Red Blood Cells, Iron, Hemoglobin and Anemia – Everything you wanted to know

Women across all age and income groups in India are at risk of suffering from anemia. So one thing is certain this life threatening condition is not restricted to one group or category.

Even though it is a chronic problem, not too many women are aware about it and they continue making mistakes which aggravate their health conditions which later requires intensive medical care.

Let us begin this detailed article by understanding every player who is involved.

What are Red Blood Cells or RBC?

RBCs is a cell which carries oxygen from the lungs to various parts of the body. Our body is made up of lakhs and lakhs of cells which need oxygen. Cells are individual power plants which generate energy which we need for various activities done by the body.

RBCs contain hemoglobin which is filled with iron. It connects with oxygen and stores it which is how it facilitates transport of oxygen. Hemoglobin in a protein which contains iron which can bind with oxygen and carry it to different parts of the body.

One RBC contains 2700 lakh hemoglobin molecules. Our body makes 24 lakh RBCs every second. They are manufactured by the bone marrow of certain bones like the thigh and leg bone. The raw material for manufacture of RBCs is amino acids and iron. There are also some trace elements required like Vitamin B6, Vitamin B12, Folic Acid and so on.

Life of a RBC is about 100 days. The body maintains a strict balance between production and elimination of RBCs. After you donate blood, the production increases suddenly to make up for the loss of RBCs. There are 25 lakh crore RBCs moving in your blood at any given point of time.

70% of all the cells in your body are the RBCs which now make them very very important. Each cell in the body requires fuel for producing energy. Similarly even the RBCs need energy to function. They use blood glucose as the source of energy.

Structure of Red Blood Cell

RBC is not exactly circular but it is biconcave disk which is thinner in the middle because it can fold. This is a very crucial factor because an individual RBC has to twist so that it can enter the thinnest capillary like the optical nerve of the eye.

How to read a report

RBC – Count of number of RBCs per millilitre of blood. 4.7 for males and 4.3 for females.
MCV – Volume or size of cell. A larger cell will have more oxygen carrying capacity. Value can be between 80 to 98.
Hematocrit – RBC count X MCV. It shows total percentage in volume of red blood cells in your blood. So 40 to 45% of your blood should be RBCs.
Hemoglobin – Ranging between values of 12 to 17 for males and 11 to 15 for females, this is the component which carries oxygen everywhere.

So the ability to deliver oxygen all over the body is linked to RBC count, MCV and Hemoglobin.

Now here is the catch. Most women are having hemoglobin values hovering at 11.5 which as per blood reports is normal. But they are already staring at a deficiency. Most of these women will never cross 12 in their whole life. Is there is a shortage of iron in food? The answer is no. Iron is abundant. But when the doctor prescribes iron supplements, they will get something called as Iron Toxicity. This will lead to problems like skin rashes, irregular periods or some allergic reaction on the body which leads to boils or redness.

Deficiency in Red Blood Cells – the symptoms

Shortage of Red Blood Cells will deprive your body parts of oxygen. That will lead to direct effects like fatigue and weakness. It will also lead to problems like shortness of breath. For any small work you will have to push your body harder and eventually you will run out of motivation and will power.

As a compounded effect you will find difficulty concentrating and feel dizzy too.

Besides the above mentioned effects and symptoms, here are some other problems which can be caused by anemia.

Skin – It starts becoming pale yellow and loses the bright complexion. Even the skin tone gets uneven with blemishes.

Nails – Iron deficiency leads to brittle nails which crack easily. The nail usually is firmly embeded in your skin. But with anemia it starts to lift up and the sides of the nail appear white.

Hair – Hair loses its texture and becomes brittle. Women will see patches of hair loss while men will start balding from the top. Since females have to face menstruation, their iron deficiency is more pronounced in the form of thin or scanty hair.

Other minor symptoms are twitching, irritation, ice cravings, restless legs, dirt craving (prominently seen in small kids).

