Nutrition Hotline
By Reed Mangels, PhD, RD
Could I Really Be Anemic?
QUESTION: I recently volunteered to give blood, but they turned me down because they said I was anemic — "a few points below" what they considered to be acceptable to give blood. I've been a vegan for over 15 years and I eat lots of beans and legumes, take vitamin B12 supplements, and haven't needed to see a doctor in 15 years. I've been a bit tired lately and have dark circles under my eyes, but I've attributed that to a new, stressful job. I'm 38 and still menstruating, and my flow is regular. I'm a bit overweight (5' 8" and 165 pounds). I've heard that there's more than one way to determine whether someone is anemic. Do I need to see a naturopath or DO? Should I be concerned?
Via e-mail
ANSWER: You'll need to be evaluated on an individual basis so that your health care provider can obtain more information about your eating habits, any medications you may be taking, your health history, and so forth. You'll probably need to have the blood test repeated, too.
Generally, the hemoglobin and hematocrit levels that are determined by the "pin prick" blood test at the donation site are a quick and inexpensive way to weed out donors that may have low blood iron stores. However, the test is not as accurate as if the blood had been drawn with a needle. A more accurate assessment of your iron status would also include some additional blood parameters, including a serum ferritin level, which measures your body's iron stores.
While vegetarians are not more prone to iron deficiency anemia than nonvegetarians, I suggest that you check with your health care provider to clear this issue up (I recommend seeing an MD, DO, or a nurse practitioner). If you are found to be anemic, you may require further tests to determine the cause of your anemia. If your body's iron stores are low, then he or she may suggest that you take an iron supplement. Also, eating plenty of vitamin C-rich fruits and vegetables with meals will boost your absorption of the iron that is present in the meals.
How Much Caffeine Is in Chocolate?
QUESTION: I am cutting all caffeine out of my diet. I am having a hard time with chocolate, though. Recently, a friend told me that cocoa contains no caffeine. Is this true? It would be a godsend!
MH, Wisconsin
ANSWER: Cocoa and hot chocolate contain very little caffeine as compared to other caffeinated beverages. An 8-ounce cup of coffee, for instance, contains approximately 137 milligrams of caffeine, and 8 ounces of tea contains about 47 milligrams of caffeine. An 8-ounce cola contains about 28 milligrams of caffeine.
In contrast, 1 tablespoon of cocoa contains only 5 milligrams of caffeine, and 3 tablespoons of a typical hot cocoa mix provides only 3 milligrams of caffeine. People vary in their sensitivity to caffeine. If you want to be sure to avoid all caffeine, you'll need to avoid cocoa and hot chocolate. Considering how little caffeine they contain, however, you may very well find that this small amount is of little consequence.
