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The Star, Tuesday 12 July 2016

“ARE you fine, lady? You look pale and weak.”
If you have encountered such a situation before, know that it is common among women during menstruation to lose more blood than usual. Heavy periods can cause low iron levels and interrupt daily activities (1).

Low iron levels is detrimental as the body needs adequate amounts of iron to produce haemoglobin in red blood cells.
If this condition persists, anaemia may develop (2).

Globally, anaemia affects more than 500 million women in the reproductive age, in 2011 (3).
Almost three out of 10 women are affected by anaemia (3), and have signs such as pale complexion, cold hands and feet, breathing difficulties, and rapid heartbeat with exercise (1). There are several types of anaemia and iron deficiency remains the most common (4).

Besides heavy periods, iron deficiency anaemia can also be caused during childbirth, low dietary intake of iron, frequent use of aspirin and medical conditions such as uterine fibroids, celiac disease, Chron's disease, ulcers, colon cancer, infections and surgery (2,4).

Another type of anaemia is vitamin deficiency anamemia, commonly caused by low levels of vitamin B12 (4). It happens in people who are unable to absorb vitamin B12 properly or who do not consume sufficient vitamin B12 from their diet.

Vitamin B12 is mainly found in foods sourced from animals and required to form proper red blood cells, neurological functions and DNA synthesis. It is also essential in many biological processes in the body (5). Deficiency in vitamin B12 can cause numbness and tingling in the hands and feet, difficulty of balancing, poor memory, dementia, and soreness of the mouth or tongue (5).

Individuals who take less animal-based foods might benefit from vitamin B12-fortified foods and vitamin B12 supplements.
However, they may have problems swallowing pills.

This is not uncommon as 37.4% of the general population have difficulty swallowing tablets or capsules, particularly women and younger population (6). People with swallowing problems may experience pills stuck in the throat, the need of repeated swallowing, choking or vomitting while swallowing. The average diameter for adult oesophagus is 20mm only while some pills or capsules are bigger in size and prove challenging for these people.

A smaller-sized pill can help them to swallow better.
Get a smaller size supplement that contains adequate amount of iron and vitamin B12 for your health and ease your swallowing.

    (1)    National Center for Biotechnology Information, US National Library of Medicine, 2013.
    (2)    Heavy periods: Overview.
    (3)    Retrieved from www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072478/
    (4)     Mayo Foundation for Medical Education and Research, 2016. Anemia. Retrieved from
    (5)    www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/basics/causes/
    (6)    con-20019327
    (7)    World Health Organization, 2015. The Global Prevalence of Anaemia in 2011. Retrieved from apps.who.int/iris/bitstram/10665/177094/1/9789241564960_eng.pdf
    (8)    Office on Women's Health, U.S Department of Health and Human Services, 2008.
    (9)    Anaemia Fact Sheet. Retrieved from www.womenshealth.gov/publications/our-publications/fact-sheet/anemia.pdf
    (10)    Office of dietary supplements, National Institutes of Health, 2016. Vitamin B12 Dietary Supplement Fact Sheet. Retrieved from ods.od.nih.gov/pdf/factsheets/VitaminB12-HealthProfessional.pdf
    (11)    Schiele, J.T., Quinzler, R, Klimm, HD, Pruszydlo, MG, and Haefeli, WF, 2013.
    (12)    Difficulties swallowing solid oral dosage forms in a general practice population:
    (13)    prevalence, causes, and relationship to dosage forms. Eur J Chin Pharmacol, 69(4):937-948

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