My results are on parade for all to see! Join me as we take an exciting journey revealing how refraining from eating animal products can keep your figures within the normal range and your figure looking trim, taut and terrific!

It’s time we took a proactive position and used blood tests as a means to keep on top of our health.

Not long ago, Hayley and I had our bloods taken. We had both been meaning to do so for a long time. And by a long time, I’m not joking. I went to a GP a few months ago to obtain a blood test request but realised only after I saw a different doctor to obtain the results of the test that he had issued a previous request for me close to two years prior. Ha! He made a joke about how he was amazed that I hadn’t lost the request form. I admitted that I had seen another GP in the interim for other unrelated issues so it had nothing to do with my super-human organisational skills.

According to my phlebotomist, my reaction was pretty normal. For a guy.

I sat in a modified chair with arms that deliberately sunk low at the front forcing me to expose my inner elbow crease. Hayley looked at me and asked if I was ok. I said confidently, “Yep! All good!” The nurse pierced my skin and before I knew it, the sample was taken and the bandaid was already on. I thought to myself that I had done it. No worries. Easy as.

Then I was asked what seemed to be a wave of needless questions.

Why must I be asked questions? It’s all done. What’s the issue? As it turned out, my confusion had a lot to do with my psychological reaction to the needle, even though it was all done and dusted. My vision blurred and narrowed to less than half of my normal visual arc and everything sounded muffled and distorted. I was instructed to lay on the examination bed, invited by an inhospitable paper sheet that absorbed the sweat from my hands as soon as I supported myself. As I lay there sipping an apple juice box from a bent plastic straw, I instinctively knew Hayley would have absolutely no problem with the whole experience. My prediction came to pass. Interestingly, blood phobia prevalence sits around 3-4% of the general population with an overrepresentation of males displaying symptoms at over double the prevalence of women.

I knew I would likely react this way but more was at stake. Feeling a bit off is a small price to pay for the maintenance of my health.

My main interest was to see the status of my serum vitamin B12, which, as it turns out is an indication of healthy intrinsic factor production (tied to pernicious anemia). I was also curious as to whether my iron levels were something that needed to be addressed.

While it certainly would have been incredibly fascinating to have my blood dripped on cancer cells and compared to other people I knew as well as the general public, sadly this wasn't available. This image is from Dean Ornish's 2005 study, 'Intensive Lifestyle Changes May Affect the Progression of Prostate Cancer.' In this study, the cancer-killing ability of vegan blood was put under empirical scrutiny.

What Can An Ampule of Blood Tell Us?

After some research across reputable websites including Australia’s Deakin University, a web article written by Karen Dwyer provided me with a basic starting point with which to start investigating the usefulness of blood tests. The first thing I came to realise is that taking blood is incredibly easy in the scheme of medical procedures. There is no requirement for expensive equipment such as MRI or X-ray machines, nor is there a need for highly trained staff. Of course, you need to be trained, but if you’re not squeamish, taking blood is easy.

A full blood count will provide the diagnostician with information relating to various parts of the blood including a red blood cell count (oxygen-carrying function), white blood cell count (immune function) as well as platelets (ability to clot the blood if bleeding occurs). Electrolytes that are carried around by the blood also show up in your test. Electrolyte measurements are used to determine kidney function broadly. Finally, measurements of albumin in the blood is a cursory liver function determinant, while C-reactive protein is indicative of inflammation, a bodily response to damage caused by pathogens, damaged cells or irritants.

Karen Dwyer goes on to talk about how blood tests can help your doctor determine things like liver disease, renal function as well as anemia. I’ll be delving a little more into these later. It should also be mentioned that a disease called septicemia can also be detected in the blood (after it is cultured). This isn’t part of the routine test and there was no reason for me to have it done. Septicemia is a state where bacteria and their toxins poison your blood. Presence of symptoms would usually spur this type of testing, rather than someone just taking a proactive approach to their health.

Anemia. It’s a little more complicated than just low iron.

According to Asrie (2017), anemia is a blood disorder in which there is a decrease in blood cell hemoglobin concentration. Considering that hemoglobin is the iron-containing, red colour-imparting protein within with red blood cell that affords it its oxygen-carrying capacity, its role is critical for normal cell processes and energy (ATP) production.

Anemia is right up there when naysayers start hurling “irrefutable evidence” that veganism is an unsatisfactory eating pattern in order to obtain all essential nutrients to live a long and healthy life. I will agree insofar as I’ve become increasingly aware that anemia is a problem. However, it’s a little more nuanced and certainly is not exclusively a vegan phenomenon. It has a closer relationship to menstruating woman (vegan or otherwise) and blood donors because you’re either losing or giving away blood potentially faster than your bone marrow is able to regenerate new red blood cells. Going even further, you’d be surprised that anemia affects more than just these two very specific groups.

