8 Vitamins for Anemia (That Aren’t Iron)

TLDR: Iron deficiency is often considered a major cause of nutrition anemia, but vitamins A, B12, C, E, folic acid and riboflavin, and other nutrients can also play a role in developing and controlling the condition. For example, vitamin A can improve the efficacy of your iron supplementation if it’s not working well, while riboflavin enhances your hematological iron response.

When we think about correcting anemia, we tend to focus on iron. In reality, several key vitamins can also play a role in anemia and blood cell production. We’ll detail the best vitamins for anemia besides using an iron supplement and explain their role in making blood cells.

It’s important to remember that your anemia may be caused by something other than iron deficiency. 

It could be that you’re deficient in one or more of the vitamins below, so your iron supplement isn’t raising your levels as it should be.

An Overview of Anemia

Anemia is a medical condition in which you don’t have sufficient healthy red blood cells or hemoglobin in your blood. A protein called hemoglobin is in red blood cells and binds to oxygen, carrying it from your lungs to the rest of the body. 

Anemia can result from varying underlying causes, and symptoms may include weakness, fatigue, shortness of breath, dizziness, pale skin, and rapid or irregular heartbeat.

Types of Anemia

The primary types of anemia a person can experience include:

• Iron deficiency anemia is the most common type, occurring when your body doesn’t have sufficient iron to produce hemoglobin. Iron deficiency can be due to insufficient diet, poor absorption, blood loss from menstruation or GI bleeding, or increased iron demands during pregnancy.
• Megaloblastic anemia occurs when there’s a production of immature, large red blood cells that occur because of impaired DNA synthesis. These are called megaloblasts. The most common causes of this type of anemia are folate and vitamin B12 deficiency. These nutrients are needed for DNA synthesis and red blood maturation.
• Hemolytic anemia describes a condition when red blood cells are removed from your bloodstream or destroyed faster than they can be produced. Autoimmune disorders, inherited conditions, toxin exposure, infections and some medicines can lead to hemolytic anemia.
• Anemia of chronic disease is also called anemia of inflammation. It occurs when someone has a chronic inflammatory condition, such as autoimmune diseases, cancer, infections, or chronic kidney disease. Inflammation interferes with the body’s ability to produce red blood cells. It can reduce the lifespan of red blood cells and impair iron metabolism.
• Sickle cell anemia is a blood disorder that’s inherited. The disorder includes abnormal hemoglobin—hemoglobin S—that causes red blood cells to be crescent-shaped, sticky and rigid. The abnormalities of the blood cells can block proper blood flow, causing anemia, organ damage and pain.

What Causes Anemia?

Anemia develops because of different underlying factors. These include:

• Inadequate red blood cell production is caused by nutritional deficiencies, chronic diseases affecting red blood cells, or bone marrow disorders.
• Increased red blood cell loss or destruction because of hemolysis, infections, autoimmune disorders or certain medications.
• Blood loss from GI bleeding, trauma, surgery, menstruation or other chronic conditions leading to internal bleeding.

Treatment for anemia varies depending on what’s causing it. It could include taking supplements, dietary changes, medications, blood transfusions or other interventions.

Vitamins for Anemia

In addition to iron supplements, you may be missing other vitamins for anemia that can help your body produce red blood cells.

Vitamin B12

Aside from taking an iron supplement, a vitamin B12 supplement may be incredibly helpful regarding the best vitamins for anemia. This water-soluble vitamin has a major role in overall health, with benefits including:

• Vitamin B12 plays a role in maintaining your myelin sheath. It’s a protective covering surrounding your nerves, facilitating the transmission of nerve impulses. Adequate levels of B12 are needed for neurological function and to prevent nerve damage.
• B12 is part of DNA synthesis and is needed for cellular division and growth. It’s especially important for your rapidly dividing cells, like those in your bone marrow, and it is responsible for producing red blood cells.
• The water-soluble vitamin is involved in your body’s metabolism of fats and carbohydrates, turning them into energy your body can use. Having sufficient levels of vitamin B12 is important for preventing fatigue and maintaining your overall energy levels.

