Please guide me with the treatment of Normocytic nomochromic anemia.

[ZABohra]

I know it's the anemia of chronic disease. Please help me with its nutritional treatment. And what drugs, food etc hinders in iron absorbtion or causes anemia.

[Gambit62 Administrator]

From a brief review it looks as if the type of anaemia you are looking at isn't associated with a B12 deficiency so not sure anyone here will be able to help.

The symptoms of pernicious anaemia are caused by a vitamin deficiency - B12 - and include some types of anaemia. Really the name is a bit of a misnomer as anaemia isn't always present - I have problems with B12 but have never had problems with anaemia - or at least not an identifiable anaemia.

I can only give you general advice on iron absorption

You need vitamin C to be able to absorb iron - one reason why green leafy vegetables are a good source of iron - brocolli is particularly good.

I would avoid spinach as it actually contains something that can inhibit the absorption of iron (though it is a really good source of folate - B9 ... but not sure that that is necessarily important to an iron based anaeima)

[Frodo]

I have read that taking iron supplements or eating iron rich foods at the same time as dairy products and/or tea will inhibit absorption.

[Galixie]

I have anemia of chronic disease also. The thing to know about this type of anemia is that iron tablets are *not* recommended as treatment. ACD is not caused by a lack of iron in the blood and, in that way, is not like iron deficiency. What's really going on has to do with how the body transports, stores, and uses iron. This appears to be the same article I read on this subject awhile back (I can't find my original link): medscape.com/viewarticle/52...

In sort, the best treatment for ACD is iron infusions (along with treating whatever underlying cause is causing the ACD) because the problem is that there is not enough iron binding capacity to move the iron from the stores to where it can be used to make red blood cells. Ingesting more iron through tablets won't make a difference because it will come up against the lack of iron binding capacity and still not be used for red blood cell production. Unfortunately, most doctors seem very reluctant to treat ACD.

[ZABohra in reply to Galixie]

Well you might be right, but I often feel tired like when climb stair or lift some weight. I am a liver cirrhosis patient. I know the disease alone is responsible for these symptoms but brittle nails and dissiness is also caused by iron deficiency and my blood test also indicated that.

[Galixie in reply to ZABohra]

You asked about anemia of chronic disease which is a different form of anemia than iron deficiency anemia. In iron deficiency anemia, you would have low serum iron and low ferritin. In anemia of chronic disease you would have low serum iron but normal or high levels of ferritin. As I said, the real problem in ACD is a transport issue. Treatment for ACD should be iron infusion (IV iron) because that method gets around the transport problem. Iron injections can also work, but you'd want to be sure the person doing them is familiar with the z-track injection method or you could end up with a permanent dot on the skin where the injection was done. I've had an iron injection but I've never had an iron infusion. If I had my choice I think I'd rather try the infusion because the injection left a lump under the skin that lasted for weeks. What has your doctor said about treating your iron deficiency?