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Iron Deficiency Anemia






Introduction

Iron deficiency anemia is a low red blood cell count or hemoglobin level caused by too little iron in the body. Hemoglobin is a molecule in the red blood cells that carries oxygen to cells throughout the body.
What is going on in the body?
Though anemia has many causes, iron deficiency is the most common. Iron is a very important part of the hemoglobin molecule. When the body does not have enough iron stored, too little hemoglobin is made to fill the red blood cells. The size and number of red blood cells decreases. This cuts down on the body's ability to carry oxygen to the tissues.
What are the causes and risks of the condition?
Iron deficiency anemia occurs when iron intake cannot keep pace with iron loss. This can be due to:
  • blood loss, such as gastrointestinal bleeding or heavy menstrual bleeding
  • decreased ability to absorb iron from the diet, which can occur with bowel disorders
  • growth spurts, which increase the body's need for iron
  • low intake of iron in the diet
  • pregnancy and breastfeeding, which increase a woman's need for iron
  • taking certain medications that interfere with iron, such as antacids
    • Women of childbearing age, pregnant women, children, and teens are at the greatest risk for this 
    condition.


    What are the signs and symptoms of the condition?
    Iron deficiency anemia doesn't cause symptoms right away. The symptoms, which develop slowly over time, may include the following:
  • dizziness or lightheadedness
  • fatigue and weakness
  • headache
  • irritability
  • less endurance in exercise
  • pale skin and eyes, called pallor
  • pica, a condition in which the person craves nonfood items such as ice
  • rapid heartbeat
  • shortness of breath, especially with exercise    


    • How is the condition diagnosed?
    Diagnosis of iron deficiency anemia starts with a medical history and physical exam. Blood tests, including a complete blood count or CBC, may be ordered. Further tests may be needed to determine the reason for the low iron if it is not clear. For example, screening tests for colon cancer can detect blood in the stool.
    A bone marrow biopsy may be done in complex cases. The biopsy involves inserting a special needle through the skin into the hipbone. A sample of bone marrow is then taken with the needle. Bone marrow is a soft substance in the middle of some bones. Red blood cells are made in the marrow. Much of the body's iron is stored inside the bone marrow. A sample of bone marrow can be examined to look for iron deficiency

    What can be done to prevent the condition?
    Many cases of iron deficiency anemia can be prevented by eating a diet rich in iron or taking iron supplements. Some of the foods that are high in iron are as follows:
  • dried beans and peas
  • dried fruit and nuts
  • green leafy vegetables
  • iron-fortified breads and cereals
  • liver and other meats
  • poultry and eggs
  • seafood
  • whole grains
    • What are the long-term effects of the condition?
    Almost all problems caused by iron deficiency anemia can be reversed with treatment. However, if the anemia is severe and other health problems exist, it can lead to:
  • confusion
  • congestive heart failure, a condition in which a weakened heart is unable to pump blood effectively throughout the body
  • a heart attack
  • low blood oxygen
  • stroke


    • What are the treatments for the condition?
    The first step in treatment for iron deficiency anemia is to find and correct the reason for low iron levels. For example, the source of blood loss may need to be identified. Iron stores are then replaced. If a person does not have a problem absorbing iron, this can be done through a diet rich in iron or iron supplements. Iron is best absorbed on an empty stomach.
    The individual should follow these dietary guidelines to increase iron stores in the body.
  • Avoid eating foods rich in calcium at the same time as the iron-rich food or supplement because calcium can reduce the absorption of iron.
  • Eat foods rich in iron, as listed in the prevention section above.
  • Eat foods rich in vitamin C, which helps the body absorb iron.
    • Even when the body is healthy, it does not take in iron very well. Because of that, a person may be advised to take iron supplements for several months to a year. Iron should be taken as prescribed by the healthcare provider. If oral iron supplements fail, iron can be given intravenously or through shots into a muscle.
    What are the side effects of the treatments?
    Iron supplements may cause nausea, diarrhea, heartburn, or constipation. Iron poisoning can occur with an overdose of iron pills. When iron is given into a vein or muscle, the healthcare provider will need to monitor the person closely. Taking iron this way can cause:
  • an allergic reaction
  • local pain
  • staining of the skin
    • What happens after treatment for the condition?
    With treatment for iron deficiency anemia, most people can return to normal activities as soon as they desire. Lifelong iron replacement is usually not necessary. The exact treatment and when it may end often depends on the underlying cause as well. For example, some people have colon cancer that has caused blood loss. This may require intensive treatment with surgery and chemotherapy.  



    Reference 
    Mahan, K, MS, RD, CDE & Escott-Stump, S., MA, RD, LDN. (2000). Krause's Food, Nutrition, & Diet Therapy (10th ed.). Pennsylvania: W.B. Saunders Company.

    Somer, E., MA, RD. & Health Media of America. (1995). The Essential Guide To Vitamins and Minerals (2nd ed.). New York: HarperCollins Publishers, Inc.

    Duyff, R., MS, RD, CFCS. (1996). The American Dietetic Association's Complete Food & Nutrition Guide. Minnesota: Chronimed Publishing

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