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Iron deficiency anemia
Anemia is a condition in which the body does not have enough healthy red blood cells.
Red blood cells provide oxygen to body tissues. There are many types of anemia.
Iron deficiency anemia occurs when your body does not have enough iron. Iron helps
make red blood cells.
Causes
Iron deficiency anemia is the most common form of anemia.
Red blood cells bring oxygen to the body's tissues. Healthy red blood cells are made in
your bone marrow. Red blood cells circulate through your body for 3 to 4 months. Parts
of your body, such as your spleen, remove old blood cells.
Iron is a key part of red blood cells. Without iron, the blood cannot carry oxygen
effectively. Your body normally gets iron through your diet. It also reuses iron from old
red blood cells.
You get iron deficiency anemia when your body's iron stores run low. This can occur
because:
You lose more blood cells and iron than your body can replace
Your body does not do a good job of absorbing iron
Your body is able to absorb iron, but you are not eating enough foods that contain iron
Your body needs more iron than normal (such as if you are pregnant or breastfeeding)
Bleeding can cause iron loss. Common causes of bleeding are:
Heavy, long, or frequent menstrual periods
Cancer in the esophagus, stomach, small bowel, or colon
Esophageal varices , usually from cirrhosis
The use of aspirin, ibuprofen, or arthritis medicines for a long time, which can cause
gastrointestinal bleeding
Peptic ulcer disease
The body may not absorb enough iron in your diet due to:
Celiac disease
Crohn disease
Gastric bypass surgery
Taking too many antacids that contain calcium
You may not get enough iron in your diet if:
You are a strict vegetarian
You are an older adult and do not eat a full diet
Symptoms
You may have no symptoms if the anemia is mild.
Most of the time, symptoms are mild at first and develop slowly. Symptoms may
include:
Feeling grumpy
Feeling weak or tired more often than usual, or with exercise
Headaches
Problems concentrating or thinking
As the anemia gets worse, symptoms may include:
Blue color to the whites of the eyes
Brittle nails
Desire to eat ice or other non-food things (pica)
Light-headedness when you stand up
Pale skin color
Shortness of breath
Sore tongue
Symptoms of the conditions that cause iron deficiency anemia include:
Dark, tar-colored stools or blood
Heavy menstrual bleeding (women)
Pain in the upper belly (from ulcers)
Weight loss (in people with cancer)
Exams and Tests
To diagnose anemia, your doctor may order these blood tests:
Hematocrit and hemoglobin (red blood cell measures)
RBC indices
Tests to check iron levels in your blood include:
Bone marrow exam (rare)
Iron binding capacity (TIBC) in the blood
Serum ferritin
Serum iron level
Tests that may be done to look for the cause of iron deficiency:
Colonoscopy
Fecal occult blood test
Upper endoscopy
Treatment
Treatment may include taking iron supplements and eating iron-rich foods.
Iron supplements (most often ferrous sulfate) are needed to build up the iron stores in
your body. Most of the time, your doctor or nurse will measure your iron levels before
starting supplements.
If you cannot take iron by mouth, you may need to take it through a vein (intravenous)
or by an injection into the muscle.
Pregnant and breastfeeding women will need to take extra iron because they often
cannot get enough iron from their normal diets.
Your hematocrit should return to normal after 2 months of iron therapy. You will need to
keep taking iron for another 6 to 12 months to replace the body's iron stores in the
bone marrow.
Iron-rich foods include:
Chicken and turkey
Dried lentils, peas, and beans
Fish
Meats (liver is the highest source)
Peanut butter
Soybeans
Whole-grain bread
Other sources include:
Oatmeal
Raisins, prunes, and apricots
Spinach, kale, and other greens
Outlook (Prognosis)
With treatment, the outcome is likely to be good. However, it does depend on the
cause.
When to Contact a Medical Professional
Call your health care provider if:
You have symptoms of iron deficiency
You notice blood in your stool
Prevention
A balanced diet should include enough iron. Red meat, liver, and egg yolks are high
sources of iron. Flour, bread, and some cereals are fortified with iron. If advised by your
doctor, take iron supplements if you are not getting enough iron in your diet.
References
Brittenham GM. Disorders of iron homeostasis: iron deficiency and overload. In: Hoffman
R, Benz EJ Jr, Silberstein LE, et al., eds.Hematology: Basic Principles and Practice
Update Date 2/24/2014
Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists &
Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network.
Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial
team.
Taken from:
Gersten, T.,…… .2014. Iron Deficiency Anemia.
https://www.nlm.nih.gov/medlineplus/ency/article/000584.htm. Accessed 16th September 2015