{"id":870,"date":"2013-04-30T14:00:14","date_gmt":"2013-04-30T18:00:14","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=870"},"modified":"2019-12-26T12:43:39","modified_gmt":"2019-12-26T17:43:39","slug":"severe-iron-deficiency-anemia-in-pregnancy-2","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/severe-iron-deficiency-anemia-in-pregnancy-2\/","title":{"rendered":"Anemia, Severe Iron Deficiency In Pregnancy\u00a0"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/anemia-pregnancy.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft  wp-image-7074\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/anemia-pregnancy-300x254.jpg\" alt=\"anemia-pregnancy\" width=\"270\" height=\"229\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/anemia-pregnancy-300x254.jpg 300w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/anemia-pregnancy.jpg 450w\" sizes=\"auto, (max-width: 270px) 100vw, 270px\" \/><\/a>What Is Severe Iron Deficiency Anemia In Pregnancy?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">S<\/span>evere iron deficiency anemia in pregnancy is characterized by abnormal formation of small, pale red blood cells that impair the ability of the fetus to obtain adequate oxygen for proper growth and development and imperil its life and cause the mother extreme fatigue with increased risk of infection.<\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: Why does this anemia imperil the fetus and cause the mother\u00a0extreme fatigue with increased risk of infection?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: Severe iron deficiency anemia significantly impedes the ability of the mother&#8217;s blood to carry sufficient oxygen for both her needs and the unborn baby&#8217;s needs. In this anemia the blood cells do not have adequate hemoglobin which functions to carry oxygen from the mother&#8217;s lungs to her body. Of course, the fetus gets its oxygen only from the mother&#8217;s blood.<\/p>\n<p style=\"text-align: justify\">Red blood cell production and function are dependent on a sufficient level of iron in the body and also the ability to use iron to make hemoglobin in red blood cells.<\/p>\n<p style=\"text-align: justify\">Hemoglobin is a protein that binds oxygen in red blood cells to be carried by the bloodstream to cells throughout the body. In iron deficiency anemia, \u00a0hemoglobin in females is below 12.5g\/dl (normal range is 12.5g\/dl\u00a0 to 16g\/dl\u00a0).<\/p>\n<h2>What Is Severe Iron Deficiency Anemia In Pregnancy In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">In celiac disease, severe iron deficiency anemia and iron depletion in pregnancy are characterized by failure of the expected response to oral iron supplementation.<a href=\"#footnote_1_870\" id=\"identifier_1_870\" class=\"footnote-link footnote-identifier-link\" title=\"Mitchell RMS, Robinson TJ. Celiac disease in pregnancy &ndash; not always a relapse. Acta Obstetricia Et Gynecologica Scandanavica. Aug 2003;82(8):777, 1p.\">1<\/a><\/li>\n<li style=\"text-align: justify\">Screening for celiac disease is recommended in patients with unexplained iron deficiency anemia,<a href=\"#footnote_2_870\" id=\"identifier_2_870\" class=\"footnote-link footnote-identifier-link\" title=\"Karnum US, Felder LR, Raskin JB. Prevalence of occult celiac disease in patients with iron deficiency anemia: a prospective study.&nbsp;Southern Medical Journal. Jan 2004; 97(1):30-4.\">2<\/a>particularly because the presence of anemia in patients with celiac disease suggests more severe disease.<\/li>\n<li style=\"text-align: justify\">Adequate vitamin C as well as intestinal acidity in the beginning region of the duodenum is needed for absorption. Other nutritional deficiencies that promote iron deficiency anemia are copper and riboflavin (vitamin B2), and these are commonly found in untreated celiac disease.<a href=\"#footnote_3_870\" id=\"identifier_3_870\" class=\"footnote-link footnote-identifier-link\" title=\"Kathleen Mahan and Sylvia Escott-Stump, ed. Krause&rsquo;s Food, Nutrition &amp; Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000.\">3<\/a><\/li>\n<li style=\"text-align: justify\">A study by Singh et al. found celiac patients\u00a0with\u00a0anemia\u00a0had significantly longer duration of symptoms, lower albumin levels, and higher anti-tissue transglutaminase fold rise, and a higher proportion had abnormal d-xylose tests and severe villous abnormalities than celiac patients without anemia.\u00a0Thus, celiac patients with\u00a0anemia\u00a0had more severe\u00a0disease\u00a0than those without\u00a0anemia. It is therefore important to diagnose these patients at an earlier stage of the\u00a0disease\u00a0even when the classical feature such as\u00a0anemia\u00a0is not clinically evident.<a href=\"#footnote_4_870\" id=\"identifier_4_870\" class=\"footnote-link footnote-identifier-link\" title=\"Singh P, Arora S, Makharia GK. Presence of anemia in patients with celiac disease suggests more severe disease.&nbsp;Indian J Gastroenterol. 2013 Nov 19.