“I can’t eat plant-based. I’m anaemic.”
It is probably one of the most common medical excuse for eating animals.
There is just one problem.
Anaemia does not create a medical requirement to eat animals.
Anaemia means there is not enough haemoglobin, or not enough healthy red blood cells carrying it. Iron deficiency is one possible cause, but so are deficiencies of B12 or folate, blood loss, inflammation, chronic disease, pregnancy and several other conditions.
The World Health Organization specifically warns against treating “anaemia” and “iron-deficiency anaemia” as though they mean the same thing. At no point does an animal become an essential nutrient.
People Eating Plant-Based Can Get Plenty of Iron
Iron is not an animal product.
Beans, lentils, peas, nuts, vegetables, wholemeal foods and fortified cereals can all provide iron. The NHS explicitly lists pulses, wholemeal bread and flour, fortified breakfast cereals, dark leafy vegetables, nuts and dried fruit as good iron sources for people eating fully plant-based. But there is an even more interesting piece of evidence.
The British EPIC-Oxford study looked at more than 65,000 people, including 2,596 vegans, alongside meat eaters, fish eaters and vegetarians.
Who consumed the most iron?
The vegans.
The fully plant-based group had the highest average iron intake of all four dietary groups. And this was not some one-off anomaly. A later EPIC-Oxford analysis again found that vegans had the highest iron intake, alongside the highest intakes of fibre, vitamin C, vitamin E, folate, magnesium and copper.
So the idea that somebody has to eat animals because they “need iron” falls apart rather quickly.
They need iron.
Plants contain iron.
“But Plant Iron Isn’t Absorbed As Well”
Plant foods contain non-haem iron. Animal flesh contains haem iron as well as non-haem iron. Non-haem iron is more affected by the rest of what you eat. Vitamin C improves its absorption, while tea and coffee consumed around meals can reduce it.
The NHS therefore recommends eating vitamin-C-rich foods alongside iron-rich plant foods and avoiding tea or coffee during or after main meals.
Lentils with tomatoes.
Beans with peppers.
Tofu with broccoli.
Fortified cereal with fruit.
This isn’t some impossible nutritional balancing act. It is lunch.
It’s also why so many traditional meals around the world combine legumes and grains for protein and minerals, and vegetables for vitamins. In the modern world we have somehow created a standard where learning one basic fact about nutrition is treated as evidence that plant-based eating is dangerously complicated. Meanwhile, someone can eat animals, know absolutely nothing about nutrition, develop iron deficiency anyway, and nobody declares their entire diet medically impossible.
People Who Eat Animals Get Anaemia Too
Of course they do.
The NHS lists heavy periods and pregnancy as very common causes of iron-deficiency anaemia. Bleeding from the stomach or intestines can also cause it, including bleeding associated with ulcers, bowel inflammation, some medicines and gastrointestinal cancers.
WHO goes further, listing nutritional deficiencies, infections, inflammation, chronic disease, gynaecological and obstetric conditions and inherited red-blood-cell disorders among the possible causes of anaemia.
You can eat animal flesh every day and still become iron deficient if you are losing iron faster than you replace it.
So if someone is anaemic, the useful question is:
Why are they anaemic?
Not:
When did they last eat a cow?
Everybody Needs B12
B12 deficiency can also cause anaemia.
But let’s stop talking about B12 as though it is some special vegan requirement.
Everybody needs a reliable source of B12.
B12 is produced by microorganisms, not magically manufactured by cows, pigs or chickens. In animal agriculture, supplementation is already part of the system. Vitamin B12 is widely used in feed for animals including pigs, poultry and calves. Ruminants such as cows and sheep can instead rely on microorganisms in their rumen to produce B12, but those microorganisms need sufficient cobalt, which can itself be supplied through supplemented feed.
So there are two basic options.
We can obtain B12 directly through fortified foods or a supplement.
Or we can feed B12, or the ingredients needed to make it, to another animal and then obtain some of that B12 by eating their body or secretions.
Why is the second route supposedly more “natural”?
People eating fully plant-based simply cut out the middle animal. Again, notice what the human body actually requires.
B12. Not beef. Not milk. Not eggs. B12.
Taking the nutrient directly is not evidence that plant-based eating is nutritionally inadequate. It is evidence that we understand nutrition well enough to obtain the nutrient without exploiting an animal.
Anaemia Is a Reason to Investigate Anaemia
WHO describes anaemia as an indicator of an underlying health or nutritional problem and says treatment depends on its cause. That is the medically relevant point. If someone has iron-deficiency anaemia because they are not consuming enough iron, increase their iron. If they need supplementation, supplement it. If they have B12 deficiency, correct their B12. If they are losing blood, find out why.
What you should not do is turn a medical condition with numerous possible causes into evidence that humans biologically require animal products. Especially when one of Britain’s largest dietary studies found that the people eating no animal products whatsoever consumed the most iron. Anaemia is a reason to find the cause and treat it. It is not a reason to eat an animal.