Can anemia cause anxiety and depression

Is There a Link? I Psych Central

Could there be a medical reason behind your gloomy mood and lack of energy? If you live with depression, anemia may be partly to blame.

A common depression symptom is the feeling that even the simplest tasks take more energy than you have. Anemia can also make you feel this way.

When you have anemia, your blood can’t transport as much oxygen as it should. This can impact many areas of your body, including your brain.

Not only does anemia reduce your energy levels, but it can also affect the way you think and feel. Anemia, particularly the iron deficiency kind, has been linked to mental health conditions like depression and anxiety.

Anemia is a condition that affects your blood cells and reduces their ability to transport oxygen.

The World Health Organization (WHO) estimates that nearly 25% (1.62 billion) of the population worldwide has some anemia. Most of these cases are due to an iron deficiency.

Depression is one of the mental health conditions that low iron can cause.

The area of your brain called the basal ganglia contains a higher amount of iron than other brain regions. Because of this, it responds readily to changing iron levels.

Researchers previously thought that the basal ganglia was mainly responsible for movement, but recent research suggests that this area also shapes the processing of emotional stimuli. So, if your iron isn’t at the right level, your brain might not process emotions properly.

A Japanese study from 2018 with 11,876 participants identified a link between self-reported depression and self-reported iron-deficiency anemia.

In a 2014 study, anxiety symptoms were linked to low iron. Neurotransmitter stability and energy metabolism influence emotions like anxiety, which are affected by iron levels.

This means that if your iron level is too low, changes to your energy and brain chemistry might make you feel anxious.

Hypoxia (reduced oxygen levels) from anemia affects multiple areas of your body, including your brain. It can cause physical, cognitive, and mental health symptoms, some of which include:

fatigue
weakness
irregular heart rate
dizziness
chest pains
cognitive impairment (trouble remembering, learning, concentrating, or making decisions)
mood changes

Anemia’s connection to mental health extends beyond long-term (chronic) blood oxygen deprivation. The most common form of this condition, iron deficiency anemia, has the added impact of insufficient iron.

Iron does more than help red blood cells carry oxygen. Along with preventing anemia, iron is involved in many essential cognition areas, including:

central nervous system (CNS) enzymes and proteins
CNS development
DNA replication and repair
white matter myelination (brain cell insulation)
development of neurotransmitter systems

A 2013 study revealed a link between iron deficiency and diagnoses like mood and developmental conditions.

It’s theorized that iron deficiency in childhood is linked to the abnormal myelination (covering) of neurons and altered neurotransmitters that contribute to child and adolescent-onset psychiatric conditions.

The cause of anemia depends on the type.

For example, iron-deficiency anemia results from inadequate amounts of iron in your body. You might not have enough iron in your diet, or you may not absorb it well. You can also lose iron through blood loss conditions such as menstruation, ulcers, or trauma.

Meanwhile, other types of anemia have causes such as genetics or autoimmunity.

There are several types of anemia, all of which can decrease the amount of oxygen transported in your blood.

Iron deficiency anemia

Iron deficiency anemia (IDA) occurs when you don’t have enough iron to make the blood hemoglobin you need to transport oxygen.

Pernicious anemia

This type of anemia is caused by a deficiency in vitamin B12, which is required to produce healthy red blood cells. People who have pernicious anemia sometimes lack intrinsic factor, which helps the body absorb B12. Other causes include diet, infections, medications, and surgery.

Thalassemia

Thalassemia is a genetic condition that causes low hemoglobin levels. Reduced hemoglobin means your red blood cells can’t carry enough oxygen.

Sickle cell anemia

Sickle cell disease is also genetic but causes abnormalities in some red blood cells. These cells become abnormally shaped, rigid, sticky, and unable to carry oxygen.

Aplastic anemia

Aplastic anemia occurs when something interferes with the production of new blood cells, leading to a blood cell count that is too low. The most common cause is when your immune system attacks bone marrow cells.

Depression can significantly impact your life, but it’s manageable. If iron deficiency anemia is causing your depression, it may be easy to treat with a change to your diet or iron supplement.

Dietary change

Many doctors recommend improving your diet before taking an iron supplement unless a blood test shows that your iron is very low.

