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Iron-deficiency Anemia

Iron-deficiency anemia is a common, easily treated condition that occurs when you don't have enough iron in your body. Low iron levels usually are due to blood loss, poor diet, or an inability to absorb enough iron from foods.

Risk Factors

Infants and Young Children

Infants and young children need a lot of iron to grow and develop. The iron that full-term infants have stored in their bodies is used up in the first 4 to 6 months of life.

Premature and low-birth-weight babies are at even greater risk for iron-deficiency anemia. These babies don’t have as much iron stored in their bodies as other babies do.

Iron-fortified foods for babies or iron supplements, when used properly, can help prevent iron-deficiency anemia in infants and young children. Talk to your child's doctor about your child's diet.

Young children who drink large amounts of cow's milk may be at risk for iron-deficiency anemia. Milk is low in iron, and too much milk may take the place of iron-rich foods in the diet. Too much milk also may prevent children’s bodies from absorbing iron from other foods.

Children who have lead in their blood also may be at risk for iron-deficiency anemia. Lead can interfere with the body’s ability to make hemoglobin. Lead may get into the body from breathing in lead dust, eating lead in paint or soil, or drinking water that contains lead.

Women

Women of childbearing age are at increased risk for iron-deficiency anemia because of blood loss during their monthly periods. About 1 in 5 women of childbearing age has iron-deficiency anemia.

Pregnant women also are at higher risk for the condition because they need twice as much iron as usual. The extra iron is needed for increased blood volume and for the fetus' growth.

About half of all pregnant women develop iron-deficiency anemia. The condition can increase a pregnant woman's risk for a premature or low-birth-weight baby.

Symptoms

Signs and symptoms of iron-deficiency anemia may include brittle nails, swelling or soreness of the tongue, cracks in the sides of the mouth, an enlarged spleen, and frequent infections.

People who have iron-deficiency anemia may have unusual cravings for nonfood items such as ice, dirt, paint, or starch. This craving is called pica.

Some people who have iron-deficiency anemia develop restless legs syndrome (RLS). RLS is a disorder that causes a strong urge to move your legs. This urge to move often occurs with strange and unpleasant feelings in your legs. People who have RLS often have a hard time sleeping.

Diagnosis

Your doctor may order a peripheral smear. For this test, a sample of your blood is examined under a microscope. In people who have iron-deficiency anemia, the red blood cells will look smaller and paler than normal.

Your doctor may recommend tests to measure iron levels in your blood and body. These tests can show how much iron has been used from your body's stored iron. These tests include:

  • Serum iron. This test measures the amount of iron in your blood. The level of iron in your blood may be normal even if the total amount of iron in your body is low. For this reason, other iron tests also are done.
  • Serum ferritin. Ferritin is a protein that helps store iron in your body. A measure of this protein helps your doctor find out how much of your body's stored iron has been used up.
  • Transferrin level, or total iron-binding capacity. Transferrin is a protein that carries iron in your blood. Total iron-binding capacity measures how much of the transferrin in your blood isn't carrying iron. If you have iron-deficiency anemia, you'll have a high level of transferrin that has no iron.

Treatment

Treatment for iron-deficiency anemia will depend on the cause and severity of the condition. Treatments may include dietary changes and supplements, medicines, and surgery.

Dietary Changes and Supplements

Iron

You may need iron supplements to build up your iron levels as quickly as possible. Iron supplements can correct low iron levels within months. Supplements come in pill form or in drops for children.

Large amounts of iron can be harmful. Thus, you should take iron supplements only as your doctor prescribes. Keep iron supplements out of reach from children. This will prevent them from taking an overdose of iron.

Iron supplements can cause side effects, such as dark stools, stomach irritation, and heartburn. Iron also can cause constipation, so your doctor may suggest that you use a stool softener.

Your doctor may advise you to eat more foods that are rich in iron. The best source of iron is red meat, especially beef and liver. Chicken, turkey, pork, fish, and shellfish also are good sources of iron.

The body tends to absorb the iron from meat better than iron in other foods. However, other foods also can help you raise your iron levels.

Nonmeat foods that are good sources of iron include:

  • Spinach and other dark green leafy vegetables
  • Peanuts, peanut butter, and almonds
  • Eggs
  • Peas; lentils; and white, red, and baked beans
  • Dried fruits, such as raisins, apricots, and peaches
  • Prune juice

Iron is added to some foods, such as cereal, bread, and pasta. You can look at the Nutrition Facts label on a food to find out how much iron it contains. The amount is given as a percentage of the total amount of iron you need every day.

Vitamin C

Vitamin C helps the body absorb iron. Good sources of vitamin C are fruits and vegetables, especially guava, red sweet pepper, kiwi, oranges and orange juice, green pepper, and grapefruit juice.

If you're taking medicines, ask your doctor or pharmacist whether you can eat grapefruit or drink grapefruit juice. This fruit can affect the strength of a few medicines and how well they work.

Other fruits rich in vitamin C are strawberries, cantaloupe, papaya, pineapple, and mango. Vegetables high in vitamin C include vegetable and tomato juices, Brussels sprouts, kohlrabi, broccoli, sweet potato, cauliflower, and kale.

Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.

Treatment To Stop Bleeding

If blood loss is causing iron-deficiency anemia, treatment will depend on the cause of the bleeding. For example, if you have a bleeding ulcer, your doctor may prescribe antibiotics and other medicines to treat the ulcer.

If your blood loss is due to a polyp or a cancerous tumor in your intestine, you may need surgery to remove the growth.

If blood loss is due to heavy menstrual flow, your doctor may prescribe oral contraceptives to help reduce your monthly blood flow. In some cases, surgery may be advised.

Treatments for Severe Iron-Deficiency Anemia

If your iron-deficiency anemia is severe, you may get a transfusion of red blood cells. A blood transfusion is a safe, common procedure in which blood is given to you through an IV line in one of your blood vessels. Transfusions require careful matching of donated blood with the recipient's blood.

A transfusion of red blood cells will treat your anemia right away. The red blood cells also give a source of iron that your body can reuse. However, transfusions are only a short-term treatment. Your doctor will need to find and treat the cause of your anemia.

Iron also may be injected into a muscle or through an IV tube into a vein. However, IV iron therapy presents some safety concerns. It must be done in a hospital or clinical setting by experienced staff. This therapy usually is given to people who need iron long-term but can’t take iron supplements by mouth or who need to be treated for iron-deficiency anemia right away.

 

Source

National Heart, Lung, and Blood Institute, USA.