“Slightly” Anemic?
In the Organon of Medicine, Samuel Hahnemann, the founder of homeopathic medicine, discussed “impediments to cure”. Hahnemann’s list of impediments included such things as certain foods and spices; wearing woolen clothes next to the skin; reading in a horizontal position; keeping late hours; mental and physical overexertion, and sedentary lifestyle.
Homeopathy is a vitalistic, not mechanistic form of medicine. Functional medicine, on the other hand, may include vitalistic components but is essentially mechanistic. There are physiological impediments to cure that allow lab diagnosis to aid our work with patients.
When I took Dr. Datis Kharazian’s Functional Blood Chemistry Analysis training a few decades ago, one of the many pearls that stuck with me was the following: Patients won’t get well if they are anemic or their blood sugar is imbalanced. These issues are basic to proper functioning of all human cells, including those of the central nervous system. Even a slightly reduced supply of oxygen or glucose can have major consequences on energy metabolism and overall functioning. Even the slightest levels of anemia may be considered a physiological impediment to cure in functional medicine.
When reviewing complete blood count reports, physicians often see borderline anemia. The red cell count, hematocrit or hemoglobin may be just a fraction of a point below the low end of the normal range.
Consider the following about “slight” anemia - normal red blood cell counts are 4.52-5.90 million cells per cubic millimeter of blood in adult males and 4.10-5.10 cubic millimeters of blood in adult females (Vlajpayee N, 2011). Let’s take the example of a slightly low red blood cell count for a male, such as 4.42 cubic millimeters (4,420,000 red blood cells per cubic millimeter). With the decimal point after the first numeral, it may be forgotten that we are talking about millions here. A male with 4.42 RBCs per cubic millimeter is deficient by 100,000 RBCs in each cubic millimeter of blood. It takes about 50 cubic millimeters to make one drop of blood. Considering that it takes 1 million cubic millimeters to equal one liter and there is an average of 5.5 liters of blood in the body, this patient is actually deficient by 550 billion RBCs!
A very smart doctor, mother and my most recent resident told me how she explains the difference between one million and one billion to her children: 1 million seconds is 11.5 days, but 1 billion seconds is 31.7 years. (Donovan, R. 2019) When you consider a deficiency of 550 billion RBCs there is likely to be a significant negative effect on cellular respiration and energy.
If a patient’s “slight anemia” is low by 0.1 they are deficient by 550 billion red blood cells.
RBCs are unique because they have no nucleus or organelles and therefore no mitochondria. In addition to their basic function of carriage and release of oxygen to tissue, they also release nitric oxide into tissues to regulate local circulation (Jensen FB, 2009). RBCs are involved in regulation of blood pH, and viscosity. Anemia may be associated with an increased risk of venous thrombosis and stroke (Kuhn V, 2017). Red cells are essential for detoxification of free radicals and prevention of lipid peroxidation via erythrocyte superoxide dismutase, glutathione, vitamin A and vitamin C.
The next time you encounter a patient with a touch of anemia, please keep in mind how significant a deficiency of erythrocytes may be as an impediment to cure. The health of every tissue is at stake.
1. Vajpayee N, Graham SS, Bem S. Basic Examination of Blood and Bone Marrow. McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 30
2. Jensen FB, The dual roles of red blood cells in tissue oxygen delivery: oxygen carriers and regulators of local blood flow, J Exper Biol 2009 212: 3387-3393
3. Kuhn V, Red Blood Cell Function and Dysfunction: Redox Regulation, Nitric Oxide Metabolism, Anemia. Antiox Redox Signal 2017 May 1;26(13):718-742.
4. Roz Donovan, ND Conversing with her brilliant offspring, circa 2019.
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