\">4<\/a><\/li>\n<li style=\"text-align: justify\">A national study investigating screening practices for celiac disease in patients with iron-deficiency anemia (IDA) because no screening guidelines exist in the literature found that practicing hematologists infrequently screen for celiac disease in IDA. Only 8.6% believed all patients with IDA should be screened for celiac disease. Physicians who have recently finished their fellowship and those who see a high volume of patients with IDA are more likely to screen for celiac disease.<a href=\"#footnote_5_870\" id=\"identifier_5_870\" class=\"footnote-link footnote-identifier-link\" title=\"Smukalla S, Lebwohl B, Mears JG, Leslie LA, Green PH. How often do hematologists consider celiac disease in iron-deficiency anemia? Results of a national survey. Clin Adv Hematol Oncol. 2014 Feb;12(2):100-5.\">5<\/a><\/li>\n<\/ul>\n<h2>How Prevalent Is Severe Iron Deficiency Anemia In Pregnancy In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p>Severe iron deficiency anemia in pregnancy has increased frequency in patients with celiac disease and may be the only sign of celiac disease.<a href=\"#footnote_6_870\" id=\"identifier_6_870\" class=\"footnote-link footnote-identifier-link\" title=\"Mitchell RMS, Robinson TJ. Celiac disease in pregnancy &ndash; not always a relapse. Acta Obstetricia Et Gynecologica Scandanavica. Aug 2003;82(8):777, 1p.\">6<\/a><\/p>\n<h2>What Are The Symptoms Of Severe Iron Deficiency Anemia In Pregnancy?<\/h2>\n<p>Severe iron deficiency anemia in pregnancy is marked by these symptoms:<\/p>\n<p><strong>In the mother:<\/strong><\/p>\n<ul class=\"cp_bullet red\">\n<li>Pallor or paleness of skin and mucous membranes..<\/li>\n<li>Fatigue.<\/li>\n<li>Faintness or lightheadedness.<\/li>\n<li>Dyspnea (shortness of breath) on exertion.<\/li>\n<li>Weakness.<\/li>\n<li>Headache.<\/li>\n<li>Susceptibility to infection.<\/li>\n<li>Irritability.<\/li>\n<li>Anorexia (loss of appetite).<\/li>\n<li>Headache.<\/li>\n<li>Angina.<\/li>\n<li>Dyspnea (shortness of breath).<\/li>\n<li>Tachycardia (rapid heartbeat).<\/li>\n<li>Visual impairment (blurry).<\/li>\n<li>Inability to pay attention.<\/li>\n<li>Reduced memory\/learning.<\/li>\n<li>Sensory motor incompetence.<\/li>\n<li>Alopecia (loss of hair).<\/li>\n<li>Dry and dull hair.<\/li>\n<li>Systolic heart murmur may develop.<\/li>\n<\/ul>\n<p><strong>In the developing fetus:<\/strong><\/p>\n<ul class=\"cp_bullet red\">\n<li>Intraterine growth retardation.<\/li>\n<li><span style=\"line-height: 1.5em\">Increased risk of fetal malformations.<\/span><\/li>\n<li><span style=\"line-height: 1.5em\"> Increased risk of spontaneous abortion.<\/span><\/li>\n<\/ul>\n<h2>How Does Severe Iron Deficiency Anemia in Pregnancy Develop In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\" style=\"text-align: justify\">\n<li style=\"text-align: justify\">Severe iron deficiency anemia in pregnancy results from iron deficiency due to malabsorption in gluten sensitive enteropathy.<a href=\"#footnote_6_870\" id=\"identifier_7_870\" class=\"footnote-link footnote-identifier-link\" title=\"Mitchell RMS, Robinson TJ. Celiac disease in pregnancy &ndash; not always a relapse. Acta Obstetricia Et Gynecologica Scandanavica. Aug 2003;82(8):777, 1p.\">6<\/a><\/li>\n<li>Iron deficiency results from lack of iron to make hemoglobin due to any of these mechanisms:<\/li>\n<\/ul>\n<ol style=\"text-align: justify\">\n<li>Failure to inonize iron in the stomach and upper duodenum due to low stomach acid so this mineral can be absorbed.<\/li>\n<li>Failure to absorb iron into the bloodstream from the duodenum due to mucosal damage to intestinal absorptive cells from gluten.<\/li>\n<li>Inadequate vitamin C needed for iron absorption.<\/li>\n<li>Interference with the usage of iron in the body for hemoglobin production.<\/li>\n<li>Deficiencies of co-factors need for normal red blood cell health: copper, which is essential for the formation of hemoglobin and red blood cell production and stimulates the absorption of iron through the copper transport protein ceruloplasmin\u00a0and riboflavin (vitamin B2), which maintains the normal lifespan of red blood cells.<\/li>\n<\/ol>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">If present, infection of the stomach with H. Pylori bacteria (an associated disorder of celiac disease) depletes iron in the body for its own metabolism.<\/li>\n<\/ul>\n<h2>Does Severe Iron Deficiency Anemia in Pregnancy Respond To Gluten-Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. Celiac disease-related iron deficiency anemia responds to a nutritious gluten free diet with adequate meat. Supplementation is advised under supervision of the doctor.<\/p>\n<h2 style=\"text-align: justify\">6 Steps To Improve Iron Deficiency Anemia In Celiac Disease and\/or Gluten Sensitivity:<\/h2>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span class=\"dropcap\"><strong>1<\/strong><\/span><strong>Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:<\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both anemia and gut health.