In fact, the World Health Organisation (WHO) reports that over a quarter of the entire world’s population is anemic.

Mind-blowing? I thought so. If you’re interested in the global distribution of anemia, the highest rates occur in Sub-Saharan Africa, while Australia, the United States, Western Europe and New Zealand are among the lowest.

The WHO states that anemia is characterised by hemoglobin levels falling below 13.0 g per 100mL of blood (g/dL) or, as it was reported on my pathology report, less than 130 g/L (multiply by a factor of 10). Additionally, hematocrit can also be used to measure anemia at levels below 39% in men and less for all other groups. This information can be found here.

For those that love the data, here’s a tabular breakdown sourced from the WHO. You’re forgiven for missing the fine detail but take note that there was no vegan cohort and startlingly, almost half of all preschool-aged children are anaemic.

Three Shades of Red.

Anemia can be categorised by three primary causes of the condition;

1. Declined, lacking or abnormal red blood cell (RBC) production;
2. Disproportionate RBC destruction and,
3. Disproportionate RBC loss.

As this article is intended to be more of a primer and instrument of personal health discovery, I will not be addressing the causes of both disproportionate RBC destruction and loss. Sufficed to say, they are related primarily to parasitic, viral and bacterial infections as well as female reproductive implications.

What did my hemoglobin and iron studies tell me?

I have been vegan since 2012, then more strictly following a whole-food vegan diet from October 2017. Both my hemoglobin and hematocrit are within the normal range. Note the collection date of 9/3/19.

While my hemoglobin levels were normal, I was interested to know more about the causes of lower than usual RBC production. The first thing that people jump to (me included) when thinking of anemia is iron. While it is important, there are other related factors including vitamin A, B12, folic acid, B6, riboflavin and the mineral, copper. Ruling out the need for nutrients due to growth (I’m well past that at age 35) or disease (loss of nutrients through diarrhoea) - HIV/AIDS, tuberculosis, malaria, thalassemia or sickle-cell anemia, it would appear more than likely that my slightly low levels of ferritin (protein-bound iron) are likely due to my diet.

High "Iron", Lower "Ferritin". Huh?

Being careful not to go beyond my own understanding of pathophysiology, I am certainly interested to know more about my slightly raised levels of serum iron. As far as I could determine, ferritin is an indication of stored iron, while serum iron is more closely related to possibly recently consumed sources of iron. I believe this is why the note down the bottom questions "? Recent iron therapy" which I have not had.

Could my serum iron be raised due to all the leafy greens? Maybe there's something else in my diet that's inhibiting its uptake into ferritin molecules which presents as "low iron".

These results are certainly interesting and I'll be following them up in a few months to compare the results. It should be noted that since I have received these results, I am consuming approximately 50-100g of cooked spinach per day as a measure to increase my dietary iron intake as well as consuming kiwi fruit which contains the daily requirement of vitamin C which aids in the uptake of iron.

A (very brief) note on anemia as a hindrance to economic output.

The authors [unknown] of the k4health.org webpage, ‘Anemia Prevalence, Causes and Consequences’ paid particular attention to how “anemia has devastating costs to individual (and national) productivity.” What struck me was the focus on improving the condition so as to improve “work output” and “gross domestic product”. I think a person suffering from any disease or disorder should conjure hope, not that they’ll be more productive members of society, but that their improved health status will, in turn, improve their own quality of life and the quality of life of those around them, of which their economic usefulness is but a small part. Call me an extreme leftist, but I’d like to think people (even strangers) want healthy citizens of their country for reasons other than their contribution to gross domestic product.

Your Defective Stomach, Intrinsic Factor (IF), B12 and Pernicious Anemia.

Your stomach is the gateway to your blood, so you’re gobbling lots of dietary B12 (which is incredibly still being discussed in some 2019 scientific literature as coming from “animal products such as red meat, dairy and eggs”) but you’re at risk of becoming anemic your doctor tells you, because your hemoglobin levels are approaching the danger zone (less than 130g/L of blood). You may have pernicious anemia.

Intrinsic factor is a glycoprotein that is secreted by parietal cells in the stomach. They’ve got a special job; escort ingested B12 molecules and get them into the blood where they can be used to do important things like keeping your hippocampus from shrinking, myelin sheaths around your neurons from degrading, indirectly contributing to normal levels of neurotransmitter production and contribute to the maturation of red blood cells in bone marrow. B12 is not something you should be missing out on and for all interested, I encourage you to check out this article clarifying a few misconceptions surrounding B12. If there’s an issue with intrinsic factor, or those parietal cells that synthesise it, you’re going to have B12 issues and the cascade of other knock-on effects that go hand in hand with a B12 deficiency.

