Question

Anemia Case Study

Mrs. M is a 68-year-old African-American female who came to the clinic due to progressive lethargy, dizziness and fatigue that began approximately three months ago. She also complains of shortness of breath, fatigue, cool lower extremities, and a beefy red tongue. She has a past medical history of type II diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), and osteoporosis. She is allergic to sulfa drugs with the reaction of hives when she took the medication four years ago. Her current medications include lisinopril/hydrochlorothiazide (Prinzide) 20/12.5mg daily, aspirin 81 mg daily, atorvastatin 20 mg daily, metformin 500 mg twice daily, ergocalciferol 800 units daily and ibandronate (Boniva) 150 mg once monthly. She denies ever smoking, denies alcohol and illicit drug use. She retired four years ago and was a social worker. She has a family history of CAD, DM and HTN; her mother died at 55 years of age of heart disease and her father died of prostate cancer seven years ago. Both her sisters are living and diagnosed with HTN.  

This patient is 5’6” tall and weighs 200 pounds, her current heart rate is 100 bpm, BP 130/80, respirations 20 breaths per minute with an oxygen saturation of 94% on room air. Her recently drawn lab results include hemoglobin 7 g/dL, hematocrit 23%, mean corpuscular volume (MCV) 73 FL, mean corpuscular hemoglobin (MCH) 25 pictograms/cell, mean corpuscular hemoglobin concentration (MCHC) 30 g/dL, total iron binding capacity (TIBC) 550 µg/dL, serum iron 50 µg/dL, and serum ferritin 15 ng/ml.

9. What dietary recommendations would you include for this patient? Give examples.  

Answer 1

Dietary recommendation for Anemia are :-

- Iron-rich meats

lean beef, veal, pork, lamb, poultry, liver

- iron-rich vegetables

spinach, okra, sweet potatoes, winter squash, white potatoes

- iron-rich grains/legumes

dried peas/beans/legumes, whole grain breads, cereals, brown rice, enriched pasta, tofu, soybeans

- iron-rich fruits

dried fruits (prunes, raisins, figs), tomato juice, prune juice

- iron-rich miscellaneous

molasses, egg yolk, nutritional yeast

- vitamin C fruits

citrus (fruit and juice), strawberries, cantaloupe

- vitamin C vegetables

brussel sprouts, broccoli, cabbage, tomatoes, asparagus, bell pepper, cauliflower, potatoes, spinach, turnips

- vitamin C miscellaneous

green chili sauce and salsa

- vit b12 foods

cheese, eggs, leafy greens, liver, milk, nuts, red meat, salmon, whole cereals

- folic acid foods

dark leafy greens, liver, meat, fish, legumes, whole grains, orange juice, peanuts