Signs of vitamin B12 deficiency can include:

• Fatigue and weakness, as well as general lethargy.
• Anemia, especially megaloblastic, occurs when you produce large, immature red blood cells that don’t function properly. This type of anemia causes symptoms like shortness of breath and heart palpitations.
• Neurological symptoms include tingling or numbness in the hands or feet, problems walking, memory and cognitive impairment.
• Digestive problems include loss of appetite, weight loss, diarrhea and constipation.

The impact of vitamin B12 on anemia and blood health occurs because your bone marrow produces immature red blood cells when you don’t have enough. Those immature cells can’t divide normally, impairing your body’s ability to transport oxygen to tissues. This effect leads to anemia symptoms, including fatigue and shortness of breath.

B12 deficiency can also indirectly affect your blood health because it impairs the production of other blood cells, including your white blood cells and platelets.

Maintaining adequate levels of B12 is necessary for your blood health and overall well-being.

Folate

Folate, also called vitamin B9, plays a role in many of your body’s critical functions. Folate is naturally found in legumes, leafy greens, fruits and fortified grains. It’s necessary for synthesizing and repairing DNA and cell division, growth, and repair.

Having an adequate intake of folate is needed for pregnant women to prevent the developing fetus from having neural tube defects like spina bifida.

It’s also necessary for neurological function, and adequate levels may lower the risk of cognitive decline and neurodegenerative disorders.

Signs of folate deficiency can include:

• Megaloblastic anemia, which, again, is defined by the production of big and immature red blood cells.
• Neurological symptoms include problems concentrating, depression, forgetfulness and irritability.
• Digestive problems like diarrhea and loss of appetite.

Folate deficiency, like B12 deficiency, is a major cause of megaloblastic anemia. Like B12, folate deficiency can impact the production of healthy red blood cells, white blood cells, and platelets.

Vitamin C

Naturally found in various fruits and vegetables, vitamin C is needed for bodily functions like:

• Collagen synthesis is a protein needed for skin, bones, blood vessels, and other connective tissue health and structure.
• Antioxidant activity. Vitamin C plays a role in cellular protection from free radicals and oxidative stress damage, and it helps reduce the risk of chronic illnesses. 
• It supports your immune system by stimulating your white blood cells’ production and proper function.
• It enhances the absorption of non-heme iron found in plant-based foods.
• The vitamin is needed for wound healing and tissue repair.
• Vitamin C is part of the maintenance of healthy skin.
• Some studies show vitamin C may reduce the risk of heart disease since it reduces inflammation and improves blood vessel function.

Signs of vitamin C deficiency include:

• Their role in energy metabolism causes fatigue, weakness and general lethargy.
• Severe vitamin C deficiency can cause scurvy, bleeding, swollen gums, joint pain, impaired wound healing and skin rash.
• Increased susceptibility to infections and illnesses.
• Vitamin C’s role in anemia and blood production includes:
• It helps prevent and treat anemia by enhancing iron absorption, which is needed to produce hemoglobin in red blood cells.
• Non-heme iron isn’t as readily absorbed by the body as heme iron, but vitamin C enhances its absorption.
• By increasing the absorption of non-heme iron from plant-based foods, vitamin C ensures an adequate supply of iron to produce red blood cells.

Vitamin C can be particularly beneficial if you eat a mostly plant-based diet or are at risk for iron deficiency anemia.

Vitamin A

Vitamin A is a fat-soluble vitamin that is a group of compounds known as retinoids. There are two main forms of vitamin A in the diet. Preformed vitamin A, including retinol and retinal, is found in animal products. Then, provitamin A carotenoids like beta-carotene are found in plant-based foods.