Dietary sources of iron include:

red meat

chicken
beans
peas
dark green leafy vegetables
fortified cereals

Foods containing vitamin C increase iron absorption. On the other hand, dairy products, tea, and coffee are examples of foods that interfere with iron. It helps to familiarize yourself with these interactions to maximize the effect of your dietary changes.

Iron supplementation

A 2020 study revealed that people with iron deficiency anemia have a higher chance of psychiatric disorders, but this decreases when they take an iron supplement.

It’s important to note that excess iron can accumulate in your body to unhealthy levels. It’s recommended that you have your iron level measured with a blood test before taking an iron supplement. Iron is a vital nutrient, but having too much can be as problematic as not having enough.

Sleep improvements

Proper sleep is a critical self-care goal. If you find it difficult to get an appropriate amount of restorative sleep, you might want to consider improving the consistency of your schedule. Sleep hygiene practices can also help, like mid-day caffeine cut-offs and a cooler bedroom temperature.

Light exercise

You can exercise with anemia but do so carefully and under a healthcare professional’s supervision. Regular movement increases circulation, improves sleep, and contributes to good health.

Anemia might cause fatigue or shortness of breath, so if you exercise, start slowly and keep your workouts short.

Sometimes a medical condition like anemia can contribute to a mental health condition such as depression. On the one hand, this may seem like you have more issues to manage. But understanding how different conditions influence each other can make them easier to treat.

Once you’ve talked with a healthcare professional about an anemia assessment, you can take steps to improve your physical health that will also help your mental health. This could mean learning more about anemia or reaching out to a nutritionist for guidance.

There are support groups available and therapists you can meet with to continue along your path of healing and self-discovery.

Low Iron Depression and Anxiety

Skip to content Low Iron, Depression, and Anxiety – A Simple Solution

Updated: January 5, 2021

The large-scale traumatic event of the COVID-19 Pandemic has amplified anxiety and depression globally.

A recent study found that depression is three times higher during COVID-19 than before the pandemic. Physical, emotional, and psychological burnout from the disruption of our normal lives otherwise known as COVID fatigue is playing a role.

Social isolation combined with a lack of activities that bring joy is extremely difficult to process emotionally. Uncertainty, hopelessness, frustration, anger, worry, and fear are just some of the emotions that may be present during these turbulent times.

If you or a loved one is experiencing depression we are here to help and ready to explore additional underlying causes of your depression. Low levels of iron is one factor that we rule out. In this article, we share insight into how iron deficiency is linked to emotional health.

I have noticed an increasing number of patients struggling with depression, anxiety, and other mood problems over my 30+ years of practice as a physician. Depression is on the rise in all age groups, with a recent survey of teenagers in the United States revealing that 36% of girls and 14% of boys experience depression at some point during their teenage years.[1] Girls are 2 times more likely to become depressed than boys, particularly after beginning menstruation at puberty.

The results of this survey raised a red flag for me. When I treat patients with mood disorders, I search for any underlying medical or nutritional causes. One nutritional deficiency that often contributes to depression is iron deficiency. When I saw that girls are more likely to become depressed than boys and that there is a spike after beginning menstruation (a time when iron is lost in the blood), I couldn’t help but wonder if iron might play a role for some of these teenage girls.

Another group of patients that I have seen become iron-deficient and depressed are my patients who come to me taking acid-blocking medications. Acid blockers, like Prilosec and Nexium, reduce stomach acid to treat symptoms of reflux and heartburn. The problem is that stomach acid is required for the proper absorption of iron from food. Ongoing use of these medications can lead to iron deficiency and a cascade of symptoms to follow.[2]

Let’s take a step back. What exactly does iron have to do with mood and depression?

Iron and Depression

Iron is a vital mineral that plays a role in every cell of the body. Iron is a component of the hemoglobin protein in red blood cells, which carries oxygen throughout the body.

Strict vegetarians are at risk of iron deficiency. Iron is obtained from food sources, such as meat, poultry, seafood, lentils, beans, spinach, and sesame seeds.

When there is a lack of iron in the body, red blood cells become small, and less oxygen circulates to body tissues—a condition called iron-deficient anemia. Common symptoms of iron-deficient anemia include lack of energy, dizziness or lightheadedness, and pale skin.

