Anemia may increase risk of heart failure mortality in certain heart patients

System Error

Anemia wears a body down. And as you age, the risk grows that that body might be yours.

For most of us, the likely key to the anemia problem is poor absorption of nutrients. Deficiencies of folate, vitamin B12 and iron contribute to the drop in red blood cell count that characterizes anemia. These cells deliver oxygen from the lungs to tissues throughout the body. When that delivery system breaks down, the result is weakness, fatigue, and even hair loss.

New research shows that anemia may also put certain heart patients at serious risk.

One for the heart

Many chronic heart failure (CHF) patients also suffer from anemia. So researchers from Australia and China mounted a study to evaluate the effect of anemia on these patients.

The team conducted a meta-analysis, using 21 studies that included more than 97,000 subjects with CHF. Results showed that anemia significantly increased risk of CHF hospitalization and death. Not surprisingly, the more severe the anemia, the greater the risk.

The authors of the study hope that doctors will take note and watch more carefully for anemia symptoms in their CHF patients.

And if those doctors are savvy about nutrition, they might also suggest more selenium for their patients.

Earlier this year I told you about a study in which researchers examined blood samples and data collected from more than 2,000 subjects who participated in the third National Health and Nutrition Examination Survey.

Nearly 15 percent of the subjects were found to be anemic. On average, blood levels of selenium were lowest in these anemic subjects, while higher selenium levels were noted in subjects with no anemia.

Getting the iron right

Anemia is often referred to as “iron poor blood.” But care should be taken when treating anemia with iron supplements.

In previous e-Alerts, HSI Panelist Allan Spreen, M.D., has noted that he wouldn’t treat anemia with inorganic iron – the iron form found in most supplements.

Dr. Spreen: “The mineral is too reactive in the body when it is not insulated from the system by being encased within the heme structure of hemoglobin. Free radical formation from free iron is just too much of a threat.”

Dietary sources of heme iron come exclusively from red meat, fish, pork, and poultry, with beef liver and chicken liver having the highest amounts of iron. An additional intake of vitamin C can also help the body absorb iron.

Supplements of folic acid and vitamin B-12 may also help address anemia. The recommended daily allowance (RDA) for folate is 400 micrograms, but Dr. Spreen recommends folic acid supplementation of 1,600 mcg per day, noting, “folate isn’t effective in low doses except in a limited percentage of cases.”

Along with folate, Dr. Spreen recommends 1,000 mcg of B-12 per day in sublingual form (dissolved under the tongue), and 100 mg per day of B-6, as well as 400-500 mg of magnesium per day to make the B-6 more effective.

Talk with your doctor or a health care professional before changing your daily supplement regimen.

“The Impact of Anemia on the Prognosis of Chronic Heart Failure: A Meta-Analysis and Systemic Review” Congestive Heart Failure, Vol. 15, No. 3, May/June 2009,
“Low Selenium Levels May Increase Anaemia Risk in the Elderly” Stephen Daniells, NutraIngredients-USA, 1/14/09,