From the Guidelines
Iron deficiency is the primary nutritional cause of hemolytic anemia, as it can lead to impaired hemoglobin production and increased red blood cell destruction. This condition occurs when the body lacks sufficient iron to produce hemoglobin, a protein in red blood cells that carries oxygen to the body's tissues. Without adequate iron, the body may produce red blood cells that are smaller and paler than normal, leading to anemia. Iron deficiency can be caused by inadequate dietary intake, increased requirement for iron, or chronic blood loss. Other nutritional deficiencies that can contribute to hemolytic anemia include vitamin B12 and folate deficiencies, which impair DNA synthesis and lead to megaloblastic anemia with some hemolytic features. Severe copper deficiency may also cause hemolytic anemia by reducing the activity of antioxidant enzymes. Treatment involves supplementation of the deficient nutrient, with iron typically administered at doses of 50-100 mg daily for adults until blood levels normalize and symptoms resolve, as recommended by the British Journal of Sports Medicine 1. Dietary sources of iron include red meat, seafood, and fortified cereals, which should be incorporated into the regular diet to prevent recurrence.
Some key points to consider in the diagnosis and treatment of iron deficiency anemia include:
- Iron deficiency is defined as low serum ferritin (<35 μg/L) and normal blood hemoglobin values 1
- Anaemia is considered present when blood haemoglobin levels are <115 g/L (females) or <125 g/L (males) 1
- A reasonable time frame for assessment of iron status is once per year in male players and twice per year in female players (more frequently when iron deficiency has been detected in recent monitoring) 1
- Iron supplementation may be considered at levels above the RDA after consultation with qualified medical and dietetic practitioners 1
- Parenteral (i.e., intravenous) supplementation is usually not indicated, except in cases of pathologically impaired iron digestion from the gut (such as in coeliac disease) 1
It is essential to note that while other studies discuss the importance of vitamin B12 and folate deficiencies in the development of megaloblastic anemia with some hemolytic features 1, and the role of pyruvate kinase deficiency in hereditary nonspherocytic hemolytic anemia 1, the most recent and highest quality study on the topic of nutritional deficiencies causing hemolytic anemia highlights the critical role of iron deficiency 1.
From the FDA Drug Label
Vitamin B12 is essential to growth, cell reproduction, hematopoiesis, and nucleoprotein and myelin synthesis. Intrinsic factor deficiency causes pernicious anemia, which may be associated with subacute combined degeneration of the spinal cord A vegetarian diet which contains no animal products (including milk products or eggs) does not supply any vitamin B12.
The nutrition deficiency that causes hemolytic anemia is not directly mentioned, however, Vitamin B12 deficiency can cause pernicious anemia, which is a type of anemia. Key points:
- Vitamin B12 is essential for hematopoiesis.
- Pernicious anemia is caused by intrinsic factor deficiency.
- Vitamin B12 deficiency can occur in strict vegetarians who consume no products of animal origin. 2 2
From the Research
Nutrition Deficiency and Hemolytic Anemia
- Hemolytic anemia can be caused by various factors, including nutrition deficiencies, genetic disorders, and autoimmune diseases 3, 4, 5, 6.
- A specific nutrition deficiency that can cause hemolytic anemia is a deficiency in glucose-6-phosphate dehydrogenase (G6PD) 4, 5, 6, 7.
- G6PD deficiency is a genetic disorder that affects the enzyme responsible for maintaining the integrity of red blood cells, making them more susceptible to oxidative stress and hemolysis 4, 5, 6, 7.
- Certain foods, such as fava beans, can trigger hemolysis in individuals with G6PD deficiency 7.
- Vitamin B12 deficiency can also cause hemolytic anemia, particularly in the case of pernicious anemia 3.