Image showing a blood sample being tested for iron deficiency anemia.

A Layman’s Guide to Iron Deficiency Anemia

Iron deficiency anemia is the most common cause of anemia worldwide, a blood disorder that affects your red blood cells. It is a condition in which your blood has low red blood cell count (RBC).

Iron deficiency anemia is due to insufficient iron in your body. Iron is an important dietary mineral, which is a key part of your red blood cells.

Your Red blood cells carry oxygen from your lungs to the tissues in your body. Your tissues produce energy with the oxygen and remove a waste, known as carbon dioxide, from your body.

Red blood cells contain haemoglobin, an iron-containing protein, that transports oxygen around your body. And, Iron is required to form haemoglobin in order to carry oxygen and remove carbon dioxide from your body.

If you’re suffering from iron deficiency, you may often experience nonspecific complaints such as fatigue and shortness of breath. People with condition may have a longer hospital stay, along with a higher number of adverse events.

Daily Requirement of Your Iron Intake

  • 8.7 mg a day for people over 18 years
  • 14.8 mg a day for women between age 19 and 50
  • 8.7 mg a day for women over 50 years

Symptoms of Iron-Deficiency Anemia

Symptoms of iron deficiency anemia can be mild initially, and therefore may not be noticeable. But when they become more severe, you may have symptoms such as:

  • Abnormally pale or yellow skin
  • Fatigue, lack of energy or weakness
  • Shortness of breath or chest pain, especially during activity
  • Unexplained generalised weakness
  • Rapid heartbeat
  • Pounding or whooshing in the ears
  • Headache, especially during activity
  • Pica (cravings for things that are not food such as dirt, starch, clay or ice)
  • Sore or smooth tongue
  • Brittle nails
  • Hair loss
  • Cracks near the side of your mouth
  • Enlarged spleen
  • Irritability
  • Restless legs syndrome
  • Cold feet and hands
  • Dizziness

These symptoms can also manifest because of your other underlying medical conditions, so always consult your Doctor.

How Iron Deficiency Anemia is Developed

Iron deficiency anemia is developed in 3 consecutive stages:

Stage 1
In this stage, your iron stores are depleted, the supply of iron to make new haemoglobin and red blood cells is reduced but your red blood cells remain unaffected.

Stage 2
At this stage, the normal process of making your red blood cells is altered, and you develop latent iron deficiency. Also, your bone marrow makes red blood cells without sufficient haemoglobin.

Stage 3
In this stage, iron deficiency anemia develops due to lack of enough iron to make haemoglobin for your red blood cells. Your haemoglobin concentration drops below the normal range, and you may begin noticing iron deficiency anemia symptoms.

Causes

Iron deficiency anemia may be caused by factors and conditions, such as:

Blood Loss

If you lose blood, you lose iron. Loss of blood can cause a decrease of iron in your red blood cells and result in iron deficiency anemia. Sources of your blood loss may include GI bleeding, menstrual bleeding or injury.

You could also lose blood from Peptic ulcer, hernia ,uterine fibroids and colon polyps. Some causes also include heavy menstrual periods, frequent blood donations and regular nosebleeds.

Diet Low in Iron Intake

Iron is a dietary mineral, and is gotten from from the foods you eat. For every 10 to 20 mg of iron ingested, you absorb only 1 mg of it. This could lead you to iron deficiency anemia.

Eating iron-rich foods like meat, eggs and some green leafy vegetables can help you.

Inability to Absorb Iron

As an adult, you absorb only about 10 to 15% of dietary iron, but others may not be able to absorb iron into their bloodstream in the small intestine due to certain reasons.

Digestive condition, such as celiac disease, can affect your intestine’s ability to absorb iron from digested food, which can lead you to iron deficiency anemia. Also surgeries (bariatric procedures, especially gastric bypass operations) performed on your small intestine may affect your ability to absorb iron.

Exercise and Workouts

If you’re an athlete and doing regular exercise, you may be prone to iron deficiency. That’s because regular exercise increases your body’s need for iron in many ways.

Also, training hard improves your blood cell production that requires iron, but much of it lost when you sweat a lot during your exercise.

Pregnancy

Pregnant women are prone to iron deficiency anemia because they need extra iron to nourish their developing babies (a source of haemoglobin for the growing fetuses).

They need to get enough iron from iron-rich diets or supplements to increase iron in their red blood cells.

