Iron Disorder Anemia Iron Deficiency

Iron deficiency anemia is one of the most common nutrition disorders in the world. An iron deficiency often results in low hemoglobin levels in the red blood cells. Iron deficiency anemia symptoms occur most often in women: one in five American women have iron deficiency anemia, and over fifty percent of pregnant women exhibit anemia symptoms. The disease is less common in men: approximately three percent of American men have iron deficiency anemia.

Low Hemoglobin and Iron Deficiency Anemia

Iron is essential for the production of healthy red blood cells. Iron deficiency results in low hemoglobin levels, which reduces the red blood cells’ ability to transport oxygen through the body.

Iron deficiency anemia affects red blood cells in several ways. Besides reducing red blood cells’ oxygen-carrying capacity, low iron levels prevent the bone marrow from producing hemoglobin and red blood cells fast enough to meet the body’s demands.

Low hemoglobin levels even change the appearance of red blood cells. Normal, healthy, iron-rich hemoglobin has a bright red color. Red blood cells with low hemoglobin levels are paler in color and smaller in size than regular red blood cells.

Causes of Iron Deficiency Anemia

A lack of dietary iron is one of the most common causes of iron deficiency anemia and low hemoglobin. This is especially true for pregnant women, who often require an iron supplement to prevent anemia symptoms during pregnancy.

Pregnancy increases a woman’s blood volume, and the growing fetus also requires iron. To avoid low hemoglobin and anemia symptoms, pregnant women require as much as thirty milligrams of dietary iron.

Other causes of iron deficiency anemia include:

  • bladder cancer
  • bleeding during childbirth
  • blood loss
  • colon polyps
  • colorectal cancer
  • heavy menstrual bleeding
  • hemorrhoidal bleeding
  • hiatal hernia bleeding
  • hookworms (rare in the U.S.)
  • kidney cancer
  • peptic ulcer bleeding
  • uterine fibroids.

Malabsorption disorders can also cause iron deficiency anemia. Intestinal disorders such as Crohn’s and celiac disease can impair iron absorption, leading to low hemoglobin levels and anemia symptoms. Some medications can also hinder iron absorption, as can intestinal bypass surgery or removal of portions of the intestine.

Risk Factors for Iron Deficiency

Iron deficiency occurs in people who experience:

  • heavy menstrual bleeding
  • pregnancy
  • low iron diets
  • bleeding conditions
  • growth spurts (in infants and children)
  • malnutrition.

Iron Deficiency Anemia Symptoms

Low hemoglobin levels are responsible for most iron deficiency anemia symptoms. Anemia symptoms are initially mild, but become worse as iron levels continue to drop.

Iron deficiency anemia symptoms include:

  • brittle nails
  • cold hands or feet
  • fatigue
  • headaches
  • an inflamed or sore tongue
  • lightheadedness
  • a low appetite
  • pale skin
  • shortness of breath
  • weakness.

Some people experience restless legs syndrome as part of their iron deficiency anemia symptoms. Restless legs syndrome is an uncontrollable urge to move the legs that often disrupts sleep.

Pica, the urge to eat inedible substances, is one of the most unusual of the iron deficiency anemia symptoms. Although it’s uncommon, some people with iron deficiency anemia do develop pica, and may have cravings for ice, dirt, starch and other substances.

Diagnosing Iron Deficiency Anemia

If iron deficiency anemia is suspected, a history of possible anemia symptoms and risk factors is gathered. Blood tests can then confirm the presence of anemia.

Blood tests used to diagnose iron deficiency anemia include the following:

  • complete blood count (CDC): This test can confirm low hemoglobin levels.
  • peripheral blood smear: In iron deficiency anemia, red blood cells take on a small, pale appearance that can be seen through a microscope.
  • reticulocyte count: The reticulocyte count measures the number of immature red blood cells. It can detect abnormalities before anemia symptoms develop.
  • serum ferritin: This test measures the total iron content in the body.
  • serum iron: This determines the amount of iron present in the blood.

Iron Deficiency Anemia and Global Diet

A country’s iron deficiency anemia rate is often related to the amount of meat in the country’s diet. Countries with mostly vegetarian diets have rates of iron deficiency anemia six to eight times higher than North American and European countries, where meat is more likely to be a staple of the diet.

Iron Supplement Therapy

Increasing iron in your diet helps relieve anemia symptoms, but an increase in dietary iron alone is rarely sufficient to reverse low hemoglobin levels. Iron supplement tablets are often prescribed to rebuild the body’s iron reserves.

An iron supplement should be taken only on the advice of a medical professional. The misuse of an iron supplement can result in toxic, organ-damaging iron overload.

Your doctor may recommend an over the counter iron supplement. Very low hemoglobin levels may be treated with a more potent prescription iron supplement called ferrous sulphate. Your doctor may suggest taking the iron supplement with orange juice or a vitamin C tablet, as vitamin C increases iron absorption.

An iron supplement is best taken on an empty stomach. If the iron supplement causes stomach irritation, it may be necessary to take the supplement with a light meal.

Iron supplement treatments turn stool black and often cause constipation. If constipation becomes a problem during iron deficiency anemia treatment, ask your doctor to recommend a stool softener.

Iron supplement therapy does not cure anemia overnight: it may take more than four months to reverse low hemoglobin and alleviate anemia symptoms.

Because of the dangers of iron overload, iron supplements are not generally used as a preventive treatment, but doctors regularly prescribe iron supplement tablets during pregnancy to prevent or treat anemia symptoms.

Other Anemia Treatments

Anemia symptoms can often be relieved by reducing bleeding or eliminating a source of bleeding. This may involve treatment to heal ulcers, or surgery to remove bleeding tumors, fibroids or polyps. Certain medications such as oral contraceptives can lighten a woman’s menstrual flow, reducing blood loss and the risk of anemia.

When iron deficiency anemia becomes severe, blood transfusions are used to replenish iron stores and low hemoglobin levels rapidly. Iron deficiency anemia symptoms must be exceptionally severe to warrant a blood transfusion.

Iron Deficiency Complications

Without treatment, iron deficiency anemia symptoms can become severe, and in some cases, complications can be life-threatening. Anemia complications include:

  • angina and heart attack (when underlying coronary heart disease is present)
  • delayed growth in children
  • high risk of childhood infection
  • high risk of lead poisoning (in children)
  • irregular heartbeat
  • low birth weights
  • physical and mental delays (in children)
  • premature births
  • rapid heartbeat.

Resources

Conrad, M. E. (2005, June 7). Iron deficiency anemia.

Crawford, R. (2001, June). A new perspective on iron deficiency.

Iron Disorders Institute. (2004, March 11). Disorders: Iron deficiency anemia.

Mayo Foundation for Medical Education and Research. (2005, March 7). Iron deficiency anemia.

National Library of Medicine. (updated 2004, August 26). Iron deficiency anemia. MedlinePlus Medical Encyclopedia.

Nemours Foundation. (2003, May). Iron-deficiency anemia.