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Iron Deficiency Anemia

Overview

Iron deficiency anemia is one of the most common types of anemia. It occurs due to a lack of sufficient iron in the body required to make hemoglobin. Hemoglobin is the protein present in your red blood cells that enables them to carry oxygen. Because of reduced hemoglobin, the oxygen-carrying capacity of your blood decreases. This means that the rest of your body tissues will not be delivered the oxygen it requires, which can slow down functions. Iron deficiency anemia can be treated to restore normal body functions. 

Causes

Multiple factors are involved in the development of iron deficiency anemia. Blood loss is one important cause. Women with heavy menstrual bleeding lose more iron than women with regular bleeding. This is frequent in females who have endometriosis. Chronic bleeding due to other causes such as gastrointestinal ulcers or hernia can also lead to iron-deficiency anemia. Lack of iron in your diet can also make your body iron-deficient. Foods that contain a high amount of iron include meat, eggs, and green leafy vegetables. Pregnant females may also suffer from iron deficiency because their body requires more iron to create blood cells for the baby.

Some underlying medical conditions can be responsible for reduced iron uptake from your intestines. This includes celiac disease and a few other genetic diseases which can affect the absorption of nutrients from your digestive tract. If a part of your intestines has been removed during surgery, that may also affect the absorption of nutrients from your diet. 

Risk Factors And Epidemiology

Iron deficiency anemia can affect any person, but women are particularly at risk because of blood loss during menstruation and increased iron demand during pregnancy. Premature babies or those with low birth weight can also be at risk if they do not get sufficient breastfeeding. Dietary factors also play a significant role. Vegetarians can develop iron deficiency anemia because they do not eat meat. Those who rely heavily on junk food are also at risk. People who donate blood very often also have an increased risk.

People of all age groups can be affected by this condition, but it is more common among older adults. According to an estimate, 720-1360 per 100,000 people are affected by iron deficiency anemia every year. 

Signs And Symptoms

The signs and symptoms of iron deficiency anemia may go unnoticed for a long time if they are mild in nature. If the deficiency is severe, anemia will progress, presenting with multiple symptoms. These include fatigue, generalized weakness, pale skin color, cold hands and feet, chest pain, rapid heartbeat, shortness of breath, loss of appetite, headache or dizziness, tongue soreness, and brittle nails. Some people may also develop cravings for non-nutritional items such as dirt or starch. 

Diagnosis

The diagnosis of iron deficiency anemia usually begins with obtaining your history and performing a brief physical examination. Your doctor will ask questions about your diet, menstrual blood loss, and other factors that may have led to this condition. The physical examination involves looking for clinical signs such as pale skin color, increased heartbeat, shortness of breath, etc. The basic test performed for diagnosing iron deficiency anemia is a complete blood count (CBC). Low hematocrit and low hemoglobin levels in CBC can be an indication. Your doctor may require additional blood tests to provide information about the iron level, ferritin level, and total iron-binding capacity. If an internal cause is suspected (such as gastric ulcehbrs), specific tests and imaging methods will be necessary to confirm its diagnosis. 

Differential Diagnosis

Iron deficiency anemia needs to be differentiated from other types of anemia and medical conditions with similar symptoms. These include thalassemia, sideroblastic anemia, sickle cell anemia, lead poisoning, G6PD deficiency, HbC disease, pyruvate kinase deficiency, and a few other conditions. 

Treatment

Iron supplements are the mainstay of treatment for iron deficiency anemia. Iron supplements should be taken as directed by your doctor. It is recommended to take these supplements on an empty stomach with a vitamin C drink as it improves absorption. Taking antacids along with iron supplements should be avoided. If you have an underlying cause, it is also treated to reduce iron loss. Oral contraceptives can be given for heavy menstrual bleeding or antibiotics for cases of peptic ulcers. Your doctor will also suggest including iron-rich foods in your diet, such as red meat, leafy vegetables, and iron-fortified cereals. In very severe cases, red blood cell transfusion or intravenous iron can be given to treat this condition.

Iron supplements alone are often sufficient enough to treat iron deficiency anemia. Medications are only required if you have an underlying condition responsible for iron or blood loss. You should consult with a doctor before taking any over-the-counter medications to check if they will interact with your iron supplements. 

Prognosis

Iron deficiency anemia can be treated completely, but it can take a few months or even more. The deficiency occurs for a long time, so it may take some time to recover from it as well. With a proper diet and intake of iron supplements, your symptoms will begin to disappear within the first 2 or 3 months. It takes longer to treat this condition in those with chronic disease. In such cases, the underlying disease will need to be addressed along with the intake of iron supplements. 

Prevention

Iron deficiency anemia can be prevented by increasing the intake of iron-rich foods. The absorption of iron from these food substances increases if you take it with foods or drinks rich in vitamin C. These include citruses, broccoli, kiwi, grapefruit, melons, etc. Females with heavy bleeding or pregnant women should get their iron levels checked and take iron supplements in advance. Newborns should be adequately breastfed or given iron-fortified formula milk to prevent iron deficiency.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 07, 2023.

 

References

https://www.hematology.org/education/patients/anemia/iron-deficiency

https://www.nhlbi.nih.gov/health/anemia/iron-deficiency-anemia

https://www.mdpi.com/2072-6643/12/2/447

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