Some people are iron deficient without actually having anemia. A unique symptom of iron deficiency is a craving for ice. There is a medical term for craving ice: pagophagia. If you crave ice, you may want to have your iron levels checked.

Iron deficiency can contribute to depression because of its relationship with dopamine—one of the neurotransmitters in the brain that keeps us happy. Iron is required for the production of dopamine in the brain.[3] Our bodies use tyrosine from protein-rich foods to produce dopamine, but this only happens in the presence of iron.[4] A lack of dopamine can lead to depression, anxiety, and even movement disorders like restless leg syndrome.[5] Think of it like this:

Symptoms of Dopamine Deficiency

Fatigue
Apathy
Anxiety / Depression
Poor Concentration
Restless Leg Syndrome

Testing for Iron Deficiency

Routine blood tests measure the number, size, and shape of red blood cells as well as the amount of hemoglobin in the blood. These measurements give insight into iron status, but they do not reliably detect iron deficiency in all patients.[6] The most reliable way to test for body stores of iron is to test ferritin. Ferritin is the body’s storage form of iron and the most reliable test for iron deficiency.

A Case Example

I had a young woman come to see me with heart palpitations. Her palpitations had begun after taking a medication to treat restless leg syndrome. We know that restless leg syndrome can be associated with low iron levels. Sure enough, her ferritin level was low. It turns out that her iron level was low because she was taking an acid-blocking medication to treat her heartburn.

Here we have a woman experiencing a side effect of a medication, which she is taking to treat the side effect of another medication. How could we turn this around? We needed to get to the root cause of the original symptom: heartburn.

We discovered that her heartburn was a reaction she was having to gluten.

We did a trial of a gluten-free diet and started her on a protocol to heal her digestive system. The heartburn went away. We gave her a natural iron supplement, which corrected the iron deficiency. As her iron levels returned to normal, her dopamine levels rose, and her symptoms of anxiety and restless leg syndrome improved.

How to Get Care for Depression

Depression can affect friendships, performance, and even lead to suicide attempts. If the answer might be as simple as correcting iron deficiency, then why not explore that possibility? If you or somebody you know struggles with a mood disorder, our integrative team of doctors, nurses, and nutritionists is here to help. We will test your ferritin levels and screen for any other underlying medical causes.

Call our office today at 303-343-3121.

Tips for Coping with Depression

Communicate with loved ones and express your feelings.
Cultivate a meditation or deep breathing practice to aid in relaxation.
Practice gratitude by thinking of three things you are grateful for every day.
Aim to exercise and move your body daily to increase your endorphins.
Sit outside on sunny days to boost your levels of Vitamin D.
Maintain a consistent sleep schedule.
Consume healthy foods and limit caffeine and alcohol intake.

If you or someone you know feels suicidal there is a National Suicide Prevention Lifeline that is available 24 hours a day. For free and confidential support, you can call 800-273-8255.

References:

[1] Breslau J, Gilman SE, Stein BD, Ruder T, Gmelin T, Miller E. Sex differences in recent first-onset depression in an epidemiological sample of adolescents. Transl Psychiatry. 2017;7(5).

[2] Hashimoto R, Matsuda T, Chonan A. Iron-deficiency anemia caused by a proton pump inhibitor. Intern Med. 2014;53(20):2297-2299.

[3] Youdim MB, Ben-Shachar D, Ashkenazi R, Yehuda S. Brain iron and dopamine receptor function. Adv Biochem Psychopharmacol. 1983;37309-321.

[4] Unger EL, Bianco LE, Jones BC, Allen RP, Earley CJ. Low brain iron effects and reversibility on striatal dopamine dynamics. Exp Neurol. 2014;261462-468.

[5] Allen RP. Restless Leg Syndrome/Willis-Ekbom Disease Pathophysiology. Sleep Med Clin. 2015;10(3):207-14, xi.

[6] Johnson S, Lang A, Sturm M, O’Brien SH. Iron Deficiency without Anemia: A Common Yet Under-Recognized Diagnosis in Young Women with Heavy Menstrual Bleeding. J Pediatr Adolesc Gynecol. 2016;29(6):628-631.

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About The Care Group: We promote optimal wellness by providing an individualized, functional medicine approach to address root causes rather than simply treating symptoms. We help patients with a wide range of issues including autoimmune/ inflammatory disease, digestive disorders, hormone imbalances, and mood disorders. To learn more about our practice, click here.

