Happy Thanksgiving David! I am helping a young woman (23) with what appears to be iron deficiency anemia. Low MCH, Low MCV, and borderline Low MCHC. She is also presenting with a high RDW, I suspect from a Vitamin C deficiency. Symptomology includes extreme fatigue, tachycardia, brain fog, etc. She has also recently visited a gynecologist. I asked her if it was due to heavy menstrual bleeding. She said, "How did you know?" Goodness!! I have recommended an additional iron panel, including total iron, ferritin, TIBC, and % saturation rate to confirm. I am also recommending a methylated B complex, Vitamin C, Magnesium bisglycinate, DHA/EPA fish oil (for other reasons), and Zinc. After confirming iron deficiency anemia, I would like to recommend herbal therapeutics, and therein lies my question. In pouring over my Materia Medica, I have written down several times that Ashwagandha needs to be taken in powdered form for anemia. H&A Iron Extract would be a fantastic formula to support her, but I am noticing that the Ashwagandha in the formula is obviously a tinctured form. Would it be beneficial or acceptable to have her add Ashwagandha powder in milk on top of taking the tinctured formula? I believe the tinctured Ashwagandha will be extremely beneficial for her for stress management, sleep, etc., but would also like to use it specifically for iron deficiency as well. Would I be overloading her on Ashwagandha if it were given in both forms? Thank you, David:) Jami

A high RDW is a sign of iron deficiency anemia. Yes, H & A's tinctures are spagyric and so contain more iron than a normal tincture. Would I be overloading her on Ashwagandha if it were given in both forms? No, but i would also give an iron supplement and if she is not vegetarian or vegan, heme iron (red meat)

David, Thank you:)