I recall a discussion I had with someone who’ll remain nameless, that taking B12 supplements isn’t effective at treating a B12 deficiency. He went on to state that fifty percent of all people are B12 deficient. While he did express concern that more people should show concern for their health, his figures were not accurate. What he was referring to was the prevalence of pernicious anemia or Biemer's disease caused by an autoimmune response to intrinsic factor (IF). Effectively, a person with this disease is destroying IF or destroying the cells that produce it. The result is low B12 uptake, causing RBC production issues leading to anemia. Pernicious anemia affects about 0.1% of the general population and 1.9% of people over the age of sixty and this disease is responsible for between 20-50% of B12 deficiencies in adults which, with a bit of simple maths means that up to 0.5% of the general population are B12 deficient, but these numbers vary within the literature. Certainly a far cry from fifty percent!

Fear not! An intramuscular shot will get B12 into the bloodstream. Who needs IF, when you can resort to hypodermic needles?

This is one reason why discussing matters of such importance as health should be backed up by sources, your health professional and your own research, of course using the balance of credible sources. If 51 of 100 studies showed that x was harmful, I’d certainly be wary of it. And of course, if you're one of the 2 out of every 100 people over the age of sixty that speaks with your doctor about treating your pernicious anemia, don't walk away and attempt to tell vegans their supplements won't help them, because chances are, you'll likely run into a well-educated vegan who has done their research, doesn't have pernicious anemia and is ready to correct your misquoted statistics!

[Spoiler: I nodded, smiled and praised myself after the fact that I didn't act like a nit trying to convince a brick wall that they were incorrect. Alas, I'd be the angry vegan!]

An Interesting Study on Kidney Function.

In a 2007 study comparing 25 vegan Buddhist monks with 25 non-vegan Buddhist monks in Thailand, the author recognises that a range of health benefits are obtained by following a vegetarian diet. While it is known that vegans may be more predisposed to megaloblastic anemia and iron deficiency this study aimed to discover more about kidney function in relation to dietary intake. Interestingly, there appeared to be a statistically significant (p < 0.05) difference in urine protein between the groups. Accompanied by slightly higher values of serum BUN, which the author links to a possible higher dietary protein load, the results support the use of a vegan diet in treating patients with renal failure.

While there were relatively few participants, the author designed the study so as to closely match the lifestyles and other environmental factors to eliminate other variables as practicably as possible. Should this one study be looked at in isolation? No. However, it is part of a cumulative effect on nutritional studies that are pointing towards diets lower in protein in order to treat renal dysfunction. We should be excited that the answers are becoming less murky.

The Down-Low on Kidney Function

I’d recommend watching this short video to learn more about the basics of how your kidneys do their job. Sure, it isn’t mandatory viewing but if it only fractionally increases your understanding of their importance, it may get you thinking more about what you put in your mouth to treat them with greater care.

The remaining results (B12, cholesterol, fasting glucose, eGFR (and Gilbert's Syndrome!)

Before leaving you with a few concluding remarks, I want to provide you with the opportunity to scrutinise my remaining blood work results.

Got yo B12? [Yuh, huh!]

The first thing the doctor said after looking at my B12 was, "Ok, so you supplement. Levels are fine."

After this whole learning process, it was also nice to know that it is sufficient for me to take B12 orally. No pernicious anemia for me! Nor do I need to brace for the monthly/quarterly B12 shot. As I've discussed in a previous article, I take both cyanocobalamin (oral spray) and methylcobalamin (chewable tablet) forms of vitamin B12 every other day. Everyone should be taking B12.

Fatty Blood? [Nope.]

This, I wasn't surprised about. I don't eat animals so it would stand to reason that I wouldn't have high levels of cholesterol.

The cholesterol to HDL (high-density lipoprotein) ratio was also important as it's the HDL's job to go cleaning up excess cholesterol, carrying it back to the liver so it doesn't go building up on artery walls. All my levels were normal, however, after some discussion the doctor told me that he has seen in his practice that excessive consumption of cashew nuts can increase cholesterol in the blood. After a cursory look through the literature, I have not seen any evidence of that. I'm almost tempted to try it myself. If anyone knows of trials where excessive cashew consumption has been shown to cause increases in cholesterol, I'd be interested to see the data.

I don't have pre-diabetes! [Never thought I did.]

My fasting glucose is normal (despite all the fruit I eat), my renal function (eGFR) is where it should be, and I've potentially inherited Gilbert's Syndrome. Fun fact: Napoleon had it, too.

I have the pleasure of knowing a person (names withheld, of course) who once proclaimed with certainty that consuming all the fruit I do causes diabetes. This is what anyone who is familiar with the causes of diabetes calls horse shit.

Type 1 diabetes is a genetic disease where the beta cells of your pancreas (contained within islets) are attacked by your own immune system. Because they produce insulin, beta cell destruction affects insulin production. Insulin is that hormone that allows glucose uptake from the bloodstream. Consuming sugary foods affects people who already have type 1 or type 2 diabetes. It isn't the cause. Interestingly, a whole-food plant-based diet has been shown to reverse type 2 diabetes in those patients who actually adhere to the eating plan. Surprise! It's all the animal junk that people inhale that causes type 2 diabetes, not nutrient-rich fruit.

