Anemia increases potential of negative outcomes

Dr. John Briggs

Anemia increases potential of negative outcomes

4 mins
November 10, 2020

About this time every year, Julie and I go to Colorado for an amazing educational seminar called Back to School for Doctors. Due to the COVID issues this year, the hotel could not accommodate the 600+ doctors who go for this educational smorgasbord.

Because of the urgency of the information this year, Mark Anderson did a weekend webinar which I will try to condense here for the sake of keeping us all well.

One area touched on is that of anemia. This is a condition often overlooked as patients age. When there’s a drop in hemoglobin, we see inability to transport oxygen properly through the body. With this we can see ringing of the ears, loss of hearing, and dementia.

Infection Risk

To make things worse, during infections, the ability to fight disease is impaired, and in the case of respiratory diseases, this is where the really sick are often put on ventilators. This can’t increase oxygen in the blood since the containers called hemoglobin are too few. Pumping more air into the lungs can’t increase blood oxygen.

Unfortunately, it’s common to see as people age, the ability to chew being adversely affected, causing poor digestion and absorption. Often times patients are use acid blockers, which reduces the ability to absorb iron and protein.

Anemia affects 33% of the world’s population, and about half the cases are due to iron deficiency. We need to consider iron deficiency anemia in several pathological disorders, notably chronic kidney disease, chronic heart failure, cancer, and inflammatory bowel disease. Overall, deficiency in iron is common, but rarely identified in so many diseases.

When a patient is widowed, making the effort to resource good meals and the ease of just filling the stomach with poor food choices is common. I’ve seen firsthand the patient that decides it’s just easier to eat frozen entries instead of taking the effort to prepare healthy meals.

Atrial Fibrilation

When we see anemia, we also see atrial fibrillation. Instead of addressing the deficiencies, the medical model is to give drugs to prevent clot formation. I’ve seen atrial fibrillation in the office on the heart sound recorder, had the patient consume the appropriate nutrients and within a few minutes, the fibrillation is gone.

Since those with cardiovascular disease are more at risk during viral outbreaks, it’s wise to address these areas. Often times anemia goes undiscovered until a blood test is done. That is why I like to run complete blood profiles on my patients. Let’s identify the problem and fix it instead of medicating the symptom.

In the Journal of Clinical Medicine, they had an article on the prevalence and predictive value of anemia and dysregulated iron homeostasis in patients with COVID-19 infection. What they came up with is: Within the retrospective analysis of 259 hospitalized patients with COVID-19, Anemia was associated with a significantly higher in-hospital mortality. Functional Iron Deficiency was present in 80.0% of patients upon admission, linked to more advanced inflammation and associated with significantly longer hospital stay. Notably, a ferritin/transferrin ratio > 10 predicted a five-fold higher risk of ICU admission and an eight-fold higher risk of the need for mechanical ventilation.

Anemia and alterations of iron homeostasis are highly prevalent in hospitalized COVID-19 patients. Iron metabolism biomarkers and hemoglobin can contribute to risk stratification of patients, as initial anemia is associated with increased mortality, whereas alterations of iron homeostasis with a higher ferritin/transferrin ratio reflect more advanced inflammation and predicts subsequent insufficient pulmonary oxygenation with the need for ICU admission and mechanical ventilation.


The results of the study indicate that anemia, and specifically Anemia of Inflammation, is prevalent in patients with severe COVID-19 disease and is associated with an unfavorable outcome. A higher ferritin/transferrin ratio reflects more advanced inflammation and predicts subsequent insufficient pulmonary oxygenation with the need for ICU admission and mechanical ventilation.

Now, this is from a medical peer review article and reflects the need to focus on improving the health of patients before any kind of immune challenges. This is where naturopathic medicine shines as we look to keeping you healthy so you can avoid the serious outcome of diseases. 

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Dr Briggs is a 1980 graduate of the National College of Naturopathic Medicine and has been practicing naturopathic medicine in the northwest corner of Oregon since his graduation. His practice involves diagnostic and therapeutic modalities which have stood the test of time and the challenges of diverse disease. We believe that each person exists dynamically as a spirit being, possessing a soul made up of their mind, will, and emotions, living in a body which requires specific care and nutrition. To address only the physical needs is to ignore the real person, and frequently, the real issues. We strive to address all your issues (spiritual, mental, emotional, and physical) with compassion and wisdom.

This article was orginally reported by
Dr. John Briggs

Dr. John Briggs is a Doctor of Naturopathic Medicine.