A little more than a year ago, I developed a deep craving for baby carrots. We always had a bag in the fridge, and more often than not it would molder in the vegetable drawer. I wanted to like them more than I did, but even with hummus available, I didn’t eat them with any regularity. That is until one day when I decided to snack on a carrot and it satiated some sort of craving I didn’t realize I had. It felt good; it tasted good; I wanted more of them. I started buying bag after bag of baby carrots and would go through a 16 oz bag in a couple of days. When my husband would go shopping, the only item I needed more of was carrots. I packed them in my purse to have whenever I needed one. I started buying the two pound bags so I wouldn’t have to go to the grocery store as often during the week, but I would still make quick work of them. I would lie in bed at night, reading a book and randomly say to Spence, “You know what would be really good right now. A carrot.” We would be driving somewhere and I would say, “I really wish I had some carrots with me.” At times, Spence would question the health of eating so many carrots. I was nothing short of addicted to them, which is never a good attitude to have toward anything. Not even something healthy. I Googled carrot cravings and would read stories about people whose skin turned orange from eating so many. I hadn’t reached that point, surprisingly. I mostly wanted to know if a sudden and intense passion for carrots indicated some sort of nutrient deficiency. It wasn’t clear from the web search.

In April of this year, my dog Lucy bit my index finger when I was trying to keep her from attacking our other dog. It was a bad bite—she cracked off a small piece of my knuckle. Five days of antibiotics didn’t relieve the swelling in my finger, so the urgent care team directed me to the E.R. for liquid antibiotics. The place was busy, so I sat on a cot in the hallway waiting to be seen. They did an x-ray of my finger, which is how I learned about the chipped knuckle. Eventually a nurse came over to take blood. “Why do you need to take blood,” I asked. “Oh, it’s part of our standard procedure to check a patient’s panel and make sure everything looks okay.” She made her draw and then I went on listening to a podcast on my phone, grateful that I had my earbuds with me.

A while later, the E.R. doctor came over to me and asked how I was feeling. “Okay,” I said. “Has anyone ever told you your hemoglobin levels are low,” she asked. “I don’t think so,” I said. “I mean really, really low. Like, I should offer you a blood transfusion,” she said. I scrunched my face. “Really?” “Yes,” she said. “You’re feeling okay?” “I’m feeling like I usually do,” I said. “You look okay,” she responded. “But your iron levels are at 6.6 and typically anything under 7 requires a blood transfusion.” (I learned later that normal is 12-18) “That can’t be right,” I told her. “We can run the bloodwork again if you want,” the doctor said. “Maybe it’s a mistake.” “Let’s do that,” I responded.

The next result showed my blood iron even lower. I was flummoxed. I declined the blood transfusion, but was sent home with a prescription for iron and instructions to follow up with my primary care physician within ten days. I was in between PCPs at this point, but had an appointment to meet my new doctor in a month, so decided to keep taking iron in the meantime and discuss with my PCP at my first appointment with her.

I’ve been vegan for six years and I know the vegan diet often needs supplementation, but too much iron or b12 also causes problems. I had always assumed I was getting enough of these vitamins in my food, so I didn’t want to risk the problems that occur if you took too much in supplementation. Based on all the various tests that followed my visit to the E.R., the anemia was caused by diet, and more bloodwork showed I also needed b12 supplementation.

And as my iron levels improved, my craving for carrots vanished. Suddenly I was back to my usual feelings about the orange vegetable, which was total ambivalence. I didn’t even finish the bag that was half empty in my fridge. I knew these two things had to be connected—my anemia and my obsessive craving for carrots. Just last night, I did a google search on the two topics and learned of other cases where people had anemia and an out-of-the-blue desire for carrots. It’s called pica, a type of eating disorder. Most of the time it’s when people want to eat non-food items. A common craving for people with anemia is dirt. But when you have a nutritional deficiency that is triggering a compulsive eating of one type of food, that is also called pica.

Now my numbers are up and I’m feeling dynamic and energetic. I’m actually amazed at all the symptoms I ignored, assuming they were from being out of shape or depressed, since I’m still mourning my brother’s death. I would get winded SO easily while walking uphill…not a problem I had before but one I attributed to not exercising enough. I was tired often, wanting to nap. In the winter, my lips were cracked and peeling constantly. My fingernails were thin and breaking. All of these were symptoms. And untreated anemia can be life threatening—just a slow sapping of your life force. I give Lucy credit for saving my life, and I’m kidding only a little. I don’t know why my most recent doctor hadn’t checked my iron levels during my annual physical, but because Lucy bit me and sent me to the E.R., I caught the numbers when they were dangerously low and was able to turn it around.