Good morning everyone, Dr. Stillman here. And today I wanted to talk about iron deficiency anemia and vitamin A deficiency. So a lot of people who come to see me have anemia or history of anemia. They also have many, you know, comorbid, or accompanying conditions that are related to anemia. And that they all often manifests are associated with nutritional deficiencies, which is one of the most important things I do in my practice is helping people identify what they’re actually deficient in, or what nutrients are imbalanced. Right, because it’s not just about having enough of things, it’s about having them in balance. Vitamin A, and iron are two of the most important nutrients that I assess for, because deficiency or excess of either of these keeps company with some of the most significant pathologies that I see. And in this case, I wanted to talk about how iron and vitamin they work together. In this example, we’re going to use today as one of the pivotal papers that I’m starting to post. And that’s what today’s post is going to be about, see the highlights on my Instagram, Facebook cetera channel. And the key finding in this study, it’s really a review of clinical trials is that simultaneous use of iron and vitamin A supplements seem to be more effective to prevent iron deficiency anemia than the use of these micronutrients alone. What I find interesting about this is that this paper, as many academic publications are is focused on only, you know, two nutrients vitamin D and iron. They don’t talk at all in this paper, about copper, zinc, molybdenum, manganese, B, six foot eight, b, 12, vitamin D, magnesium, many other minerals and essential elements that are necessary for homeostasis, and even for red blood cell production. Specifically, I find it interesting that in their conclusion, they say considering the multiple micronutrient deficiencies often coexist and several micronutrients play an important role in the etiology of nutritional anemia. We also suggest further investigations to assess the effect of combined micronutrient regimens on anemia control, which is just a fancy way of saying, we really ought to study this in a way where we’re actually analyzing all of these relevant nutritional markers. And looking at someone’s anemia. When I talk to people, and when I counsel people, I’m interested very much in what they’re eating, and how much of what they’re eating, because I often find low vitamin D levels and people who are not eating any vitamin D rich foods. And usually they’re not eating any vitamin D rich foods, because they’ve been told that they’re allergic to them, or they’ve been told that they’re not healthy. And in some cases, they’re just not absorbing it, we need to figure out what’s going on in their GI tract in order to get those levels normal. What I want people to understand specifically about vitamin A, and iron is that without vitamin A iron cannot traffic through the cell properly, and it gets stuck in the cell and you can actually end up with iron overload syndromes. And these iron overload, consequences really boil down to excessive oxidative stress, that oxidative stress sets you up for premature disease. The full blown iron toxicity, phenotype or clinical entity is called hemochromatosis, and it results from a genetic defect. Now, an actual actually a high proportion of particularly the white Northern European population of the United States is positive for at least one copy of this gene. And I often screen people for it, because particularly if they’re coming in with a lot of premature disease, I wonder Do they have iron overload just from having one gene copy? And are they for example, not getting enough vitamin A, or at some point in their life? Did they not get enough vitamin A? And is that why the iron is creating excessive oxidative stress because it’s built up in the cells because you don’t have the nutrients to handle it. I actually see this all the time. I actually recommend phlebotomy more than probably any other clinician that I know because I’ve seen how much relief it can give people who have got too much total body iron. And the literature on this is actually very clear, even though it’s not in the it’s not most clinicians are not aware of this literature. And it’s very, it’s actually astonishing to find out just how toxic iron can be. And people can read this paper and they can look into Jim Moon’s book, iron the most toxic element. They want to learn more about that. As always, thanks everyone for watching. Don’t forget to subscribe to my email newsletter. It’s coming out for January on Thursday night. And if you’re ready to work with me to achieve optimal health and well being apply via my website Stillman md.com. Take care everyone