Feeling Tired, Breathless, Dizzy and Pale

If you are experiencing abnormal tiredness and general weakness which does not seem to remedy with added rest; you become breathless and/or dizzy; People say you look unusually pale; there may be palpitations, headaches, brittle nails, poor appetite, swollen feet and leg pains. Then you may be Anaemic.

Anaemia is most common (but not exclusive) in adolescent girls, women in their reproductive years and pregnant women. Toddlers on milk-based diets are also at risk.  Anaemia is diagnosed when red blood cell levels fall below normal. Red blood cells contain haemoglobin responsible for carrying oxygen to the tissues. As a result of anaemia the amount of oxygen supplied to the tissues is reduced. The most common type of anaemia is Iron deficiency. Iron is needed for the production of red blood cells. The main causes of iron deficiency anaemia are;

  • Poor diet: Your body needs iron regularly. Over a period of time a diet lacking in iron will result in iron deficiency.
  • Blood loss: Loss of blood during menstruation puts women at risk of anaemia, particularly if the periods are heavy. Slow, chronic blood loss can be through peptic ulcer bleeding, a colon polyp, colorectal cancer.
  • Inability to absorb iron: Conditions like celiac disease and pancreatic disease affects intestinal absorption and can lead to iron deficiency anaemia. Hypochlorhydria is associated with low levels of hydrochloric acid in the gastric juices of the stomach which affects the absorption of iron present in the diet.
  • Pregnancy: In pregnancy it is normal for the total blood volume to increase. Without iron supplementation there may be a risk of developing anaemia. However since iron blocks the absorption of zinc, it must not be prescribed without first checking serum ferritin levels.
  • Drugs that block iron absorption: Prolonged use of antacids and ulcer medication will lower the levels of hydrochloric acid thus reduce the absorption of iron.
  • Dietary blockers: Some foods if eaten in larger amounts and frequently can hinders iron absorption e.g. calcium (milk, yogurt, cheese, broccoli, almonds), eggs contains a phosphoprotein which binds with iron, Oxalates (spinach, kale, beets, nuts chocolates, tea) bind with iron, Polyphenols found in tea, coffee, cocoa, spices, walnuts, apples, blackberries have the ability to inhibit iron absorption. Similarly tannins are naturally occurring plant-based substances can interfere with non-haem iron absorption from some plants such as beans, legumes, spinach and other dark-green leafy vegetables. Phytates (soy protein, fibre, almonds sesame, dried beans lentils, pea and whole grains) also have strong inhibitory affect on iron absorption.


  1. Improving iron intake

Iron deficiency anaemia can be corrected by introducing plentiful of iron rich foods. These include;

  • Meat, poultry and liver
  • Seafood
  • Dark fresh green leafy vegetables, beans, peas
  • Dried fruits (raisins, apricots)
  • Iron-fortified cereals, breads and pasta
  1. Enhancing Absorption

As a general rule always take multivitamins alongside any iron supplements that may have been prescribed to you. This will enable the various chemical processes that take place when iron is being absorbed. This can further be enhanced by taking probiotics, which will be of particular benefit if there are any digestive symptoms. Drinking plentiful of fluids and water is also a must. Other things to consider include;

  • Increasing foods with high vitamin C content such as; broccoli, citrus fruits, kiwi, leafy greens, melons, peppers, strawberries and tomatoes.
  • Avoid foods containing tannins e.g. black, green and rooibos tea, coffee, grapes, wine, ¬†sorghum and corn.
  • Avoid gluten, particularly if there is a diagnosis of celiac disease or other food allergies or intolerances. Gluten is damaging to the intestinal wall.
  • Avoid foods containing phytates (see examples above).
  • Avoid antacids and ulcer medication.
  • Long term alcohol intake can damage the gut and inhibit folate absorption and functioning of iron.