About the Author: Dr. Gerard Guillory, MD is Board Certified in Internal Medicine and has published two books on Irritable Bowel Syndrome (IBS). In 1985, he opened The Care Group, PC. Today, his clinic is a Primary Care facility that is a hybrid of functional and traditional medicine treating patients with digestive disorders, autoimmune disease, and other conditions. You can learn more about Dr. Guillory here.

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Why anemia affects mental health

Various conditions, including anemia, can affect a woman's mental health. Anemia results from a deficiency of hemoglobin, which helps red blood cells transport oxygen to cells.

Many women experience too much blood loss during their menstrual cycles. Iron deficiency can cause more severe periods, which in turn can lead to anemia in some cases. This type is called iron deficiency anemia. nine0004

Common symptoms of mental illness due to anemia include fatigue, dizziness, headache, and difficulty concentrating, according to a National Center for Biotechnology Information article.

Nzinga Harrison, a board-certified psychiatrist specializing in general psychiatry and addiction, reports that the symptoms of anemia can be classified as symptoms of some mental disorders.

"Anemia is one of the most common diseases in America that has symptoms of a mental disorder," says Harrison. “The most common of these are fatigue, loss of energy, difficulty sleeping, palpitations and lightheadedness. When we compare them to the symptoms we use to diagnose depression, we see a striking coincidence: loss of energy, fatigue, difficulty sleeping. ” nine0004

Anemia and anxiety can also share some of the same symptoms.

“Symptoms of palpitations and anxiety can sometimes be indistinguishable from the anxiety symptoms associated with panic attacks,” says Harrison. The symptoms are so similar that psychiatrists need to perform regular complete blood counts to rule out anemia as a cause of depression or anxiety in women.

Anemia can even hinder the recovery process for people who have previously abused drugs and alcohol. nine0004

"While there is a perception among psychiatrists that anemia can be associated with symptoms of depression and anxiety, the fact that anemia can put drug and alcohol addicts back into relapse is greatly overstated," says Harrison.

Dr. Douglas Beach, says that anemia is not usually the cause of mental health problems.

"Anemia is a sign or manifestation of the [underlying] disease process," Beach says. “If the degree of anemia is severe, it can cause fatigue and shortness of breath on exertion. Fatigue can have a direct impact on overall well-being and lead to depression.” However, a mild form of anemia usually cannot have any effect on the psyche. nine0004

On the other hand, the underlying disorder that causes anemia is more likely to affect mood. For example, chronic diseases such as kidney disease, inflammatory arthritis, and an underactive thyroid gland. Anemia resulting from a lack of vitamins such as B12 can rarely be associated with depression and memory loss/dementia.”

Do you think anemia affects mental health? Do you have anemia and have you suffered from its effects? Share your stories in the comments. nine0004

Source: empowher
Translation: im30.club

Fatigue and depression as a result of iron deficiency

: Natalia Pichugina

MEDI SPA is often visited by clients who report chronic fatigue, loss of concentration, depression, sleep disturbance or dizziness. Most of these patients already have diagnoses such as "vegetative dystonia", "psychosomatic illness" or "depression" and received appropriate treatment. However, Dr. Beat Schaub, MD, suggested that these conditions may be associated with iron deficiency, which was confirmed and corrected in a number of cases. nine0004

When recommending spa treatments to help manage non-specific symptoms identified, such as fatigue, loss of concentration, depression, insomnia or dizziness, consider whether they are associated with iron deficiency.

According to the World Health Organization (WHO), approximately 4 billion people suffer from iron deficiency . In Europe alone, about 50 million people suffer from it.

Although iron deficiency syndrome affects half of humanity, this disease is not recognized by conventional medicine. However, Beat Schaub, MD, has come a long way in researching iron deficiency, and has come to the conclusion that the vast majority of people suffering from iron deficiency can be completely cured. nine0004

Many people suffer from a range of non-specific symptoms. Often the cause of these symptoms, despite extensive research, cannot be identified and is ultimately misinterpreted as psychosomatic or even psychic. Most of these patients had diagnoses such as "vegetative dystonia", "psychosomatic illness" or "depression" and received appropriate treatment. However, a closer examination of this issue in some cases reveals deeper relationships. nine0004

MD Beat Schaub has come a long way in the study of patients suffering from non-specific symptoms, comparing medical records. In this way, he identified coincidences, which in turn showed causal relationships.

