Anemia is a condition that occurs when the body does not have an adequate amount of red blood cells. There are several types of anemia with a variety of causes. Causes can include poor production of red blood cells, destruction of red blood cells, or bleeding that depletes red blood cells. If possible, it is best to determine the cause of the anemia to treat or improve anemia-related symptoms. There are several types of anemia with a variety of causes. Below are the specific types of anemia and their cause:

Iron-deficiency anemia is caused by blood loss or not eating enough iron-rich foods. This results in the body not being able to make enough red blood cells.

Pernicious anemia is caused by the body not being able to absorb vitamin B12 properly, causing a B12 deficiency. Vitamin B12 deficiency can lead to the body not being able to make enough red blood cells.

Folic acid-deficiency anemia is caused by not eating enough foods rich in folic acid or the body’s inability to absorb enough folic acid. It also can be related to illness. Again, the result is the body is not able to make enough red blood cells.

Hemolytic anemia is an acquired or inherited disease that causes red blood cells to be deformed. The result of this disease is that the body destroys red blood cells too quickly.

Sickle cell anemia is an inherited disease that is most common among African Americans. Sickle cell anemia causes red blood cell to be deformed and sickle shaped. Sickle shaped blood cells do not carry oxygen properly, break down easily, and clog blood vessels.

The first four types of anemia are the most common anemias that occur during cancer treatment. Anemia can be related to poor nutrition, the body not functioning optimally, or some of the medications that are being given to treat the cancer. The following are some tips and suggestions to help manage anemia:

Choose iron rich foods to incorporate into meals and snacks.

The recommended daily iron intake for men is 8 mg/d. The recommended daily intake for women ages 19-50 is 18mg/d. The recommended daily intake for women over the age of 50 is 8/mg/d. Pregnant and lactating women have increased needs. There are two types of iron in food: heme and non-heme. Heme iron is more easily absorbed and is found only in meat, fish and poultry. Non-heme iron is found in vegetables, fruits, dried beans, grains, and nuts. Here is a chart showing some iron rich foods and their iron content:

Food Serving Size

Iron Content (mg)

Clams (canned) 3 oz 23.8
Oysters 3 oz 13.2
Cereal, 100% iron-fortified bran or whole grain ½ cup 9-12
Chicken liver 3 oz 10.8
Cereal, other ½ cup 2-7
Clams 3 oz 6.3
Beef liver 3 oz 5.2
Cream of wheat ½ cup 5.2
Oatmeal, instant fortified ½ cup 5
Beans baked with pork ½ cup 4.5
Soybeans ½ cup 4.4
Pumpkin Seeds 1 oz 4.2
White beans (canned) ½ cup 3.9
Lentils ½ cup 3.5
Tofu (firm) ½ cup 3.4
Pretzels 2 oz 3.1
Beef, veal, or lamb 3 oz 3
Spinach (canned, cooked, or raw) ½ cup cooked, 1 cup raw 3
Vegetable or soy burger 1 patty 2.9
Pork 3 oz 2.7
Soy milk 1 cup 2.7
Kidney beans ½ cup 2.6
Shrimp 3 oz 2.6
Chickpeas ½ cup 2.5
Sardines 3 oz 2.5
Spinach  (frozen) 1/2 cup 2.5
Lima or navy beans ½ cup 2.3
Beef, ground 3 oz 2.2
Dried peas, cooked ½ cup 2
Turkey (dark meat) 3 oz 2
Swiss chard 1/2 cup 2
Potato, baked with skin 1 medium 1.9
Black, pinto, or great northern beans 1.8 1.8
Cashews 1 oz 1.6
Molasses 1 Tbsp 1.5
Plain baked beans 1/2 cup 1.5
Tuna (canned) 3 oz 1.3
Almonds 1/4 cup 1.3
Peas (frozen) 1/2 cup 1.2
Chicken breast 3 oz 1.1
Turkey (light meat) 3 oz 1.1
Egg 1 large egg 1

Sources: US Department of Agriculture Agricultural Research Service. USDA National Nutrient Database for Standard Reference and Nutrient Data Laboratory; NutritionData.com. Nutrition Facts and Information.

Eat iron-containing foods with foods containing vitamin C.

Vitamin C enhances the absorption of iron. Here is a list of foods containing vitamin C.

Fruits

Vegetables

Cantaloupe, citrus fruits, citrus juice, kiwi, mango, papaya, pineapple, strawberries, blueberries, raspberries, cranberries, watermelon Broccoli, Brussel sprouts, cauliflower, green peppers, red peppers, spinach, cabbage, turnip greens, other leafy greens, sweet potatoes, potatoes tomatoes, tomato juice, winter squash

Avoid foods, beverages and behaviors that may reduce iron absorption.

Tannins found in tea can block iron absorption. Limit tea consumption and drink between meals instead of with meals and snacks or when not eating iron-containing foods. Do not drink alcohol if you are anemic or if you are taking medications or supplements to treat anemia.

Only begin taking an iron supplement if blood work shows an iron deficiency.

Your healthcare team or a Registered Dietitian can provide direction on which supplement(s) to take. Do not begin any supplements without consulting with a healthcare provider first. If you are instructed to take an iron supplement, take it on an empty stomach if tolerated. Iron is absorbed best on an empty stomach.

Be sure to eat enough protein.

Foods high in protein are very important to include during cancer treatment because they help support the immune system. Many of these protein containing foods also contain iron. Protein is found in the highest amount in meat, eggs, fish, dairy products, beans, tofu, and nuts.

Eat foods containing folate.

Folate is a B vitamin that supports the production of red blood cells. Eating enough folate-containing foods may help to prevent anemia. The best sources of folate are lentils, pinto beans, garbanzo beans, spinach, black beans, navy beans, kidney beans, collard greens, turnip greens, and lima beans.

Eat foods containing vitamin B 12.

Although vitamin B 12 deficiency is rare, poor nutrition over a long period of time may result in a deficiency. Since vitamin B 12 also plays a role in the production of red blood cells, consuming foods containing vitamin B 12 is important. The best sources of vitamin B 12 are eggs, sardines, salmon, venison, lamb, beef, shrimp, halibut, scallops, yogurt, and milk. Your healthcare provider may check your blood level of vitamin B 12 to determine if you have a deficiency.

Be aware of anemia symptoms.

It is common not to have any symptoms at all. However, the most commonly reported symptoms are excessive fatigue, shortness of breath, general weakness, and in some cases heart palpitations. If any signs of blood loss are present such as blood in the stool or urine or frequent nose bleeds, alert your health care provider immediately.