"How are you feeling, Preethi?"

It was 6:26am and I was just waking from a long night of sleep. Standing a few inches away, a tall Caucasian man in a white coat watched me. It looked like he had been waiting for me to wake up.

"I'm good," I replied, a little confused. It took me a few seconds to figure out where I was and why I was there.

Suddenly, I remembered I had checked myself into the hospital the night before. The man standing near me was my doctor.

“You were given a blood transfusion overnight to bring your hemoglobin levels back up to normal.”

“Thank you, Doc,” I replied. I was still a little out of it. The doctor must have noticed, because he continued:

“Your hemoglobin count was at 5.6 grams. Normal levels for a woman are around 12 to 15 grams. I’ve never seen a patient walking and moving around with a hemoglobin level of 5.6. You are our new medical mystery!”

His tone was slightly sarcastic, but I appreciated his cool demeanor. I nodded and thanked him again. We spoke for a few minutes as he continued to explain what had happened before telling me I was ready to be discharged.

The quick backstory‍

At the time, I was 22 years old and living in New York City during the summer while I attended the Goldman Sachs summer training program. One day during a morning training session, I suddenly started feeling nauseous and light-headed. I assumed I had just not eaten enough and excused myself for a moment.

I headed to the building’s cafeteria and bought a ready-made protein shake, gulping it down before returning to session. I sat in the back and tried to catch up on what I had missed. The nausea, however, continued to worsen. I couldn’t pay attention to the lesson for the life of me and excused myself once more to return to the cafeteria. This time, I purchased a salad and an apple in the hopes some solid food would help.

But it didn’t.

I badly wanted to just go home and lay down. Defeated, I stepped out of the room and let the training staff know I wasn’t feeling well. They told me to go home and rest, so I left for the day.

After taking the subway back to my hotel, I crashed and slept for 8 hours straight. When I woke the next day, I felt better and was ready to conquer the day. I went to the gym, showered, and hopped back on the subway to head to that day’s training session. 

Unfortunately, I started feeling light-headed again. My stomach was queasy and I had the urge to vomit. The crowded subway was only making things worse. I closed my eyes and prayed that I would get to my stop soon so I could get some fresh air. 

When the subway finally arrived at the station, I briskly walked to the building where training was held. I had hoped the walk would help clear my head, but there was no such luck. Trying hard to maintain my composure, I headed upstairs to the main training room and sat in the back. I tried my hardest to pay attention but I simply couldn’t.

I had no choice but to excuse myself again. Instead of the cafeteria, this time I went to the nurse’s office on site. They checked me in and a nurse practitioner saw me right away. She took my vitals and told me to lay down for a bit to see if I felt any better.

After my head hit the pillow, I was asleep within a heartbeat.

A couple of hours later, I woke up hazy-eyed and confused. I looked at my phone to see that it was already noon. I had been asleep for two hours! Seeing I was awake, the nurse asked if I was doing any better. I simply nodded and thanked her for letting me sleep. She proceeded to hand me a slip of paper with a worried look on her face.

“I want you to go see a primary doctor right away. I’m writing a referral for you.”

I thanked her and took the paper before returning to the training session. Unfortunately, I could hardly keep my eyes open, let alone pay attention. I was forced to surrender and return to my hotel room for more sleep.

By the time I woke up, it was almost 3pm and the doctor’s office closes at 5pm. I figured it would be a good idea for me to get checked out before they closed shop, so I dressed quickly and walked over. After getting checked in and waiting, the doctor called me back and asked a barrage of standard questions before drawing some blood. He told me to go home and rest while the blood work was processed.

Walking back to the hotel, I was nervous. I had an exam in the morning and badly needed to study for it, especially since I had missed most of the week’s training sessions. I hurried back and started studying. I felt like death, but I knew there was no choice but to push through. Within a few minutes of cramming for the exam, my phone started buzzing and I answered.

I recognized the voice from the doctor’s office.

“Hey there, what’s up doc?” I said.