<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li style=\"text-align: justify\">A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li style=\"text-align: justify\">Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li style=\"text-align: justify\">Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_7_870\" id=\"identifier_8_870\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">7<\/a><\/li>\n<li style=\"text-align: justify\">The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).<\/p>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Her<\/strong><strong>e Are Major Inflammatory Food Types<\/strong>:<\/p>\n<ul class=\"cp_bullet red\" style=\"text-align: justify\">\n<li><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_8_870\" id=\"identifier_9_870\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_870\" id=\"identifier_10_870\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li><strong>Bad Fats.<\/strong>\u00a0Includes deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_8_870\" id=\"identifier_11_870\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a>.<\/li>\n<li><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_870\" id=\"identifier_12_870\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_870\" id=\"identifier_13_870\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a><\/li>\n<li><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_8_870\" id=\"identifier_14_870\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">8<\/a>\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li><strong>Fruits.\u00a0<\/strong>Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.<\/li>\n<li><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, phytochemicals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources include tuna, salmon, cod, and others. Plant sources include flax, chia seeds, canola oil, and others.<\/li>\n<li><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 for examples such as ginger.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>3<\/strong><\/span>\u00a0<strong>Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Click here.<\/p>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>4<\/strong><\/span><\/span><\/em><em><strong>\u00a0<span style=\"color: #800000\">Manage Your Medications\u00a0<strong>Safely<\/strong>:<\/span>\u00a0<\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p>Certain medications deplete nutrients that promote iron deficiency anemia. \u00a0Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below.\u00a0<strong>Do not stop prescribed medications without supervision.<\/strong><\/p>\n<p>This is not a complete listing.<\/p>\n<p style=\"text-align: justify\"><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Colestid\u00ae and Questran\u00ae\u00a0deplete\u00a0Iron.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTI-INFLAMMATORIES<\/strong>\u00a0 disrupt intestinal permeability.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Aspirin and Salicylates deplete\u00a0Iron.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTACIDS \/ ULCER MEDICATIONS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Pepcid\u00ae, Tagamet\u00ae, Zantac\u00ae deplete\u00a0Iron.<\/li>\n<li>Magnesium and Aluminum Antacid\u00a0preparations (Gaviscon\u00ae, Maalox\u00ae, Mylanta\u00ae) deplete\u00a0Iron.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><b>5<\/b><\/span><\/span><strong><span style=\"color: #800000\">Nutritional Supplements To Help Correct Deficiencies:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<ul class=\"cp_bullet orange\" style=\"text-align: justify\">\n<li>Multivitamin\/mineral as prescribed for pregnancy.<\/li>\n<li>Ferrous fumarate or gluconate as prescribed following blood test for iron status. Do not take with other supplements because of interactions with iron. \u00a0Always check with your doctor when taking supplements to avoid interactions with medications.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Storage Note for Supplements<\/strong>:<em>\u00a0Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet \u00a0&#8211; not in the bathroom or on the kitchen table.\n\t\t\t<\/div><\/div><\/em><\/p>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><b>6<\/b><\/span><\/span><strong><span style=\"color: #800000\">Manage Natural Remedies:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.<\/li>\n<li style=\"text-align: justify\">If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.<\/li>\n<li style=\"text-align: justify\">Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.<\/li>\n<li style=\"text-align: justify\">What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminatives<\/strong>\u00a0are plant sources that tone muscle and improve peristalsis, and thus aid in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort. Puree any foods that cannot be thoroughly chewed. Cook meats well or make them into soups and stews for ease of digestion.