In 1997, in collaboration with programmers , Beat Schaub created a special program - a medical database for optimizing patient care (MEDAPORT). It provided an opportunity to gradually answer many questions that remained open. nine0004

As a result, in 1998 he found that the majority of women suffering from these symptoms were of childbearing age. Their iron content is only about ten percent of that of men, and symptoms usually disappear when they get the missing iron. Only 12% of them were simultaneously diagnosed with iron deficiency anemia. 88% suffered from the iron deficiency syndrome discovered by Beat Schaub.

Doctor found three matches. The first coincidence: the bulk of patients with conditions of fatigue are women of childbearing age. The second coincidence: "neurasthenic" women have very little iron. The third coincidence: if we compare the concentration of iron in the blood of women with iron deficiency with the concentration of iron in men, then the symptoms caused by iron deficiency in most cases disappear by themselves. nine0004

Beat Schaub adjusted the treatment according to the "dictation" of the patients. It quickly became clear that most patients with low blood iron concentrations benefited from intravenous iron. Their chronic fatigue disappeared, or at least significantly decreased. When additional tests were carried out, many patients not only felt "returned to life", but also unanimously listed other symptoms that disappeared due to the introduction of iron. As a result of a computer assessment, Beat Schaub determined that iron deficiency can cause not only chronic fatigue, but also loss of concentration, sleep disturbances, dizziness, depression, stiff neck and hair loss. nine0004

The term " Iron Deficiency Syndrome " (Iron Deficiency Syndrome, IDS) was chosen consciously, because we are talking about a range of symptoms that have a common cause and take on a specific framework.

The knowledge gained back in 1998 convinced Beat Schaub that iron deficiency can cause various symptoms even before the onset of anemia. As a researcher, as a person and as a doctor, Beat Schaub wanted to offer his patients the best possible treatment, so he had no doubts that this topic should be studied further. Far too many patients have suffered years of uncomplaining iron deficiency and have to undergo useless examinations and treatments. Instead of making up for the lack of iron, they often receive useless explanations and treatments that only alleviate their suffering. The main problem lies in two fallacies of the classical medical school:

Iron deficiency only appears when iron deficiency anemia sets in.
A ferritin level of 10 ng/mL is sufficient for all patients.

First, iron deficiency can indeed occur with a normal hemoglobin level. The body needs iron not only for the synthesis of hemoglobin. Iron is also a component of myoglobin, and in the respiratory chain it is involved in energy metabolism processes. Iron plays a significant role in cell proliferation, the synthesis of various transmitters and hormones such as adrenaline and dopamine, and in the destruction of free radicals. However, the body's primary use of iron stores is to produce hemoglobin. When the reserves of this “raw material” approach a minimum, the hemoglobin level remains at a normal level for a long time, while iron deficiency is already observed in other organs. nine0004

Secondly, Beat Schaub urges to simply be guided by logic: if ferritin levels between 10 and 400 ng / ml were really the norm, would people with iron levels in this range have at least one symptom that would disappear after administration of appropriate iron preparations? However, the reality is that it is these ailments that people often complain about, especially women of childbearing age. Consequently, this norm, determined by high university structures, should not be considered undeniable. In other words, it is simply wrong. The same relationship can be traced on the other hand: patients with the indicated symptoms and supposedly normal levels of ferritin in the blood very quickly stop complaining as soon as replacement therapy is completed and their concentration of deposited iron significantly exceeds the “allowed” lower limit so far. After treatment, it is usually measured in the range from 100 to 200 ng / ml, which is the best indicator from experience. nine0004

Between 1998 and 2005, Dr. Schaub developed a new concept for optimal diagnosis, treatment and prevention Swiss Iron System (SIS) , which is available to medical iron therapy centers as a Health Banking database via the Internet.

Thus, if a client came to you with a number of non-specific symptoms similar to those of vegetative dystonia, psychosomatic illness or depression, it makes sense to conduct a differential diagnosis with an iron deficiency condition, the correction of which, along with spa treatments, will help improve the life of your client.

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