Comic: Annie Has Anemia

Annie is teaching in a classroom with elementary school kids. There is a chalkboard with a container of chalk with the chalk sticking out of it.

Annie is eyeing the chalk

Annie: Why do I suddenly feel like eating that chalk?

Annie is walking home and looks at dirt next to the sidewalk/grass.

Imagination bubble that is her remembering weird things that she wanted to eat:

Chalk

Lined piece of paper

Soil/dirt

Ice

Annie thought bubble: I sure have been having some weird cravings lately. I really want to eat that dirt, but that seems strange.

Annie is climbing her front porch stairs at her house and gets short of breath

She goes inside and grabs a big cup of ice and starts eating it.

Annie’s mom, enters

Mom: Are you OK? Every time I come over lately, you’re eating a big cup of ice. And you seem to be taking a lot of naps.

Annie: I don’t know. I’ve been craving ice a lot — and also some other strange things like chalk.

Mom: Hmm... I’ve heard of cravings like that, especially for women with heavy bleeding from fibroids like you have. I think you should see your healthcare provider.

The next week …

Annie is at the doctor, a female WOC, mid 40s

Thought bubble “I’m not going to tell her about the weird cravings. It’s too embarrassing!”

Annie: I’ve just been so tired lately, and I’m not sure why.

I’ve also been having really heavy periods because of my fibroids.

Doctor looks at Annie’s mouth (cracks on the sides), brittle nails and overall pale skin.

Doctor uses stethoscope to check heart

In doc office

Doctor: You look pale, your nails are brittle and you said you’ve been tired, weak and short of breath.

You also have an irregular heartbeat. Have you been having any unusual cravings, by chance?

In doc office

Annie: Now that you mention it, I have had some strange cravings. I thought I was losing it!

In doc office

Doctor: What types of cravings? Were they things like dirt or ice?

Annie: Yes! Exactly! How did you know? I keep craving dirt, ice and chalk. It’s been really strange.

Doctor: Those non-food cravings are called pica. And they can come from having severe anemia, which is really low iron. This could be because of your heavy bleeding from your fibroids. Let’s run some bloodwork and see. We’ll also check your vitamin D levels.

A week later …

Annie is back at the doctor in different clothes

Foods heavy in iron:

Meat

Eggs

Nuts

Iron-fortified bread & cereal

Fruit & dried fruit

Dark leafy green vegetables

Legumes

Doctor: Well Annie, your bloodwork shows that you’re severely anemic and low on vitamin D.

I’m going to prescribe an iron pill and a vitamin D supplement to help get your levels back up. If the iron pills don’t work, we can refer you to a hematologist to discuss other options. Also, be sure to add iron-rich foods to your diet.

Annie: Thanks. I’ll start taking these today. Is there anything else I should know?

Doctor: Sometimes taking iron can make you constipated so be sure to get enough fiber.

I can help with the anemia for now, but you should talk to your OB-GYN about your heavy bleeding and fibroids. There are treatment options that could help you.

3 Months Later …

Annie is at the fridge extending a glass of water with 2 cubes of ice in it to her mom and has 2 cubes in her own glass as well.

The mom and Annie clink glasses.

Annie: I’m feeling so much better — and look, mom, I’m back to 2 ice cubes!

Mom: I’m so glad. Cheers to healthy iron levels!

For more information, please visit HealthyWomen.org

This resource was created with financial support from Myovant Sciences GmbH and Pfizer.