed. Floradix Iron Plus Herbs from Salus Haus 2 teaspoons daily. Contains a readily absorbable form of iron that is nontoxic and from a natural source. Vitamin B12 injections 2 cc once weekly or as prescribed by health care provider. Essential in red blood cell production and to break down and prepare protein for cellular use. Injections (under health care providers supervision) are best. If injections are not available, use lozenge or sublingual form for best absorption. Or vitamin B12 2,000 mcg 3 times daily Essential in red blood cell production and to break down and prepare protein for cellular use. Injections (under health care providers supervision) are best. If injections are not available, use lozenge or sublingual form for best absorption. Vitamin B complex 50 mg 3 times daily. B vitamins work best when taken together. A sublingual form is recommended. Pantothenic acid (vitamin B5 50 mg 3 times daily. Important in red blood cell production. Vitamin B6 (pyridoxine) 100 mg daily. Involved in cellular reproduction. Aids absorption of vitamin B 12. Vitamin C 3,000-10,000 mg daily. Important in iron absorption. Brewer's yeast As directed on label. Rich in basic nutrients and a good source of B vitamins. Copper 2 mg daily. Needed in red blood cell production. Note: If more zinc is used, increase copper proportionately. Zinc 30 mg daily. Do not exceed this amount. Needed to balance with copper. Raw spleen glandular As directed on label. See Glandular Therapy for more information. Vitamin A 10,000 IU daily. Important antioxidant. Plus natural beta-carotene 15,000 IU daily. Important antioxidant. Or carotenoid complex (Betatene) As directed on label. Important antioxidant. Vitamin E 600 IU daily. Take separately from iron supplements. Important for red blood cell survival; prolongs the life span of these cells. Use emulsion form for better assimulation.
ANEMIA SUPPLEMENTS & PRODUCTS
Information for help with anemia, a condition that occurs when either the number of red blood cells or the amount of hemoglobin in the blood is reduced.
Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm - 16 fl. oz.
WaterOz Ionic Iron is a pure liquid Iron supplement. Iron is called the "energy giver." It attracts oxygen and builds blood. Along with manganese and copper it is necessary for healthy blood chemistry and is essential for recovery from illness.Appetite Stimulant Formula Tincture, 100% Organic - 2 fl. oz.
This herbal appetite stimulant has been designed by a Master Herbalist to stimulate the appetite. It combines herbs well known, and recommended by the German Commission E, for improving the appetite and eliminating symptoms of appetite loss.Iron Complex w/ Vitamins & Herbs, Vegetarian Formula, NOW Foods - 250 Tabs
Iron is part of myoglobin, which helps muscle cells store oxygen - iron-deficient people tire easily in part because their bodies are starved for oxygen and without enough iron, ATP (the fuel the body runs on) cannot be properly synthesized so, as a result, some iron-deficient people become fatigued even when their hemoglobin levels are normal.St. John's Wort, Perika, 300mg - 60 Tabs
Nature's Way St. John's Wort is scientifically advanced to maintain a healthy emotional outlook.Folic Acid (Vitamin B-9) 100% Natural, Nature's Way 800mcg - 100 Caps
Folic acid (Vitamin B-9) is necessary precursor for the manufacture of genetic material like RNA and DNA. It also assists in the growth and repair of tissues and in the conversion of fats and amino acids into other useful products in the body.Brewers Yeast, NOW Foods 650mg - 200 Tabs
Brewer's Yeast has been shown to help people having difficulty sleeping, fatigued, and diarrhea caused by Clostridium difficile.Alfalfa Leaves, Nature's Way, 405mg - 100 Caps
Nature's Way Alfalfa Leaves are organically grown by Trout Lake Farm, Washington, and Certified Organically Processed in accordance with Oregon Tilth standards and the California Organic Foods Act of 1990.Bilberry Extract Tincture, 100% Organic - 2 fl. oz.
Helpful with many different diseases of the eyes including vascular retinal disturbances, cataracts, diabetic-induced glaucoma, myopia, and all forms of eye strain.Black Cherry Fruit Extract 750mg NOW Foods - 90 Vcaps
Black Cherry extract or Black Cherry concentrate has been found to prevent attacks of gout. Black, sweet yellow, and red sour cherries have all shown to be effective.Dandelion Root Tincture, 100% Organic - 2 fl. oz.
Dandelion root is a natural diuretic and improves appetite and minor digestive problems. Dandelion leaves are commonly recommended as a food supplement for pregnant and postmenopausal women.Goldenseal Root Tincture (Hydrastis canadensis), 100% Organic - 2 fl. oz.