“Preethi, I need you to go to the hospital right now. We got your blood test results back and your hemoglobin count is extremely low. We are not sure how you’re awake right now. You need to get yourself checked into the Emergency Room!”

“Wait, what?” I responded. “I can’t do that. I have an exam tomorrow. I need to study. Is it really that bad?”

“Yes!” he shrieked. “I’ve never ever seen a patient with a hemoglobin count this low and still alive. The normal for a woman your age is 12 to 15 grams per deciliter. Yours is at 5.6 grams.”

“I’m not sure what that means, but I feel fine. I can’t miss this test. I promise I’ll go tomorrow after the test is over.”

There was a short silence on the other end of the line before the Doctor sighed. “I cannot force you to go. You have the right to do what you want, but I highly recommend you go as soon as possible. I’m worried for you.”

After hanging up the phone, I sat there puzzled. I was torn: Do I study for my test or go to the ER? Honestly, I felt a lot better after the doctor’s visit and going to the ER seemed a bit extreme. Against the doctor’s advice, I decided to return to my studying.

After a half an hour attempting to study, however, I couldn’t ignore what the doctor had said any longer. I got up, dressed, and walked 40 minutes to the nearest hospital. I checked myself into the Emergency Room and was seen almost immediately.

Twelve hours later, I was waking up to the sound of my doctor asking how I was.‍

I spent many years in hell and didn’t even know it‍

I distinctly remember how I felt that morning in the hospital bed after I had the blood transfusion and my iron levels were back to normal. Laying on those stark white sheets in a thin gown, I felt different. Very different. For the first time in a long time, I actually felt energetic. In fact, I had more energy than I could remember having in years. I felt alive, truly alive.

“Is this what it feels like to have normal blood iron levels?” I thought.

I had grown so used to dragging myself around, I had forgotten what it felt like to have so much energy. I had allowed myself to be blinded.

After that hospital incident, I had multiple colonoscopies and endoscopies done. The doctors wanted to test whether the cause of my hemoglobin count dropping so low was due to internal bleeding.

Ultimately, the doctors determined that there was no internal bleeding. I learned that my fatigue, light-headedness, nausea, and extremely low hemoglobin level all stemmed from one condition: anemia.

My anemia had gotten progressively worse over the years—until it was almost too late.

What is anemia?‍

I was first diagnosed with “iron-deficiency anemia” in college. Anemia occurs when your red blood cell count (or hemoglobin) is lower than normal. Hemoglobin plays a really important function in your body. It makes it possible for your lungs to take oxygen from the air you breathe and then carry it throughout your body. Hemoglobin also takes carbon dioxide from various parts of your body and returns it to your lungs to be breathed out. If your hemoglobin is too low, your tissues and organs don’t get enough oxygen.

Iron-deficiency anemia is caused by a lack of adequate iron in the blood. Iron deficiency is the most widespread nutritional disorder in the world, especially among children and premenopausal women and it results in iron-deficiency anemia. In fact, it is so prevalent that it contributes to more than 30% of the world’s population being anemic.

I can still distinctly remember what living with anemia feels like, as I lived that way for over a decade. I was constantly fatigued and cold. Sometimes, I would even have shortness of breath. Every day felt like an uphill battle, every struggle way harder than it needed to be. Eventually, I grew so used to being tired and cold all the time that it became my baseline. I forgot what life before anemia felt like.‍

My previous diet‍

When I was extremely anemic, I was eating a mostly vegetarian diet consisting of lots of vegetables, beans, fruit, and some dairy. I ate meat sparingly (once a week at most). Despite how many “iron rich” vegetarian foods I ate, my anemia never went away. Later, I would learn that it is actually very common for vegetarians to have iron-deficiency anemia.‍

“Vegetarians also have a higher risk for developing low iron stores, iron depletion, and associated iron deficiency anemia, compared to nonvegetarians. These findings are consistent with a conclusion made by the authors of the Institute of Medicine’s report on iron, who stated, “Serum ferritin concentrations have been observed to be markedly lower in vegetarian men, women, and children than in those consuming a nonvegetarian diet.”‍

Why is this the case?