<\/p>\n<p style=\"text-align: justify\"><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Raspberry.<\/li>\n<li style=\"text-align: justify\">Carrot is also a cleansing digestive tonic.<\/li>\n<li style=\"text-align: justify\">Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li style=\"text-align: justify\">Redbeets stimulate and improve digestion and are easily digested.<\/li>\n<li style=\"text-align: justify\">Cabbage stimulates and improves digestion and is also a liver decongestant.<\/li>\n<li style=\"text-align: justify\">Lettuce stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li style=\"text-align: justify\">Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Chamomile (as a tea) also promotes healing and help relieve nervous tension. Drink as a tea.<\/li>\n<li style=\"text-align: justify\">Parsley relieves colic, gas and indigestion.<\/li>\n<li style=\"text-align: justify\">Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.<\/li>\n<li style=\"text-align: justify\">Thyme is a soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<\/ul>\n<p><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Cloves are also antispasmodic.<\/li>\n<li>Ginger also supresses inflammation.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p>Exercise improves circulation and rids the body of toxins.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<h2>What Do Medical Research Studies Tell About Severe Iron Deficiency Anemia in Pregnancy In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;How often do hematologists consider celiac disease in iron-deficiency anemia? Results of a national survey.&#8221;<\/strong> This study investigating screening practices for celiac disease in patients with iron-deficiency anemia (IDA), which is a common presentation of celiac disease, because no screening guidelines exist in the literature found that practicing hematologists infrequently screen for celiac disease in IDA. Physicians who have recently finished their fellowship and those who see a high volume of patients with IDA are more likely to screen for celiac disease.<\/p>\n<p style=\"text-align: justify\">A survey was e-mailed to members of the American Society of Hematology to survey hematologists to determine rates of celiac disease screening.<br \/>\nThere were 385 complete responses from 4551 e-mails. Most respondents were practicing clinicians (74%), clinical researchers (10%), or laboratory researchers (6%). Specialists in benign hematology accounted for 45% of respondents, oncologists accounted for 33%, and specialists in malignant hematology accounted for 22%. The most common practice types were university-affiliated hospital (43%), private clinic (29%), community hospital (12%), and Veterans Affairs or military hospital (9%).<\/p>\n<p style=\"text-align: justify\">Only 8.6% believed all patients with IDA should be screened for celiac disease. Respondents who had completed their fellowship within 5 years were more likely than more experienced clinicians to believe that all patients with IDA should receive celiac disease screening. Having a higher volume of IDA patients per month also increased the likelihood of testing. In multivariate analysis, specialists in malignant hematology and oncologists were more likely than specialists in benign hematology to screen all patients for celiac disease, as were those who saw predominately pediatric patients with IDA vs adult patients.<a href=\"#footnote_5_870\" id=\"identifier_15_870\" class=\"footnote-link footnote-identifier-link\" title=\"Smukalla S, Lebwohl B, Mears JG, Leslie LA, Green PH. How often do hematologists consider celiac disease in iron-deficiency anemia? Results of a national survey. Clin Adv Hematol Oncol. 2014 Feb;12(2):100-5.\">5<\/a><\/p>\n<p style=\"text-align: justify\"><strong>&#8220;Presence of anemia in patients with celiac disease suggests more severe disease.&#8221;<\/strong>\u00a0This database study investigating what proportion of celiac disease\u00a0patients had normal hemoglobin levels and if there were any differences in characteristics of those with and without\u00a0anemia found that\u00a0celiac disease\u00a0patients with\u00a0anemia\u00a0had more severe\u00a0disease\u00a0than those without\u00a0anemia.<\/p>\n<p style=\"text-align: justify\">Of 338 celiac disease\u00a0patients, 14.8\u00a0% had normal hemoglobin levels at diagnosis. When compared with celiac disease\u00a0patients without\u00a0anemia, those with\u00a0anemia\u00a0had significantly longer duration of symptoms, lower albumin levels, and higher anti-tissue transglutaminase fold rise, and a higher proportion had abnormal d-xylose tests and severe villous abnormalities. Thus, celiac disease\u00a0patients with\u00a0anemia\u00a0had more severe\u00a0disease\u00a0than those without\u00a0anemia. &#8220;It is therefore important to diagnose these patients at an earlier stage of the\u00a0disease\u00a0even when the classical feature such as\u00a0anemia\u00a0is not clinically evident.