Uses include Adrenal Glands; Eye Problems; Fainting; Gallbladder; Gallstones; Nephritis; Pancreatic Disorders; Peritonitis; Poison Ivy/Oak; Prostate Problems; Psoriasis; Pyorrhea; Quinsy,;Scarlet Fever; Spinal Meningitis (sometimes referred to simply as Meningitis); Spleen; WoundsPau D Arco (Purple Lapacho), Inner Bark 545mg - 180 Caps
Pau d'arco is a South American herb which helps strengthen and nourish the body's defense system. A healthy immune system is a key in fighting diseases and infections.Red Raspberry Leaves, 480mg - 100 Caps
Red raspberry leaf strengthens the uterus wall and regulates menstrual flow. It nourishes the reproductive organs, especially the uterine muscles, and helps strengthen and prepare the body for childbirth. It is also highly valued for its soothing and astringent properties to the stomach and intestinal tract.Maca (Lepidum meyenii) Tincture, 100% Organic - 2 fl. oz.
Today Maca is used to increase energy and support the immune system. Maca can help a number of conditions from fatigue to frigidity.Instant Energy B-12 (2,000 mcg of B-12 per packet), NOW Foods - 75 Packets
NOW® Vitamin B-12 Instant Energy is the perfect way to keep alert and energized, regardless of the situation. These convenient, fast-acting packets are perfect when traveling or for convenience.Vitamin C 1000 with Bioflavonoids, Nature's Way, 100% Natural, 1000mg - 250 Vcaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Meta C Vitamin C Supplement, 1000mg - 100 Tabs
Meta C Vitamin C Supplement is a unique form of vitamin C that is absorbed faster than regular vitamin C and maintains higher serum levels for longer period of time with no intestinal discomfort.Vitamin C Liquid, with Rose Hips and Bioflavonoids, Kosher, Natural Citrus Flavor, 1000mg - 16 fl. oz.
Liquid Vitamin C with Natural Rose Hips & Bioflavonoids is an easy to swallow dietary supplement that exceeds the recommended daily intake of vitamin C.Nettle Tincture, 100% Organic - 2 fl. oz.
Nettle leaf has become a popular treatment of allergies (hay fever) and it can improve goiter, inflammatory conditions, and arthritis.Amalaki (Dhatri), 100% Natural, 450mg - 120 VCaps
Amalaki is an Ayurvedic effective against allergies, anemia, cold & flu, constipation, diabetes, digestive disorders, and liver problems.Copper Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm - 16 fl. oz.
WaterOz Ionic Copper is a pure liquid Copper supplement. Copper influences protein metabolism and general healing, improves vitamin C oxidation and is integral in the formation of RNA.Vitamin B-12 (Cobalamin), 50mcg & B-9 (Folic Acid), 400mcg - 1 fl. oz.
Vitamin B-12 (Cobalamin) helps to maintain a healthy nervous system and helps in the prevention of pernicious anemia.Heart Formula Tincture, 100% Organic - 2 fl. oz.
The Heart Formula can be used for anemia, fatigue and heart problems.Spleen & Pancreas Formula Tincture, 100% Organic - 2 fl. oz.
Use the Spleen & Pancreas Formula to strengthen and nourish the spleen and pancreas naturally.Dong Quai Root Tincture, 100% Organic - 2 fl. oz.
Dong Quai root is often used in the treatment of menstrual cramps, or dysmenorrhea and PMS, hot flashes, and other menopausal symptoms.Once Daily Multi Vitamin & Mineral, All Natural, Lactose Free, w/ Iron - 100 Tabs
Nature's Way Daily Multi Vitamin & Mineral provides many of the essential nutrients that modern diets may lack. They are useful for protection, growth and maintenance of body systems as they age.Alive! Whole Food Energizer Multi Vitamin with Mineral, Nature's Way 18mg of Iron added - 90 Tabs
Alive Whole Food Energizer Multi Vitamin with Mineral with Iron by Nature's Way is absorbed into your blood stream 5 times faster than other leading brands.Ester C with Bioflavonoids, 25% More Free, 500mg / 200mg - 150 Vcaps
Nature's Way Ester C with bioflavonoids is 100% natural calcium ascorbate with biologically active metabolites. These metabolites enhance cellular uptake and retention of Vitamin C. Now get 25% more free.Vitamin C Liquid, with Rose Hips and Bioflavonoids, Kosher, Natural Citrus Flavor, 1000mg - 16 fl. oz.
Liquid Vitamin C with Natural Rose Hips & Bioflavonoids is an easy to swallow dietary supplement that exceeds the recommended daily intake of vitamin C.Barberry Tincture, 100% Organic - 2 fl. oz.
Barberry is used for treating gallbladder disease, heartburn and indigestion and diarrhea. This herb can also be used to treat infections, parasites, psoriasis, and vaginitis.Cocoa Powder - Certified Organic 100% Natural
From holiday desserts and everyday baking, to a steaming cup of hot cocoa on those cold winter days, NOW® Organic Cocoa Powder offers a guilt-free way to satisfy your sweet tooth without the high amounts of sugar, fat and preservatives common to many commercially available mixes.
Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
Click Here To Visit Herbal Remedies Product Page
NOTIFY YOUR MIDWIFE OR HEALTH CARE PRACTITIONER IF...
You or a family member has symptoms of anemia.
Nausea, vomiting, severe diarrhea or constipation occur during treatment.
MOONDRAGON'S ANEMIA LINKS
