Building Blood

From Anemia to Abundance

There is a question I find myself asking nearly every time I review prenatal blood work.

Not,

"Is she anemic?"

But rather,

"Does her body have enough abundance to build another human being without borrowing from itself?"

Those are very different questions.

Modern medicine often becomes concerned when hemoglobin drops below a certain number or ferritin reaches a particular threshold. Those laboratory values certainly matter, and they help us recognize when intervention is needed.

But they don't always tell the whole story.

I have cared for women whose laboratory values technically fell within the normal range, yet they were exhausted before pregnancy had truly begun. Their hands and feet were cold. Their hair had lost its fullness. Climbing a flight of stairs left them breathless. They woke each morning already tired.

Their bodies were functioning.

They were not thriving.

Pregnancy asks extraordinary things of a woman's body.

Before she ever holds her baby, she will increase her blood volume by nearly fifty percent. She will build an entirely new organ—the placenta. She will create billions of new cells, construct a skeleton, form a brain more complex than any computer ever designed, and nourish another human being every minute of every day.

That requires far more than calories.

It requires reserves.

When I think about building blood, I don't picture a laboratory report.

I picture a river.

Blood is the river that carries oxygen to every cell. It delivers nutrients to the placenta, hormones to growing tissues, immune cells where they are needed, and eventually becomes part of the milk that will nourish a newborn.

A slow, shallow river cannot irrigate an entire landscape.

Neither can a depleted body sustain the remarkable work of pregnancy without eventually asking for help.

This is why I encourage women to think about blood long before they think about anemia.

Our goal is not simply to stay above the lower limit of normal.

Our goal is vitality.

What Does It Mean to Build Blood?

One of the greatest nutritional misunderstandings of our time is the belief that blood is built by iron alone.

Iron is certainly essential, but it is only one musician in a very large orchestra.

Healthy blood depends upon protein to create hemoglobin.

Vitamin A helps direct stem cells toward red blood cell production.

Copper allows iron to move where it is needed.

Vitamin B₁₂ and folate help immature blood cells divide and mature.

Vitamin B₆ participates in making hemoglobin itself.

Vitamin C improves the absorption of non-heme iron from plants.

Even adequate thyroid function influences the body's ability to produce healthy red blood cells.

When any one of these pieces is missing, the orchestra loses harmony.

Simply adding more iron cannot always compensate.

We Were Designed to Eat Living Food

One of my favorite teachers, Atom Bergstrom, often challenged people to think differently about minerals.

Whether or not you agree with all of his conclusions, one observation has stayed with me.

Human beings do not naturally eat rocks.

We eat the plants that drew minerals from the soil.

We eat the animals that grazed upon those plants.

Nature packages minerals inside living food, accompanied by proteins, enzymes, vitamins, and countless compounds that help the body recognize, transport, and utilize them.

Iron found in liver arrives differently than iron found in a tablet.

The body has evolved alongside one of those for hundreds of thousands of years.

This doesn't mean iron supplements never have a place. They absolutely do, and for some women they are an important part of restoring iron stores, especially when deficiency is significant or dietary changes alone cannot meet the need. But supplements work best when they support—not replace—a deeply nourishing dietary foundation.

Food remains the language our bodies know best.

The Foods That Build Blood

If I were rebuilding someone's blood from the ground up, I would begin in the kitchen.

Not because food is always enough.

But because it provides far more than isolated iron.

Liver remains one of the richest foods for iron, vitamin A, B vitamins, copper, and other nutrients essential for healthy blood formation.

Grass-fed beef and lamb provide highly bioavailable heme iron along with complete protein.

Clams, oysters, and mussels are extraordinary sources of iron, B₁₂, copper, zinc, and trace minerals.

Egg yolks contribute choline and fat-soluble vitamins.

Bone broth and slow-cooked meats provide collagen, glycine, and amino acids that support connective tissue and overall recovery, even though they are not major sources of iron themselves.

For women who eat little or no meat, foods such as moringa, spirulina, nettles, legumes, pumpkin seeds, lentils, and leafy greens can contribute valuable nutrients. Pairing these foods with vitamin C-rich fruits and vegetables can improve non-heme iron absorption.

For women who have followed vegetarian or vegan diets for many years, pregnancy can be an invitation—not a judgment—to honestly evaluate iron, B₁₂, DHA, zinc, iodine, vitamin A, and protein status. Many women do beautifully on thoughtfully planned plant-forward diets, while others discover that pregnancy asks more of their nutrient reserves than they expected. When I work with my clients, I ask them to listen; what is their body is asking for? Are they dreaming of foods? Does the smell of them in a restaurant make their mouth water?

The goal is not to defend a philosophy.

The goal is to nourish a mother.

Understanding Pregnancy Blood Work

One of the most common worries I hear is,

"My hemoglobin dropped. Am I becoming anemic?"

Sometimes.

Sometimes not.

By the late second trimester, a mother's plasma volume expands dramatically. Red blood cell mass also increases, but not quite as quickly. As a result, the blood becomes naturally diluted—a normal physiologic adaptation that helps support the placenta and protect against blood loss at birth.

This is one reason why a lower hemoglobin value around twenty-eight weeks does not automatically mean something has gone wrong.

Ferritin, which reflects iron stores, often provides a more complete picture, although it can also rise during inflammation. Looking at ferritin alongside hemoglobin, red blood cell indices, symptoms, and the overall clinical picture offers a much more meaningful understanding than any single number alone.

Laboratory values are guides.

They are not the whole story.

Building Abundance

Perhaps this is why I prefer talking about building blood rather than treating anemia.

One language begins with deficiency.

The other begins with possibility.

Blood is warmth returning to cold hands.

It is climbing the stairs without losing your breath.

It is waking with energy instead of exhaustion.

It is hair that grows, nails that strengthen, a mind that thinks clearly, and a body that has enough resilience not only to carry a pregnancy, but to recover from birth and nourish a baby afterward.

Pregnancy is one of the most generous acts the human body will ever perform.

My hope is that we stop asking how little nourishment a woman needs to get by.

Instead, let us ask a different question.

How do we create so much abundance that she can build another human being without leaving herself behind?

I have a feeling our grandmothers knew the answer.

It began with the recipes that were passed from one Nana to another, around the hearth, cooking foods that were part story time and part lineage. Foods that were a way of life.