&#8221;<a href=\"#footnote_9_870\" id=\"identifier_16_870\" class=\"footnote-link footnote-identifier-link\" title=\"Singh P, Arora S, Makharia GK. Presence of anemia in patients with celiac disease suggests more severe disease. Indian J Gastroenterol. 2013 Nov 19.\">9<\/a><\/p>\n<h4 style=\"text-align: justify\"><strong>CASE REPORT SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;Celiac disease in pregnancy \u2013 not always a relapse.&#8221;<\/strong>\u00a0In this case series, all of the patients in this series had typical gastrointestinal (GI) manifestations of celiac disease in infancy that had resolved despite a normal diet, but subsequently relapsed in pregnancy or the puerperium. In most patients, a previous history of GI disease or anemia cannot be elucidated, and refractory sideropenic anemia during pregnancy may be the only sign of celiac disease. Although the acute presentation of celiac disease in pregnancy or the puerperium is concerning, potentially of more concern is the risk of spontaneous abortion and intrauterine growth retardation of undiagnosed celiac disease.<a href=\"#footnote_6_870\" id=\"identifier_17_870\" class=\"footnote-link footnote-identifier-link\" title=\"Mitchell RMS, Robinson TJ. Celiac disease in pregnancy &ndash; not always a relapse. Acta Obstetricia Et Gynecologica Scandanavica. Aug 2003;82(8):777, 1p.\">6<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_870\" class=\"footnote\">Mitchell RMS, Robinson TJ. Celiac disease in pregnancy \u2013 not always a relapse. <em>Acta Obstetricia Et Gynecologica Scandanavica. <\/em>Aug 2003;82(8):777, 1p.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_870\" class=\"footnote\">Karnum US, Felder LR, Raskin JB. Prevalence of occult celiac disease in patients with iron deficiency anemia: a prospective study.\u00a0<em>Southern Medical Journal<\/em>. Jan 2004; 97(1):30-4.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_870\" class=\"footnote\">Kathleen Mahan and Sylvia Escott-Stump, ed. Krause\u2019s Food, Nutrition &amp; Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_870\" class=\"footnote\">Singh P, Arora S, Makharia GK. Presence of anemia in patients with celiac disease suggests more severe disease.\u00a0<em>Indian J Gastroenterol<\/em>. 2013 Nov 19.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_870\" class=\"footnote\">Smukalla S, Lebwohl B, Mears JG, Leslie LA, Green PH. How often do hematologists consider celiac disease in iron-deficiency anemia? Results of a national survey. <em>Clin Adv Hematol Oncol<\/em>. 2014 Feb;12(2):100-5.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_870\" class=\"footnote\">Mitchell RMS, Robinson TJ. Celiac disease in pregnancy \u2013 not always a relapse. <em>Acta Obstetricia Et Gynecologica Scandanavica<\/em>. Aug 2003;82(8):777, 1p.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_17_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_870\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_870\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_870\" class=\"footnote\">Singh P, Arora S, Makharia GK. Presence of anemia in patients with celiac disease suggests more severe disease. <em>Indian J Gastroenterol<\/em>. 2013 Nov 19.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_16_870\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Severe Iron Deficiency Anemia In Pregnancy? Severe iron deficiency anemia in pregnancy is characterized by abnormal formation of small, pale red blood cells that impair the ability of the fetus to obtain adequate oxygen for proper growth and development and imperil its life and cause the mother extreme fatigue with increased risk of &#8230;<\/p>\n","protected":false},"author":29,"featured_media":7074,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,120,108,1682,227,974,48],"tags":[300,925,544,327,776,614,1906,277,400,1434,1019,228,1979,918,1349,100,1886],"class_list":["post-870","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-blood-plasma-and-cells","category-iron","category-malabsorption-disorders","category-pregnancy-and-birth","category-symptoms","category-blood","tag-anemia","tag-congenital-anomalies","tag-dyspnea","tag-fatigue","tag-health-conditions","tag-intrauterine-growth-retardation","tag-iron","tag-iron-deficiency","tag-iron-deficiency-anemia","tag-malformation","tag-pallor","tag-plasma-and-cells","tag-pregnancy-and-birth","tag-severe-iron-deficiency-anemia-in-pregnancy","tag-spontaneous-abortion","tag-symptom","tag-blood"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/870","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=870"}],"version-history":[{"count":19,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/870\/revisions"}],"predecessor-version":[{"id":15431,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/870\/revisions\/15431"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/7074"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=870"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=870"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=870"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}