Vitamin A is needed for bodily functions, including:

• Vision because it’s part of the retina’s functioning. The retina helps you see in low-light conditions, and it’s a component of rhodopsin, a pigment found in this part of the eye that allows detecting light.
• Vitamin A supports your immune system by promoting white blood cell production and turnover.  
• Vitamin A is part of the regulation of cell growth and differentiation.
• You need vitamin A for normal reproductive function, including sperm production and fetal development.
• Vitamin A supports healthy skin, supports your skin cells’ growth and repair, and prevents dryness and damage.

Signs of vitamin A deficiency include:

• Dry, irritated eyes.
• Night blindness.
• Skin problems like rough, scaly or dry skin.
• Compromised immune function.

Regarding the role of vitamin A in anemia and blood production, first, it helps to support the bone marrow’s ability to grow and differentiate red blood cell precursors. Vitamin A deficiency isn’t a direct cause of anemia; it indirectly affects blood health because it impairs how the body produces and functions red blood cells.

Vitamin A can also support the absorption of iron from the foods you eat, and like vitamin C, it converts non-heme iron into a more absorbable form.

Vitamin A also regulates iron storage in the body. It helps maintain optimal ferritin levels, a protein responsible for iron storage in cells, organs, and tissues. Vitamin A helps balance iron status by regulating ferritin levels, preventing deficiency and harmful excess iron accumulation.

Vitamin E

A fat-soluble antioxidant, vitamin E helps maintain general well-being. It refers to compounds with antioxidant properties called tocopherols and tocotrienols. Vitamin E is found in some foods, such as nuts, seeds, and leafy greens.

Vitamin E has benefits, including:

• It’s a powerful antioxidant that can neutralize unstable molecules that damage cells, contributing to chronic diseases and aging.
• Vitamin E can help heart health by preventing the oxidation of LDL cholesterol, improving blood vessel function, and reducing artery inflammation.
• The vitamin is beneficial for skin health.
• Vitamin E helps to regulate inflammation and improve the activity of immune cells.

Signs of vitamin E deficiency include:

• Muscle weakness and problems coordinating movements.
• Vision problems include damage to the optic nerve.
• Neurological symptoms like peripheral neuropathy and impaired balance.
• Increased susceptibility to infections.

Vitamin E deficiency doesn’t cause anemia by itself; it indirectly affects your blood cell formulation, contributing to anemia. Vitamin E helps protect your red blood cell membranes from oxidative damage. Red blood cells are especially vulnerable to oxidative stress because they have a high lipid content. Vitamin E helps prevent them from being prematurely destroyed.

If you have elevated oxidative stress levels because of anemia or a chronic disease, taking a vitamin E supplement can help protect your blood cells and support the overall formation of red blood cells.

The anti-inflammatory properties can also help with overall blood health.

Vitamin D

A fat-soluble vitamin, D, plays a role in many of your body’s physiological processes. Vitamin D, synthesized by the body with sunlight exposure, is also found in foods like fatty fish and fortified dairy products.

The general benefits of adequate vitamin D levels include:

• Bone health is important because vitamin D helps regulate calcium absorption in your intestines and phosphorus and promotes bone mineralization. Sufficient levels of vitamin D can play a role in preventing osteoporosis.
• Vitamin D modulates the immune system’s function by regulating genes involved in your inflammation and immune response. It supports the innate and adaptive immune systems, lowering the risk of autoimmune diseases and infections.
• Muscle function and strength depend on vitamin D, which regulates muscle contraction and relaxation. It is also needed for mobility and physical performance.
• There may be benefits of adequate vitamin D levels for heart health.

Signs of vitamin D deficiency include bone disorders, muscle weakness, bone pain, muscle weakness, cramps and aches, and an increased risk of infections, especially respiratory diseases.

Some studies are showing a link between vitamin D deficiency and mood disorders (depression and seasonal) disorder as well.

Vitamin D may also be linked to blood health and anemia in several ways.

First, vitamin D cells are found in cells involved in erythropoiesis, the red blood cell production process. Research suggests vitamin D could regulate this process and influence red blood cell production. 

Vitamin D deficiency is often linked to chronic inflammation, which contributes to anemia in chronic disease. Vitamin D’s anti-inflammatory properties might help reduce inflammation and improve outcomes in this type of anemia.

