Decreased dietary intake of protein may lead to mild to moderate anemia. This type of anemia is seen in vegans, vegetarians, elderly, endurance athletes, anorexia nervosa, and people with diminished intake of protein for any cause.
Protein deficiency anemia is also called “hypo proliferative anemia” and may even develop in people with chronic liver disease, chronic kidney disease, and low function thyroid. The mechanism is simple. Inadequate intake of protein slows down the body metabolism (basal metabolic activity). Decreased metabolic activity reduces oxygen demand and consumption by the kidneys, which are responsible for producing erythropoietin (EPO) hormone. It is a hormone that is released by the kidneys and stimulates the production of the red blood cells. The release of EPO is very sensitive to oxygen demand and basal metabolic rate.
Decreased metabolic activity resulted from protein deficiency impairs the release of EPO, which causes inadequate production of the red blood cells followed by developing anemia. Deficiencies in other nutrients such as iron, folic acid, and vitamin B12 may complicate the anemia. Therefore, if your anemia cannot be corrected by supplemental iron, folic acid, and vitamin B12, you know now what the cause might be!
Abazar Habibinia, MD, DFN
CEO of the Canadian Academy of Sports Nutrition