Overview
Iron deficiency anemia is a type of anemia in which the body lacks sufficient healthy red blood cells due to insufficient iron. Red blood cells carry oxygen to the body's tissues, and without enough iron, the body cannot produce enough hemoglobin, a substance that enables red blood cells to carry oxygen. This can result in feelings of fatigue and shortness of breath. Iron deficiency anemia can usually be corrected with iron supplementation. If a doctor suspects internal bleeding, additional tests or treatments may be necessary.
Understanding the disease
Symptoms
The symptoms of iron deficiency anemia include extreme fatigue, weakness, pale skin, chest pain, fast heartbeat or shortness of breath, headache, dizziness or lightheadedness, cold hands and feet, inflammation or soreness of your tongue, brittle nails, and unusual cravings for non-nutritive substances. Other symptoms specific to iron deficiency anemia that may occur due to heavy menstrual bleeding are headaches, feeling tired, and severe pain during menstrual cramps.
Risk Factors
The risk factors for developing iron deficiency anemia include:
- Intestinal disorders: Conditions such as celiac disease or Crohn's disease that affect the intestine's ability to absorb nutrients can contribute to iron deficiency anemia.
- Menstrual periods: Women who experience heavy periods may lose a significant amount of iron, increasing their risk of iron deficiency anemia.
- Pregnancy: Pregnant individuals who do not take a multivitamin containing folic acid and iron are at higher risk of developing iron deficiency anemia.
- Ongoing or chronic conditions: People with cancer, kidney failure, diabetes, or other chronic conditions are more likely to develop anemia due to chronic diseases.
- Slow, chronic blood loss: Internal bleeding from sources like ulcers can cause iron deficiency anemia over time.
- Family history: Inherited anemias, such as sickle cell anemia, can run in families and increase the risk of iron deficiency anemia.
- Other factors: Certain infections, blood diseases, autoimmune conditions, excessive alcohol consumption, exposure to toxic chemicals, and certain medications can contribute to anemia.
- Age: People over 65 years old are at an increased risk of anemia.
Development
Iron deficiency anemia develops when there is insufficient iron in the body. This can occur due to various reasons such as inadequate iron intake, excessive iron loss, or poor iron absorption.
- Inadequate iron intake: This is the most common cause of iron deficiency anemia. It occurs when an individual does not consume enough iron-rich foods or supplements to meet the body's requirements.
- Excessive iron loss: This can happen due to blood loss from various sources such as menstrual bleeding, internal bleeding from an ulcer or cancer, or heavy sweating during intense exercise.
- Poor iron absorption: Certain medical conditions or lifestyle factors can interfere with the body's ability to absorb iron from food. Examples include intestinal disorders like celiac disease, inflammatory bowel disease, or surgical removal or bypass of the small intestine. Additionally, consuming excessive amounts of calcium, tea, or coffee can reduce iron absorption. In pregnant women, iron deficiency anemia can occur due to increased blood volume and the growing fetus's demand for iron, as well as inadequate iron intake or absorption.
Assessment and Diagnosis
Triage
You should see a doctor if iron deficiency anemia is suspected. Iron deficiency anemia isn't something to self-diagnose or treat. Symptoms include poor appetite, fatigue, weakness, pale skin, chest pain, headache, dizziness, cold hands and feet, and unusual cravings. It's essential to get a proper diagnosis from a doctor rather than taking iron supplements on your own, as overloading the body with iron can be dangerous and cause complications.
Diagnosis
To diagnose iron deficiency anemia, your doctor will typically perform blood tests after you have been fasting. These tests may include:
- Serum transferrin saturation: This test measures the amount of iron bound to the protein transferrin in your blood. Transferrin saturation values greater than 45% are considered too high.
- Serum ferritin: This test measures the amount of iron stored in your liver. Low levels of ferritin indicate low stored iron in your body.
- Complete blood count (CBC): This test evaluates your red blood cell count, size, and appearance. It can help identify anemia and provide information about other blood cell parameters. If the blood tests indicate iron deficiency anemia, your doctor may order additional tests to identify the underlying cause, such as endoscopy or liver function tests. Treatment for iron deficiency anemia typically involves iron supplements and dietary changes to increase iron intake.
Management and Treatment
Complications
Potential complications of iron deficiency anemia include heart problems, such as a rapid or irregular heartbeat, an enlarged heart, or heart failure; problems during pregnancy, including premature births and low birth weight babies; growth problems in infants and children, such as delayed growth and development, and an increased susceptibility to infections; and extreme fatigue, weakness, pale skin, chest pain, fast heartbeat or shortness of breath, headache, dizziness or lightheadedness, cold hands and feet, inflammation or soreness of the tongue, brittle nails, and unusual cravings for non-nutritive substances, such as ice, dirt, or starch.
Prevention
iron deficiency anemia can be prevented by following a healthy diet that includes iron-rich foods. Consuming iron-rich foods such as red meat, pork, poultry, seafood, beans, dark green leafy vegetables, dried fruit, and iron-fortified cereals, breads, and pastas can help maintain adequate iron levels. Eating foods rich in vitamin C, like citrus fruits, broccoli, peppers, and tomatoes, can enhance iron absorption from non-meat sources. Pregnant women may require iron supplementation to prevent iron deficiency anemia.
Treatment
Treatments for iron deficiency anemia typically involve iron supplementation and, in some cases, addressing any underlying causes of bleeding or poor iron absorption. Iron supplements can come in various forms, such as pills, capsules, or liquid, and are usually taken orally. In some cases, your doctor may recommend intravenous (IV) iron supplementation, especially if you have severe anemia or are unable to take oral supplements. In addition to iron supplements, your doctor may suggest dietary changes or recommendations to increase iron intake. Eating a diet rich in iron-rich foods, such as red meat, poultry, seafood, beans, dark green leafy vegetables, and fortified cereals, can help improve iron levels. Consuming vitamin C-rich foods, like citrus fruits, broccoli, and peppers, can enhance iron absorption from non-meat sources. If an underlying cause of bleeding is identified, such as heavy menstrual periods or an ulcer, treating the underlying condition can help resolve the anemia. In cases of hemochromatosis, a genetic disorder that causes excessive iron absorption, regular blood removal through phlebotomy (venesection) is the primary treatment to reduce iron overload and prevent further complications. It's important to consult with a healthcare professional for personalized advice and appropriate treatment recommendations based on the severity of the iron deficiency anemia and any underlying conditions.
Preparing for medical consultation
To prepare for an appointment for iron deficiency anemia, you should:
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment.
- Note down key personal information, such as any major stresses, recent life changes, and medical devices you have in your body.
- Make a list of all medications, vitamins, or supplements you're taking, including the doses.
- Prepare a list of questions to ask your doctor. Some basic questions to ask include:
- What's the most likely cause of my symptoms?
- Are there other possible causes for my symptoms?
- Is my condition likely temporary or long-lasting?
- What treatment do you recommend?
- Are there any alternatives to the primary approach you're suggesting?
- How can I best manage other health conditions with this condition?
- Are there any dietary restrictions I need to follow?
- Are there any brochures or other printed materials I can take with me? What websites do you recommend? By gathering this information and preparing questions ahead of time, you can make the most of your appointment and have a productive conversation with your doctor.