Copper

While not a vitamin, copper is an essential trace mineral. It is found in some foods, such as seeds, nuts, legumes, shellfish, organ meats, and dark leafy greens.

Copper is involved in converting food into energy that the body can use. It’s a cofactor for antioxidant enzymes, and the body must synthesize collagen and elastin. Copper is part of the body’s absorption, transport, and use of iron. It helps to convert iron into a form more readily absorbed by the intestines.

Copper also facilitates iron’s incorporation into hemoglobin.

Signs of copper deficiency can include:

•  Anemia, primarily due to impaired iron metabolism. If you don’t have enough copper, your iron absorption and use can be compromised.
• Fatigue and weakness can occur because of anemia related to copper deficiency. Copper deficiency and the resulting anemia can lead to reduced exercise tolerance because there’s less oxygen delivery to tissues, fatigue and weakness.
• Copper deficiency can impair collagen and elastin synthesis, leading to connective tissue disorders such as joint pain, skin abnormalities, and brittle bones.
• Severe copper deficiency can lead to numbness and tingling in extremities, problems walking and cognitive impairment.

As far as anemia and blood cell production, copper is involved in several steps of iron metabolism, including:

• You need copper to absorb dietary iron in your intestines. Copper helps convert ferrous iron into a more easily absorbed form, allowing its uptake by your intestinal cells.
• Copper is required to incorporate iron into transferrin. A protein, transferrin’s role is to transport iron in your bloodstream to different organs and tissues, including your bone marrow, where your red blood cells are produced.
• The mineral is a cofactor for enzymes that are part of the hemoglobin synthesis. If you don’t have enough copper, it can impair your hemoglobin synthesis, decreasing red blood cell production.

Copper is an essential mineral with diverse functions, including energy metabolism, antioxidant activity, and iron metabolism. Being copper deficient can lead to anemia because impaired iron metabolism decreases red blood cell production.

Riboflavin

Riboflavin, or vitamin B2, is found in meat, fish, and poultry. It’s a precursor to two enzymes, FMN and FAD, which play a role in different metabolic pathways, including energy production.

General benefits of riboflavin include:

• Energy metabolism: Riboflavin is necessary to metabolize fats, carbs and proteins. It plays a role in converting these nutrients into energy your body can use.
• Antioxidant activity: The enzymes mentioned above are antioxidant enzymes, and they neutralize free radicals, protecting cells from damage.
• Skin and eye health: Riboflavin supports the health of the skin, eyes and mucous membranes. It’s also involved in collagen production.

Signs that you’re deficient in riboflavin include:

• Mucous membrane disorders. These include cheilosis, cracking fissures at the corner of the mouth, and glossitis, which is tongue inflammation.
• Skin problems include dermatitis, which is inflammation of the skin. Riboflavin deficiency can also lead to seborrheic dermatitis, a scaly rash on the scalp and face.
• Eye disorders like photophobia or light sensitivity, blurry vision and itching or burning eyes.

Riboflavin deficiency can also contribute to anemia because it impairs the absorption and use of iron and other nutrients in red blood cell production.

The B vitamin is needed for the synthesis of ATP, which is the main cellular energy currency. Enough energy production is required for the proliferation and proper maturation of red blood cell precursors in your bone marrow.

Riboflavin also contributes to healthy mucous membranes, including those lining your GI tract. A healthy GI function is necessary for iron and other nutrient absorption. Iron absorption in your GI tract is needed to synthesize hemoglobin and red blood cell production.

Final Thoughts—Vitamins for Anemia

When we think about anemia supplements, our mind tends to automatically go to iron, but many other nutrients can play a role. These include B12, copper, riboflavin and vitamin A, among others. 

Each nutrient uniquely influences red blood cell formation, hemoglobin synthesis and overall blood health. Deficiencies in these key nutrients can contribute directly or indirectly to anemia and symptoms like weakness, fatigue and shortness of breath.