Iron Deficiency & Anemia: Key Facts to Know

Iron deficiency anemia is a common type of anemia - which, is a condition where the blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues. Iron deficiency anemia is also due to insufficient iron. Without enough iron, your body can't produce enough of a substance in red blood cells that enables them to carry oxygen. As a result, iron deficiency anemia may leave you feeling tired and short of breath. 

Iron deficiency anemia can usually be corrected with iron supplementation. Sometimes, additional tests or treatments for iron deficiency anemia are necessary, especially if your doctor suspects that you're bleeding internally. 

Symptoms of Iron Deficiency Anemia

Initially, iron deficiency anemia can be so mild that it often goes unnoticed. However, as the body becomes more deficient in iron and the anemia worsens, the signs and symptoms greatly intensify. 

Iron deficiency anemia signs and symptoms 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
• Unusual cravings for non nutritious substances, such as ice, dirt, or starch
• Poor appetite, especially in infants and children   

If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your doctor. Iron deficiency anemia isn't something to self diagnose or treat, so you must consult with your doctor or other qualified health care professional before taking any medication, supplements, or beginning any health regimen. 

It's key to remember that overloading your body with iron can be dangerous, as excess iron accumulation can damage your liver and cause other complications. 

Causes of Iron Deficiency Anemia

Iron deficiency anemia occurs when your body doesn't have enough iron to produce hemoglobin. Hemoglobin is the part of red blood cells that gives blood its red color, and enables the red blood cells to carry oxygenated blood throughout the body. If you aren't consuming enough iron, or if you're losing too much iron, your body cannot produce enough hemoglobin - thus, leading to iron deficiency anemia. 

Causes of iron deficiency anemia include:

Blood Loss: Blood contains iron within red blood cells, so if you lose blood, you will lose some iron. Women with heavy menstrual cycles are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body, such as from a peptic ulcer, hiatal hernia, colon polyp, or colorectal cancer - can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over the counter pain relievers, especially ibuprofen and aspirin.

Diet: Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron rich foods include: meat, eggs, leafy green vegetables, and iron fortified foods. For proper growth and development, infants and children need iron from their diets as well.

An inability to absorb iron: Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, can lead to iron deficiency anemia.  If part of your small intestine has been bypassed or removed, that may also affect your ability to absorb iron and other nutrients. 

Pregnancy: Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume, as well as be a source of hemoglobin for the baby. 

Risk Factors

The following groups of people may have an increased risk of iron deficiency anemia:

Women: because women lose blood during menstruation, women in general are at greater risk of iron deficiency anemia. 

Infants & Children: Infants, especially those who were low birth weight or born prematurely, who don't get enough iron from feeding, may be at risk of iron deficiency. Children need extra iron during growth spurts. If your child isn't eating a healthy, varied diet, he or she may be at risk of anemia. 

Vegetarians: People who don't eat meat may have a greater risk of iron deficiency anemia if they don't eat other iron rich foods. 

Frequent Blood Donors: People who routinely donate blood may have an increased risk of iron deficiency anemia, since blood donation can deplete iron stores. Low hemoglobin related to blood donation may be a temporary problem that can be remedied by eating more iron-rich foods. 

Complications 

Mild iron deficiency anemia usually doesn't cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following:

Heart problems: Iron deficiency anemia may lead to rapid or irregular heartbeat. Your heart must pump more blood to compensate for the lack of oxygen carried in your blood when you're anemic. This can lead to an enlarged heart, or heart failure. 

Problems During Pregnancy: In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies. The condition is preventable in pregnant women who receive iron supplements as part of their prenatal care. 

Growth Problems: In infants and children, severe iron deficiency can lead to anemia as well as delay growth and development. Additionally, iron deficiency anemia is associated with an increased susceptibility to infections. 

Prevention

You can reduce your risk of iron deficiency anemia by choosing iron-rich foods, such as:

• Red meat, pork and poultry
• Seafood
• Beans
• Dark green leafy vegetables, such as spinach
• Dried fruit, such as raisins and apricots
• Iron-fortified cereals, breads, and pastas
• Peas

Your body absorbs more iron from meat than it does from other sources. If you choose not to eat meat, you may need to increase your intake of iron-rich, plant based foods to absorb the same amount of iron as does someone who eats meat. 

You can also enhance your body's absorption of iron by drinking citrus juice or eating other foods rich in Vitamin C at the same time that you eat high iron foods. Vitamin C in citrus juices, such as Orange Juice, helps your body better absorb dietary iron. 

Vitamin C is also found in:

• Broccoli
• Grapefruit
• Kiwi
• Leafy Greens
• Melons
• Oranges
• Peppers
• Strawberries
• Tangerines
• Tomatoes

To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow's milk is not a good source of iron for babies and isn't recommended for infants under 1 year. After age 6 months, start feeding your baby iron-fortified cereals or pureed meals at least twice a day to boost iron intake. After one year, be sure children don't drink more than 20 ounces of milk per day. Too much milk often takes the place of other foods, including those that are rich in iron. 

PLEASE CONSULT WITH YOUR DOCTOR OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL BEFORE TAKING ANY MEDICATION, SUPPLEMENTS, OR BEGINNING ANY HEALTH REGIMEN. 

Diagnosis & Treatment

To diagnose iron deficiency anemia, your doctor may run specific tests to look for the following:

Red blood cell size & color: With iron deficiency anemia, red blood cells are smaller and paler in color than normal. 

Hematocrit: This is the percentage of your blood volume made up by red blood cells. 

Hemoglobin: Lower than normal hemoglobin levels indicate anemia. 

Ferritin: This protein helps store iron in your body, and a low level of ferritin usually indicates a low level of stored iron. 

Endoscopy: Doctors often check for bleeding from a hiatal hernia, an ulcer, or the stomach with the aid of endoscopy. In this procedure, a thin, lighted tube equipped with a video camera is passed down your throat to your stomach. This allows your doctor to view the esophagus and your stomach to look for sources of bleeding.

Colonoscopy: To rule out lower intestinal sources of bleeding, your doctor may recommend a colonoscopy. A colonoscopy allows your doctor to view inside some or all of your colon and rectum to look for internal bleeding. 

Ultrasound: Women may also have a pelvic ultrasound to look for the cause of excess menstrual bleeding, such as uterine fibroids. 

For treatment, your doctor may recommend over the counter iron tablets to replenish the iron stores in your body. If necessary, your doctor will also treat the underlying cause of your iron deficiency. Your doctor will let you know the correct dose for you or your child. You may be instructed to:

Take iron tablets on an empty stomach: If possible, absorption is better when you take iron tablets on an empty stomach. However, they can also cause stomach upset.

Don't take iron with antacids: Medications that immediately relieve heartburn symptoms can interfere with the absorption of iron. Take iron 2 hours before or 4 hours after you take antacids. 

Take iron tablets with Vitamin C: Vitamin C improves the absorption of iron. Your doctor may recommend taking your iron tablets with a glass of orange juice or with a Vitamin C supplement.

Iron supplements can cause constipation, so your doctor may also recommend a stool softener. Iron also may turn your stools black, which is a harmless side effect.

Iron deficiency cannot be corrected overnight. You may need to take iron supplements for several months or longer to replenish your iron reserves. Generally, you should start to feel better after a week or so of treatment. Ask your doctor when to have your blood rechecked to measure your iron levels. To be sure that your iron reserves are replenished, you may need to take iron supplements for a year or more.  

Once again, PLEASE CONSULT WITH YOUR DOCTOR OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL BEFORE TAKING ANY MEDICATION, SUPPLEMENTS, OR BEGINNING ANY HEALTH REGIMEN.