How is iron utilised

Bone Marrow – The story of RBCs begin at the bone marrow where their production begins. There are certain genetic defects which obstructs the production of RBCs.

Kidney – Kidneys produce the hormones needed to trigger the release of RBCs. So if there is a problem with your kidneys, it will translate to production related problems. This hormone is EPO.

Food – We have already seen earlier that we need Iron, Vitamin B12, Vitamin B6 and Folic Acid for production of RBCs. Most vegetarian and vegan diets are deficient of these exact four components.

Digestion – There are a number of factors which interfere digestion of the food we eat. To begin with stress interferes with the production of hydrochloric acid which gives problems with breaking down food. Problems with intestines will also create problems with absorption such as damage in the inner lining.

Bleeding – Any kind of bleeding inside or outside the body will disturb the balance of RBCs and that balance has to be restored quickly. Blood donation, injury and ulcers are the most common reasons. But for women it is the monthly periods which is the cause of concern. Those who experience heavy bleeding will enter the danger zone if the production of RBCs does not match up.

Improperly formed RBCs – Due to any reason if the RBCs are not formed properly, they are destroyed and cleaned up. They do not go on to life for their complete life of 120 days. They are processed by the spleen which removes unhealthy RBCs and other waste from the blood. This problem can either be genetic or can be due to toxins in the blood which are able to destroy the healthy RBCs.

So by this time it should be pretty clear that if you are in the danger of getting anemia it is not just as simple as poping in a few tablets of iron daily. Each of the six points mentioned above needs detailed investigation.

How to fix it

The first approach to the problem should be solving the diet issue. How do you intake iron. There are two types of sources of iron in food, heme and non heme. This is related to how much iron is absorbed by the body.

Iron from sources like spinach, beans, grains, seeds, leafy greens and so on are non heme sources. The iron absorption from such sources is very less.

While from heme sources like liver, red meat, dairy and sea food, the absorption can be upto 10 times that of non heme sources.

So start consuming small portions of red meat.

The next issue to be fixed is digestion. Lack of acidity of hydrochloric acid will affect the digestion and absorption of iron. The most common way how people make it worse is to take a medicine or ayurvedic remedy for taking care of stomach acidity. These medicines simply dilute the stomach acid. They do relieve you of acidity but absorption of iron and so many essential minerals and nutrients is now in serious danger.

The second part of digestion is inflammation of the gut. It is caused by the refined oils, grains, fried food and all that omega 6 fatty acids which you are consuming. You need to increase your intake of omega 3 fatty acids to balance it. Stop eating things that cause inflammation in your gut.

Inflammation is actually more dangerous that you can imagine. Iron is the only essential mineral which cannot be stored in. the body. It has to come in the correct amount in the body almost on a daily basis. So too less of iron and too much of iron, both are going to be an issue. Apart from your body, the bacteria staying inside your gut also needs iron. Whenever there is an infection, the body locks up the iron so that it is not stolen by the bad bacteria and pathogens which have caused the infection. It is part of the body mechanism to starve the pathogens and kill them. But chronic inflammation caused by refined carbs and sugars might keep iron locked up forever making it unavailable for both the good bacteria and the bad bacteria and the body too.

Phytic acid present in grains, nuts and seeds is another component which blocks the absortion of iron. One way to get rid of it is to soak it in water overnight and peel off the skin and the other way is to sprout them. Sprouts also pack in a punch of proteins.

Finally alcohol is also a reason which blocks iron absorption by the body.

As we come to the end of this detailed article here is another crazy but effective way to increase the number of RBCs or maybe their size and oxygen carrying capacity too.

Intermittent Hypoxia Training

Have you ever seen an athlete or sportsperson training with a mask on. That is deliberate deprivation of oxygen for a short duration of time. This increases the production of RBCs upto 10 times! That is beneficial for athletes and people doing physical training because it helps more oxygen delivery. For normal people, it helps you to sleep better, takes away tons of stress and keeps you body fit and healthy.