Dialysis for End-Stage Kidney Failure

People may lose much blood during dialysis for end-stage kidney failure, and medications taken during such periods can also result in iron deficiency anemia.

Medications

Anti-inflammatory drugs can cause internal gastrointestinal bleeding. Proton pump inhibitors, used for the control of your acid reflux, can prevent your body from absorbing enough iron into your red blood cells.

Genetics

Two inherited diseases, hemophilia and von Willebrand disease, can make you to bleed more and lose your iron.

Are You At Risk of Iron Deficiency

You are at the increased risk of iron deficiency anemia, if you fall under any of these following groups.

  • Women who menstruate or are pregnant or breastfeeding or have given birth to a baby recently
  • People who have undergone major surgery
  • People with celiac disease and inflammatory bowel diseases such as ulcerative colitis or Crohn disease. And persons with peptic ulcer disease.
  • Patients who have undergone bariatric procedures, notably gastric bypass operations
  • Vegetarians and vegans who don’t eat meat may have a greater risk of iron deficiency anemia.
  • Children between 6 months and 2 years and adults above 65 years could be at high risk of iron deficiency anemia.
  • Frequent blood donors are at the high risk
  • Those exposed to lead in water or in their environment.
  • Athletes who physically exert a lot and sweat

Diagnosis

Complete Blood Count

Iron deficiency anemia is diagnosed through blood tests include a complete blood count (CBC). This comprehensive test allows your Doctor to evaluate each type of cell in your blood that includes:

  • red blood cells (RBCs)
  • white blood cells (WBCs)
  • haemoglobin (shows the amount of this protein in your blood. If you have anemia, your haemoglobin will be low)
  • hematocrit (shows how much of your blood is made up of red cells)
  • platelets

Serum Iron Test

This test is to determine how much iron is in your blood.

Ferritin Blood Test

This test measures the amount of your particular blood protein called ferritin, which stores iron.

A Total Iron-Binding Capacity Test (TIBC Blood Test)

This test shows you how much transferrin in your blood is binding to iron, which tells you how well iron is functioning in your body.

Reticulocyte Count Test

This test measures the number of reticulocytes in your blood. If the count is too high or too low, it can mean a crtical health issue, including anemia.

Once your blood tests show that you have iron deficiency anemia, your Doctor may further suggest these following additions tests for you.

Fecal occult blood test

It’s a lab test used to check stool samples for hidden (occult) blood. Occult blood means you can’t see it with your naked eye.

Pelvic Ultrasound

By this test you can find out why you are bleeding a lot during your monthly periods.

Endoscopy

An endoscopy is a test to look inside your body. In this case, a lower GI endoscopy test that allows your doctor to examine the lining of your colon.

Treatment

If you have severe iron deficiency anemia, you should limit your physical activity until it is corrected.

Once the cause of your iron deficiency has been identified and treated, it may still be necessary to take iron supplements until your deficiency is corrected and your body’s iron stores are increased.

In certain cases, if the cause cannot be identified or corrected, the person may have to receive supplemental iron on an ongoing basis.

Let’ see how your iron deficiency anemia can be treated through the following:

Increasing Iron Intake Through Diet

  • Beef, pork or lamb and organ meats such as liver
  • Chicken, turkey, chicken or turkey liver and dark meat
  • Fish like shellfish, sardines, and anchovies
  • Leafy greens like broccoli, kale, turnip greens and collard greens
  • Legumes that include lima beans, peas, pinto beans and black-eyed peas
  • Iron-enriched pastas, grains, rice and cereals
  • Dried fruits, such as prunes and raisins

Blood Transfusion

If taking iron supplements or eating iron-rich diets don’t help you, you Doctor will ask you to go for a red blood cell transfusion (intravenous iron).

This transfusion increases your haemoglobin and iron levels, while improving the amount of oxygen in your body.

Prevention

Iron fortification remains one of the important efforts aimed towards better treatment or prevention of iron deficiency anemia.

Dietary supplements alone can’t prevent or treat. It is also your gut that must be able to absorb iron to prevent or treat iron deficiency anemia.

Here, a personalised recommendation of your daily iron requirements can help you effectively. But coupled with lifestyle recommendations tailor-made for you, you can positively overcome your iron deficiency.

 

If you have a question related to this blog post, write to us here and we will update this post with a response.

Sources: Mayo Clinic, Healthline, Medline Plus, American Society of Hematology, Johns Hopkins, National Library of Medicine, Cleveland Clinic, Better Health Channel and WebMD.

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