What to know about iron deficiency anemia
The body uses iron to produce red blood cells, which transport oxygen around the body.
Without enough iron, there may be too few healthy red blood cells to carry sufficient oxygen to satisfy the body's needs.
The result of this situation is called iron deficiency anemia, which can leave a person feeling extremely tired and out of breath.
What is anemia?
When there are not enough healthy red blood cells or hemoglobin present in the body, this is called anemia.
Anemia is a blood condition characterized by a lack of healthy red blood cells or hemoglobin.
Hemoglobin is the part of the red blood cells that binds to oxygen.
When the body does not have enough hemoglobin circulating, not enough oxygen gets to all parts of the body either.
As a result, organs and tissues may not function properly, and a person may feel fatigued.
Iron deficiency anemia occurs when the body does not have enough iron to produce the hemoglobin it needs.
Iron deficiency anemia relates directly to a lack of iron in the body. The cause of the iron deficiency varies, however.
Some common causes include:
- poor diet or not enough iron in the diet
- blood loss
- a decreased ability to absorb iron
Diets that lack iron are a leading cause of iron deficiency.
Foods rich in iron, such as eggs and meat, supply the body with much of the iron it needs to produce hemoglobin. If a person does not eat enough to maintain their iron supply, an iron deficiency can develop.
Iron is found primarily in the blood, as it is stored in red blood cells. An iron deficiency may result when a person loses a lot of blood from an injury, giving birth, or heavy menstruation.
In some cases, slow loss of blood from chronic diseases or some cancers can lead to an iron deficiency.
Decreased ability to absorb iron
Some people are not able to absorb enough iron from the food they eat. This may be due to a problem with the small intestine, such as celiac disease or Crohn's disease, or if a portion of the small intestine has been removed.
Low iron levels are a common problem for pregnant women. The growing fetus needs a lot of iron, which can lead to an iron deficiency.
Also, a pregnant woman has an increased amount of blood in her body. This larger volume of blood demands more iron to meet its needs.
Frequent blood donation may increase the risk of developing an iron deficiency.
Some groups of people have a higher risk of developing iron deficiency anemia.
Groups that are at risk include:
Vegetarians: People, such as vegetarians, who eat a plant-based diet, may be lacking in iron. To combat this, they should be sure to include foods rich in iron, such as beans or fortified cereals. Vegetarians who also eat seafood should consider oysters or salmon, as a part of their regular diet.
Women: Monthly menstrual cycles can put women and teenage girls at an increased risk of iron deficiency.
Blood donors: People who give blood regularly increase their chances of developing an iron deficiency. This is because of the frequent blood loss.
Infants and children: Premature babies and those with a low birth weight can be at risk of iron deficiencies. Also, infants who do not get enough iron through breast milk are at a greater risk. A doctor may advise a breast-feeding woman to add iron-rich formula to their baby's diet if their iron levels are low.
Similarly, children going through growth spurts have an increased risk of iron deficiency. It is important for children to eat a varied and nutrient-rich diet to help avoid iron deficiencies.
Iron deficiency anemia often takes a long time to develop. People may not know they have it until the symptoms are severe.
In some cases, an iron deficiency may improve with no intervention, as a person's situation changes, such as after a woman has given birth.
However, if a person has any symptoms of iron deficiency anemia, they should talk to their doctor.
A person with an iron deficiency can have some of the following symptoms:
- general weakness
- dizziness or lightheadedness
- extreme fatigue
- fast heartbeat
- easily broken and brittle nails
- paler than normal skin
- chest pain
- shortness of breath
- cold hands and feet
- soreness or inflammation of the tongue
- cravings for non-nutritive things, such as dirt, starch, or ice
- poor appetite, especially in children
In milder cases of iron deficiency anemia, a person is unlikely to have more than the normal symptoms described above. However, additional complications can occur if the iron deficiency anemia is left untreated.
Possible complications include:
- slow growth and developmental delays in children and infants
- heart problems, including heart failure or an enlarged heart due to it compensating for lack of oxygen
- pregnancy complications, including low birth weights and an increased risk for premature birth
A blood test may be required to diagnose blood deficiency anemia.
Only a doctor can diagnose iron deficiency anemia. It is important for a person to seek advice from a medical professional if they have noticeable symptoms.
It is likely that a doctor will begin the exam by asking questions about a person's general health. They may examine the skin tone, the fingernails, and under the eyelids to look for physical signs of iron deficiency anemia.
However, since iron deficiency anemia does not always have visible symptoms, a blood test will probably be needed.
A doctor will check the blood for the following:
- the hematocrit or the percentage red blood cells in the total volume of blood
- size and color of the red blood cells, looking especially for smaller pale cells
- low ferritin levels where a shortage of this protein indicates poor iron storage in the blood
- lower hemoglobin levels that are associated with iron deficiency
A doctor may ask further questions or run additional tests to help determine if the iron deficiency anemia is the result of an undiagnosed underlying condition.
These tests may vary, depending on other symptoms a person describes. For example, someone experiencing pain during digestion may require a colonoscopy to see if a gastrointestinal disease is the cause of the iron deficiency.
Treatment and self-management
Iron deficiency anemia is usually treated in two ways, which involve increasing iron intake and treating any underlying conditions.
Doctors may recommend using iron supplements to help correct iron intake levels. Supplements are often available over the counter. It is important to take the supplements as prescribed. This is because too much iron can be toxic and damage the liver.
Furthermore, large amounts of iron can cause constipation. As a result, a doctor may prescribe stool softeners or laxatives to ease bowel movements.
If an underlying condition is found, further treatment may be needed. Treatments for underlying conditions will depend on the problem but may mean additional medications, antibiotics, or surgery.
Self-management involves adding more iron and vitamin C to the diet. Foods rich in iron include beans, red meat, dried fruits, iron-fortified cereals, and peas. Foods rich in vitamin C include citrus fruits, leafy greens, and broccoli.
Whether a person chooses to self-manage or to follow a doctor's recommendations, it is important to remember that correcting iron deficiency will take time. Symptoms may improve after a week of treatment, but it may take several months or longer to raise the iron supply in the blood.