What is Anaemia and how do Vegans avoid it?

There are a few nutrients and deficiencies that seem to cause vegans more concern than others. I covered one biggie, B12, last week, and today I want to write about Anaemia. This describes the state of low haemoglobin levels in the blood. But what is haemaglobin? Haemaglobin, shortened to Hb, is a protein found in red blood cells which carries oxygen around the body. It’s a pretty important little protein, as oxygen is needed by all of our cells in order to function.

The ranges for ‘normal’ Hb vary between males and females, but anaemia is a Hb of less than 12g/dl in women who aren’t pregnant (<11g/dl if pregnant), and less than 13g/dl in men. There are lots of causes of anaemia, but I’ll cover the dietary ones here, as that’s what us vegans are most concerned about, right?

As I mentioned earlier, and hopefully you read it, I covered B12 deficiency in my last blog. Just to briefly recap, this results in an anaemia which your doctor identifies because your red blood cells are bigger than they should be (macrocytosis, for those who may have heard the term). The other dietary cause of anaemia is a low iron level. There are other medical conditions which can reduce your iron level, then resulting in anaemia, but for the sake of simplicity, and keeping it relevant to you, vegan reader, we’ll assume that when I’m writing about iron deficiency, it’s because of low dietary intake. Iron deficiency causes small red blood cells (microcytosis), and a person can have low iron levels without being anaemic, but in all likelihood, if this iron is not replaced, they would become anaemic.

The recommended daily intake of iron is 14.8mg for women aged less than 50, and 8.7mg for women over 50 and men. Younger women will be having regular periods, and therefore losing blood and iron every month. Iron is found in many foods, and most people would think of meat and liver as iron-rich foods, but there are plenty of sources where vegans can get their iron. For example, 100g of lentils contains 3.5mg of iron, which is actually more than 100g of beef. Other good sources of iron include:

  • Beans including soya
  • Dark green vegetables, including spinach and kale, as well as peas
  • Dried fruits, including raisins and apricots
  • Nuts
  • Tinned fruits, including blackcurrants, raspberries and cherries
  • Cereals and cereal products, including pasta and bread

If you are not getting enough iron in your diet, you may be at risk of becoming anaemic. Symptoms of this would include:

  • Tiredness
  • Shortness of breath, particularly on exerting yourself
  • Chest pain when exerting yourself (with severe anaemia)
  • Headaches
  • Sore tongue or painful cracking at the corners of the mouth
  • Spoon shaped nails, or brittle nails with lines running down the length
  • Hair thinning

If you experience any of these symptoms, then see your GP, who will be able to arrange blood tests including a full blood count and iron levels. If you are indeed anaemic, you may need to take a prescribed iron replacement, as it will have a higher iron content than anything you would buy over the counter.

When I wrote about B12 deficiency, I insisted that a supplement was necessary for all vegans. However, iron is a different matter because as you have read, there are plenty of good sources of iron from plant derived foods. But if you are worried about your intake, there are multivitamins which contain iron – for example, a well known health food shop does a vegan multivitamin which contains 100% of your RDA of iron. But, as most of the iron rich plant-based foods contain many other nutrients (and they are super tasty), it is very easy to get what you need by just munching on good food.

Thanks for reading,

The Vegan Doctor

7 thoughts on “What is Anaemia and how do Vegans avoid it?”

  1. Greetings! I am making the transition from vegetarian to vegan and I find your articles very informative -I just found out about your blog via The Guardian newspaper- this one in particular is very useful for me as I have suffered from anaemia in the past and I now adore cooking dishes with spinach & lentils. Just a few “tweaks” on a diet can make all the difference.
    Yurena from Tenerife – Canary Islands


  2. The best plant-based source of iron is sarsaparilla which can be taken as a tea or in a tincture. I’m not an advocate of pharmaceuticals and I try to identify needed dietary changes and also herbal intervention. This herb has alleviated my husbands anaemia and certainly boosted my energy level. It works!


  3. Is it possible to overdo supplements? I take both B12 and Iron supplements and try to have a diet that it diverse and inclusive of iron rich vegan foods. Would taking over the RRD harm me in any way?


  4. I am very pleased to find your website, my healthcare professional shared it with me. A recent blood test has shown I’m just under the minimum for iron (it will hopefully explain a range of symptoms such as fatigue, more hair falling out than usual, hard to focus). I’ve been prescribed Ferrous Fumarate 210mg and thought I’d check the ingredients before taking it home. It contains gelatin. I have seen that there is an argument that sublingual iron ie mouth spray (also vegan) might be more easily absorbed but the strongest I’ve seen is 10 mg having 4 sprays a day. I understand that the tablets have more iron because there is a lot you don’t absorb.
    I just wondered if you have a view on a vegan friendly prescribed high dose tablet and/or the spray? I appreciate if you cannot say. Many thanks 🙂


    1. Hi Alison, thanks for your comment. Unfortunately I haven’t yet come across a prescription-dose iron that is vegan. As you’ve noticed, the iron that you can buy is a much lower dose and may not be adequate. As medications are exempt from veganism, it may be worth topping up with a short course of prescribed iron and then keeping on top of your levels with a spray or other vegan iron supplement


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