My elevated levels of bilirubin, which is a byproduct of heme-containing waste product metabolism by the liver, may be a result of Gilbert's Syndrome (GS). The syndrome is characterised by a reduction in the activity of the enzyme, glucuronosyltransferase which is caused by a mutation in the UGT1A1 gene. As luck would have it, those with GS have a significantly decreased risk of coronary artery disease. I call that a win if ever I've seen one. It might explain why I've always thought the whites of my eyes are a bit yellow.

Your first blood test may be the prompt you need to become a more health conscious individual.

It takes a concerned person to go and get a blood test. You can be a health-minded person and never get a blood test, while the converse is also true – you can go and get a blood test without the prerequisite of going and changing up your whole lifestyle beforehand. In fact, this is something that I wished I had of done before I went on a whole-food vegan diet (I used to be a moderate consumer of junk food vegan products prior to October 2017). Being able to compare your own results before and after a sensible lifestyle change such as crowding out animal products with whole plant foods such as beans, seeds, grains, fruits and vegetables enables you to be your own experiment. Too often and alarmingly so, people think that they’re the exception to all the studies including Dan Buettner’s ‘Blue Zones’ which explores populations across the world who seem to be void of the most common killers in the Western World. It is becoming increasingly accepted that these populations appear to be protected from diabetes, some cancers and heart disease due to their diet which largely consists of plant foods.

Like me, you might even find you have a genetic anomaly and refuse to allow your genetics to control your life, be it for good or bad. While GS predisposes me to a significantly reduced chance of coronary heart disease, there is no way I'm changing those odds by living recklessly. If you find your figures are way out, it's time you corrected them yourself.

May this be the prompt you need to go and get your blood tested.

While you might be quick to judge whatever aspect of my blood work you feel suits your meat-eating agenda (ie. after everything that's been discussed you still think low iron and anemia is a "vegan thing"), or you're a health-conscious plant-eater like myself, getting your blood taken should be a priority. It's quick and easy and won't cost you a cent (in Australia, at least).

The worst that can happen is that you get a little woozy and need a juice box and a lie down.

To Your Health,

Nick.

[Thumbnail photo credit: Sorrento, Italy 2017.]

All content is original and belongs to @nickmorphew [1 April 2019].

Disclosure: This article was not a paid promotion and was not self-upvoted. Nor were there any affiliate links.

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References and Resources

Anemia Prevalence, Causes and Consequences (accessed March 26, 2019).

Andres, E & Serra K (2012) 'Optimal management of pernicious anemia', J Blood Med, Vol. 3, pp 97-103.

Ankar, A & Kumar, A (2019) ‘Vitamin B12 Deficiency (Cobalamin)’, StatPearls Publishing.

Asrie, F (2017) ‘Prevalence of anemia and its associated factors among pregnant women receiving antenatal care at Aymiba Health Center, northwest Ethiopia’, J Blood Med, Vol. 8, pp 35-40.

Bowen, R ‘Intrinsic Factor’, Vivo Pathophysiology (accessed March 31, 2019)

Dhondup T and Qian Q (2017) ‘Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure’, Blood Purif, Vol. 43, pp 179-188.

Kennedy, DO (2016) ‘B Vitamins and the Brain: Mechanisms. Dose and Efficacy – A Review’, Nutrients, Vol. 8, 2, p 68.

Koury, MJ & Ponka, P (2004) 'New insights into erythropoiesis: the roles of folate, B12 and iron', Annual Review of Nutrition, Vol. 24, pp 105-31.

Latif Wani, A & Ahmad Bhat, S (2014) 'Blood Injury and Injection Phobia: the Neglected One', Behavioural Neurology, Vol. 2014, 471340.

McDowall, J (2005) ‘Haemoglobin’, European Bioinformatics Institute [Accessed 26/3/2019.]

Ornish, D et al (2005) 'Intensive Lifestyle Changes May Affect the Progression of Prostate Cancer', The Journal of Urology, Vol. 174, 3, pp. 1065-1070.

Pasricha, S (2014) ‘Anemia: a comprehensive global estimate’, Blood, Vol. 123, pp 611-612.

Pernicious Anaemia Society, accessed March 2019

Wiwanitkit, V (2007) ‘Renal Function Parameters of Thai Vegans Compared With Non-Vegans’, Renal Failure, Vol. 29, pp 219-220.

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I’m currently working on my debut fantasy novel based on my early work, Adventures in Elowyn Glade. Please contact me if you would be interested in supporting the project to secure a high quality publication.

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You didn’t think you’d leave here without me shamelessly plugging my other work, right?

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