Because the iron found in vegetables is much less bioavailable compared to the iron found in meat. Meat is by far the best way to get enough iron in our diet. According to the American Red Cross:‍

“Food has two types of iron — heme and non-heme iron. Heme iron is found in meat, fish and poultry. It is the form of iron that is most readily absorbed by your body. You absorb up to 30 percent of the heme iron that you consume. Eating meat generally boosts your iron levels far more than eating non-heme iron.

Non-heme iron is found in plant-based foods such as fruits, vegetables and nuts. Foods with non-heme iron are still an important part of a nutritious, well-balanced diet, but the iron contained in these foods won’t be absorbed as completely. You absorb between two and 10 percent of the non-heme iron that you consume.“‍

It wasn’t until I switched to eating more meat (especially red meat) almost every day that I realized that my diet was the main culprit. Since making the change, my anemia has completely disappeared and I have not had to take a single iron supplement in over 11 months. My hemoglobin levels are even in the normal range! I honestly consider this to be a miracle.‍

How much iron is enough iron?‍

The recommended amount of iron to consume daily is 8 mg for men and 18 mg for women. To get an idea of what foods are a good source of heme iron and non-heme iron, let’s take a look at some information.

Foods like clams, oysters, and liver are by far the best sources when it comes to heme iron. For non-heme iron, beans, lentils, and sesame seeds are some of the top sources. Remember, though: non-heme iron is anywhere from 3 to 15 times less absorbable than heme iron. 

In the past when I was eating mostly vegetarian, I was likely not getting enough iron even though I thought I was eating wisely. Now that I eat primarily fish and meat (which contains heme iron), a lot more iron is absorbed into my blood.

Long story short: Eating a vegetarian diet was not enough for my body to sustain healthy hemoglobin levels. I would have had to eat way more beans, lentils, and fortified cereals (which would leave me feeling gross) to get enough iron. Personally, I would much rather eat a serving of meat with every meal and be done with it.‍

Does this mean we all should eat meat?‍

No. Everyone has the right to choose what type of diet they want to follow.

In addition to personal preference, people often cite religious or ethical reasons for why they are vegetarian. These make total sense.

If you do choose a vegetarian or vegan lifestyle, it is important to understand the risks of doing so. In addition to iron deficiency, going vegan can also lead to vitamin B-12 deficiency anemia.‍

“For vegetarians who eliminate meat, anemia can be due to an iron deficiency. For vegans, who give up all animal products including dairy, eggs, and even honey, anemia can also be caused by vitamin B-12 deficiency.“

“In nature, B-12 is only available in meat or animal products, which is why vegans must be careful to find other ways to include it in their diets. Vegetarians who eat dairy and eggs usually get enough B-12 through these sources.”‍

The problem I often see with vegetarian and vegan diets is that they are executed very poorly. I have observed my vegetarians and vegans (including my own family members) and am always horrified. Their diets entail over-consuming carbs and sugars while vastly under-consuming protein and nutrient dense foods.

That is not to say it is impossible to be healthy and vegetarian or vegan. If a person follows a diet that meets all their essential nutrient needs, they should have no problem staying healthy. It is not easy, but it is definitely doable. Unfortunately, most people seem to take the easy route and consume boat loads of carbs and sugar instead.‍

Conclusion‍

Anemia due to either iron deficiency or B-12 deficiency is no joke. Vegans and vegetarians are more susceptible to these types of anemia, so it is important to ensure you are meeting your nutrition needs if you follow a meatless diet.

Personally, I find it much easier to supply my body with all essential nutrients (including iron and B-12) by consuming meat. Of course, the diet choice you make is 100% up to you. I’m simply here to share my personal experience and why I started eating red meat again.

I hope you learned something and find a diet that works for you!