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Nutrition and Anemia

Spring 1999

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

My name is Shelley and I have HIV. I am not a doctor or registered dietitian, I am a full-time student of HIV. I want to share with you what I am learning about anemia.

Anemia is a condition brought on by a decrease of the red blood cells in your body. Among its symptoms are fatigue and loss of appetite.

Studies show anemia can occur in 17% of asymptomatic HIV+ people and upwards of 66%-85% of us with advanced HIV and AIDS.

According to a survey conducted in 1996, physicians rank fatigue the second-most prevalent side-effect of treatment for HIV. Fatigue negatively affects a person's ability to work, and their outlook on life. Half of those with HIV said they never discuss fatigue with their doctors and 73% weren't aware that treatment for it exists.



Open and honest communication between you and your doctors is crucial. I've learned it's better to tell my doctor or P.A. all my complaints, big and small, and to fully describe how I'm feeling and getting along. I ask a lot of questions, too. This has helped me learn so much more about my body and my health. Your doctor should be told of all your symptoms. He or she will take tests to determine the cause. Your doctor will most likely give you a CBC (complete blood count) and check your iron and vitamin levels, including B-12 and folate. Vitamin deficiencies are a common and easily treatable cause of anemia and should not be overlooked. A doctor may prescribe B-12 injections or supplemental folic acid if your labs show deficiencies.

"Studies show anemia can occur in 17% of asymptomatic HIV positive people."

Building a relationship with a registered dietitian (R.D.) will help you understand your personal nutritional needs. Together you can improve your diet, identify possible food deficiencies and tailor your eating habits. This may help you maintain proper vitamin and nutrient levels. An R.D. can help improve your nutritional status and establish guidelines for you to follow. I have sought the wisdom of the registered dietitian at AIDS Project Los Angeles, my personal "food guru," Marcy Fenton, M.S., R.D. She and other R.D.'s are eager to answer questions and share their knowledge. Marcy has also helped me in finding information to write this article.

Eating Right

First, I have learned about some of the foods that contain these vitamins. B-12 (cobalamin) is found in meat, fish, shellfish, poultry and to a lesser degree milk. If you are a vegetarian suffering from anemia you may need to research other food sources of B-12. Folic Acid (folacin) is found in Brewer's Yeast, spinach, asparagus, dark leafy greens, lima beans and even beef liver.

To help coordinate your meds with a healthy diet write out your typical activity schedule, including times you take meds and eat meals. Write out everything you eat in a 24-hr period. This will help you see what you eat and if you are getting enough foods that contain needed vitamins and nutrients. Part of a good diet includes plenty of protein- and nutrient-rich foods.

It's not always easy to eat when suffering fatigue and loss of appetite. Absorption can be compromised when the ability or desire to prepare and eat food is reduced by fatigue, pain or depression. This can then play a negative role in getting the proper balance of needed vitamins.


If you have a poor energy level, some solutions are: eat small frequent meals; keep easy-to-prepare or ready-made foods available; prepare and freeze extra foods when energy levels are higher; keep a chair in the kitchen and sit down while preparing meals; increase activity and exercise when possible. If your appetite is poor: eat nutrient-dense foods and avoid high-fat "nutrient-empty" foods, avoid lying down flat after eating; drink liquids after meals not during.

Many of us know about the B.R.A.T. diet to combat diarrhea; eat soluble fibers like bananas, white rice, apple sauce and toast (B.R.A.T.) and avoid insoluble fibers like corn, nuts, raw fruits and veggies with skins on. Following these tips may help you overcome problems of fatigue that would interfere with your new diet plan.

The bottom-line is that anemia may be caused by numerous factors, most of which are out of our control. Proper nutrition and vitamin supplementation of B-12 and folic acid are within our control. It's nice to have the power to aid our own quest for good health. Talk to your doctors, seek out a registered dietitian familiar with HIV/AIDS and learn all you can on your own. Be your own #1 advocate for good health. You can make a difference. Below are a few sources for more information on Anemia, Fatigue and the role of good Nutrition.

Written Resources

Mary Romeyn, M.D. Nutrition and HIV: A New Model for Treatment. San Francisco: Jossey-Bass Publishers, 1995. (Nutrition and HIV from the perspective of the patient as well as the physician.)

C. Smigelski, Eat Up! Nutrition Advice and Food Ideas for People Living with HIV and AIDS. Cambridge, MA: Charlie Smigelski, 1996. (Booklet -- concise reference guide for eating right.)

Internet Resources

Find A Dietitian: (identifies R.D.'s claiming knowledge of HIV throughout the U.S.).

Nutrition and HIV Program: (fact sheets, nutrition class calenders and more).

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

This article was provided by Women Alive. It is a part of the publication Women Alive Newsletter.
See Also
An Introduction to Dietary Supplements for People Living With HIV/AIDS
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