1. Anemia Presentation and Nutraceutical Wellness Dr Bill Deagle MD Updated Feb 15 th 2006

2. Groups of Anemia:  Microcytic or Small Cell Type  Macrocytic or Large Cell Type  Dependant of type of deficiencies  Chronic disease related  Maldigestion related  Chronic or acute bleeding related  Defiencies in diet over long time

3. Pre-Disposing Factors:  Poor digestion with lower hydrochloric acid, or hypochlorhydria  Diet deficient in organic plant or animal based iron,copper, and folic acid from plants as well as vitamin B12  Internal bleeding – typically from menses in women and in both sexes from stomach to large or small colon  Chronic disease which prevents conversion from iron stores to bone marrow RBC red blood cell production from Fe2+ to Fe3+ conversion

4. Subjective Signs and Symptoms of Anemia:  Fatigue and shortness of breath on exertion, particularly at higher altitude  Bluish ‘whites’ of the eyes in iron deficiency anemia  Cold hands and feet in iron deficiency  Ridges horizontally across nails in iron deficiency anemia  Leg cramps at night in iron deficiency anemia

5. Signs and Symptoms of Anemia:  Tingling and numbness or paresthesia in extremities – hands and feet in B-1, B6, B12 and folic acid anemias including genetic thallasemias of Mediteranean or African orgins  Pica or desire to eat dirt or other non-food, e.g. ice cube pica in iron deficiency anemia  Depression and negative outlook on life due to lack of brain oxygen and fuel burning of glucose in brain and central nervous system, combined with brain cell effects of similar deficiencies e.g. B12 and folate contribution to predementias or dementia.

6. Diagnose and Support of Anemia:  Peripheral blood smear analysis under microscope by Pathologist  CBC/Differential – Complete Blood Count and Differential breakdown of cell types and population parameters of sizes and hemoglobin concentration with Hematocrit or amount of RBC, red cells in blood plasma

7. Diagnose of Anemia:  RBC, Red Blood Cell B12 and Folate analysis  Stool Occult blood analysis for microscopic chronic blood loss  Reticulocyte count to see is the bone marrow is making new red cells, to replace those lost every 180 days  Bone Marrow biopsy by Hematologist is other causes have not found cause and infiltration with fibrous tissue or cancer cells are suspected as cause of anemia

8. Nutrients in Anemia:  Organic iron – Ferritin or Fe3+  Iron carrier molecules in Colostrum – Lactoferrin  B12 in organic transcobalamin form  Folic acid  Copper for aid in conversion of Fe2+ to Fe3+  Protein amino acids to aid in heme production

9. Hemglobin Heme Support:  Chlorella helps heme synthesis as plant phosynthesis chlorophyll only has Magnesium as central ion and not Iron  Digestive support to allow anabolic state or building up total body proteins, in chronic disease and illness often catabolic states are present, or destruction of body proteins.

10. Anemia Nutraceutical Physiological Support: Use Search on www.NutriMedical.comwww.NutriMedical.com  Ferritin Fe 3+– Ecological Formulas or Ferrotate chelated iron or Ferrochel Iron Bis-Glycinate Iron Chelate  Methylcobalamin and Adenosylcobalamin B12 – Best Absorption  Folic acid and 5 Methyl Folate jumps over converting enzyme pathways with deficiency of enzyme converstion in 25% of world population.