What It's Like To Have Severe Iron Deficiency Anemia

I’m severely anemic. Hence, I have approximately the same skin tone as the Vampire Lestat. It’s sort of punk rock/goth-y, so it doesn’t bother me. But I also get so tired that I nap almost every afternoon, and that’s decidedly not punk rock. That fatigue is brutal: I’ve cried because I couldn’t walk up a mountain I’d traipsed up before. Those are traditional signs of iron deficiency anemia. Most people know them. But there are plenty of signs you’ve probably never heard of.

You probably know anemia comes in several flavors: sickle-cell anemia, which is inherited and has to do with the shape of the red blood cells, for example. But the Mayo Clinic explains that there are more: Thalassemia, another inherited blood disorder, when your red blood cells don’t make enough hemoglobin; aplastic anemia, when your body simply stops producing new red blood cells; vitamin deficiency anemia, which happens when you don’t get enough Vitamin B-12, Vitamin C, and folate; and iron deficiency anemia, which occurs when you simply don’t ingest enough iron.

I have iron deficiency anemia.

What Causes Iron Deficiency Anemia

According to Hematology.org, anemia is the most common blood disorder. One study by the National Health and Nutrition Examination Survey found that 11%, or 3.3 million American women, have iron deficiency anemia. It happens, simply, when your body doesn’t have enough red blood cells. Biology 101 flashback: red blood cells, the Mayo Clinic explains, contain hemoglobin. That’s the stuff that makes blood red. Hemoglobin lets blood cells carry oxygen from the lungs to the body, and carbon dioxide from the body back to the lungs.

Your body needs iron to make red blood cells.

Iron deficiency anemia means, simply, that your body doesn’t have enough iron to make an adequate number of blood cells. It happens in a lot of pregnant people, and it can also happen from heavy periods.

But iron deficiency anemia often causes heavy periods, too, as Jacques Moritz, MD, director of gynecology at Mount Sinai St. Luke’s Roosevelt in New York City told Health.com, “They lose too much blood, replace about half of it, and then lose too much again the following month. It’s like filling up a car with a small hold in the tank.”

It can also happen simply because you don’t ingest enough iron.

I’ve always gotten heavy periods. And I really, really suck at ingesting iron.

I hate meat. I came into this world hating meat, and I’ll eat some of it (bacon, occasionally chicken, steak or pulled pork BBQ), but generally, I’m a vegetarian. And I don’t eat seafood either (other than oysters). Last week, I ate meat once: I scavenged my kids’ chicken tenders.

Then I bled half of my iron out again. My periods are bad enough that if I was immediately postpartum, I’d send ER docs running, not walking. Think the worst period you’ve ever had. Multiply it. Think multiple layers of period protection. Think days when I can’t leave the house.

Discovering My Anemia

Three months ago, because of my Lestat-like complexion and severe fatigue, coupled with dark lines at the tops of my fingernails and cracks at the corners of my mouth (both signs of a vitamin deficiency, usually iron), my primary care doc drew my blood and eyeballed my hemoglobin values. Normal levels for a woman are 12 grams per deciliter, according to Hematology.org. My hemoglobin value was an eight. I was missing a third of my red blood cells.

My doctor looked at me and said, Look. I can refer you to a hematologist now. They’ll give you iron infusions. I had severe iron deficiency anemia during my last pregnancy and received iron infusions: twice a week I drove to a clinic where they stuck a needle in my arm and dripped iron into me for three hours while I played on my phone. It didn’t bother me much — until the next day, when my entire skeleton hurt. Every. Single. Bone. Ached. For like, two days. Then I had a good day. Then I had another freaking infusion.

I did not want infusions.

So I begged for three months. Look, if we can’t get them up, I’ll take the referral then. Please, please, please. He agreed to give me three months and sent me home with some medical-grade iron pills.

Real talk: I could not have averted this with over-the-counter iron pills. I can’t take them. They do … things … to my digestive system. The kind of things that necessitate lots of prunes and Miralax and Metamucil, and all that still doesn’t work.

How We’re Treating My Anemia

Some of my problems with iron probably stem from disordered eating left over from anorexia: I generally eat one full meal a day. I don’t freak about the calories in it, but I hardly snack; I never liked breakfast; and I don’t get hungry for lunch.

My husband knew two more meals a day was probably a losing battle, because I wasn’t going to eat a substantial breakfast, and I legitimately forget about lunch (that happens when you don’t get hungry). So he concocted a chili recipe involving pureed iron-rich greens, a ton of legumes, and lots of veggies. Basically, it’s a superfood. And as long as I like something, I’ll eat it every goddamn day, because I don’t have to think about it (my ADHD gives me choice paralysis: I can’t make a simple decision and freak out. This usually happens at dinnertime). And no, you can’t taste the spinach.

So I eat chili. I eat a lot of chili. I also eat a lot of chickpea pasta, which contains about half of your daily iron needs.

But clearly this isn’t enough to defeat iron-deficiency anemia, so I have to take pills and drink a vitamin supplement called Floradix. It doesn’t taste great, and I throw it down like a frat boy.

But when I went in three months later, despite three hellish periods, my iron levels had gone up to a 9.5. So I’m only missing a little less than a quarter of my blood cells now. Moral: never underestimate the power of chili.

I’ll have to keep this up. If I don’t, my levels will drop again. So hello, life of supplements and chili. You’ll be with me forever. But at least I won’t sleep for four hours every day, and I look a little less vampire and a little more standard goth.

And at least I really, really like that chili.