Causes, Symptoms and Treatment of Iron Deficiency Anemia
Iron deficiency anemia is a condition that is caused by having inadequate iron in your body. It is both, relatively easy to treat and common. The three main causes of this type of anemia are the inability to absorb sufficient iron from food, a poor diet and blood loss. Your body needs iron to make red blood cells or erythrocytes. When your body does not have sufficient iron available to make erythrocytes, it dips into its iron stores. Once these stores are used up your body can no longer produce enough red blood cells and you develop anemia.
Fast Facts about Iron Deficiency Anemia
- Iron deficiency anemia occurs, as the name indicates, when the body does not have enough iron. This condition is common and most of the time it can be successfully treated.
- When the body has used up its stores of iron, it can no longer efficiently produce healthy erythrocytes (red blood cells).
- The two groups at highest risk are infants and young children, and women.
- Preventing iron deficiency anemia involves eating a balanced diet that includes iron rich foods. Taking iron supplements can also help if your body does not adequately absorb iron from food.
Common Causes of Iron Deficiency Anemia
The three causes of iron deficiency anemia are poor diet, blood loss or an lack of ability to absorb sufficient iron from your diet.
Blood loss – The loss of blood equals the loss of iron and when your body does not have sufficient iron stored to compensate for the loss, you can acquire iron-deficiency anemia. Bleeding fibroids in the uterus or heavy menstruation can cause low iron levels. Internal bleeding is an additional cause. A few of the types of internal bleeding are:
- Bleeding in the urinary tract
- Colon polyp, colon cancer or a bleeding ulcer
- Frequent use of pain medications such as aspirin
Poor Diet – Poultry, fish, meat and foods fortified with iron are the best sources of iron. You have a greater chance of developing iron deficiency anemia if you do not eat these foods regularly and do not take a supplement. There are good non-meat sources of iron like iron fortified cereals and breads, tofu, spinach, beans and dried fruits. This means that vegetarians can also have enough iron included in their diet if they eat the right foods.
Inability to Absorb Enough Iron – If you have a disease of the intestines, like celiac disease or Crohn’s disease or if you have had gastric bypass surgery your body may not be able to properly absorb iron from the food you eat. There are prescription medications available that reduce stomach acid that can also affect the body’s ability to absorb iron.
Risk Factors for Iron Deficiency Anemia
The first group of people who are at risk for iron deficiency anemia are young children and infants. Within 4 to 6 months of birth an infant’s iron stores can be completely depleted. Babies who have a low birth weight or who are premature are at an even greater risk. Children are at an even higher risk if they have lead in their bodies from drinking tainted water or eating lead in soil or paint.
Underweight teenagers or teenagers who have ongoing illness are at a heightened risk for iron-deficiency anemia too. When teenage girls have a heavy period, they are also at a heighted risk of anemia.
Women of child bearing age have a higher risk of iron deficiency anemia due to blood loss during menstruation. About half of all pregnant women develop iron deficiency anemia because of the lack of extra iron needed during pregnancy.
Internal bleeding can also cause iron-deficiency anemia. There are several conditions that can cause internal bleeding such as bleeding ulcers and colon cancer. Certain medications such as aspirin can also cause internal bleeding.
There are other groups that are at risk as well, such as people who need dialysis. This is because there is blood loss associated with dialysis and the kidneys can no longer make a hormone that is needed by the body to produce new erythrocytes.
Patients who have undergone gastric bypass surgery are also at risk of developing iron deficiency anemia. Gastric bypass surgery can thwart the body’s ability to absorb the iron it needs. There are also certain eating habits that can put a person at risk for iron deficiency anemia even if they have not had gastric bypass surgery. Dietary habits that can put you at risk for this type of anemia are:
- Eating an excessively low fat diet for an extended period of time. Some of the top sources of iron are higher fat foods.
- Consuming a diet high in fiber. Fiber in large amount will possibly slow your body’s ability to absorb iron.
- Financial, social or health problems that cause you to eat poorly.
- Following a diet that excludes fish and meat. These are some of the best sources of iron. Vegetarians can get enough iron if they eat a diet that includes rich plant sources of iron.
Symptoms of Iron Deficiency Anemia
While fatigue is the most frequent symptom the various types of anemia, there are specific symptoms that go along with being iron deficient.
- A tongue that is swollen or sore
- Cracks in the sides of the mouth
- Frequent infections
- Brittle nails
- Enlarged spleen
- Pica disorder – the urge to eat non-food items like dirt, ice or starch
- Restless leg syndrome or RLS
When you do not have enough erythrocytes to properly carry oxygen to the body, the heart works harder. This can trigger severe symptoms such as heart murmur, enlarged heart, heart failure and arrhythmia.
Diagnosing Iron Deficiency Anemia
A diagnosis of iron deficiency anemia is established by your doctor taking a personal medical history, doing a physical examination and running diagnostic tests. When the doctor takes your medical history they will ask you about any anemia you have had in the past. The doctor will also need to learn about any medications you are taking and will want to know your diet. If you are a woman the doctor will want to know whether you are pregnant.
There are specific things the doctor will be looking for during the physical exam. They include:
- Pale gums, skin and nail beds
- Uneven or rapid breathing
- Irregular or rapid heart beat
- Measure the size of your spleen and liver
- Look for internal bleeding by doing a rectal and pelvic exam
Your doctor will also do blood tests to test you for signs of anemia. A complete blood count will check your levels of hemoglobin, responsible for carrying oxygen in blood and will measure the amount of white blood cells, erythrocytes and platelets in your body. In addition to blood tests, your doctor may do tests to see if you are having gastrointestinal blood loss.
Treatment Options for Iron Deficiency Anemia
There are several treatments for iron deficiency anemia. The treatment that will work best for each patient depends on the severity and cause of the anemia. Available treatments include supplements and dietary changes, blood transfusions, medications and surgery.
When you need to bring your iron levels up very quickly your doctor may recommend or prescribe iron supplements. These should be taken as directed as too much iron can be dangerous. All iron supplements should be kept out of the reach of children.
Your doctor will probably also suggest that you eat more iron rich foods. Some of the best sources of iron are meat and liver. Poultry, shellfish, fish and pork are also good sources. While the body does tend to absorb iron better from meat than from non-meat sources, there are several non-meat foods that can help elevate your iron level. Getting adequate vitamin C will improve your body’s absorption of iron.
When the cause of your iron-deficiency anemia is internal bleeding, the treatment will also be intended to stop the bleeding. When the cause is an ulcer that bleeds, you may be given antibiotics or another type of medications to treat the ulcer. If colon cancer or a polyp are causing the bleeding, a patient may need to have the growth surgically removed. Heavy menstrual bleeding can be slowed with help of birth control pills or in severe cases with surgery.
For severe cases of iron-deficiency anemia a blood transfusion may be needed. Transfusions treat your anemia immediately, however, they are only a temporary solution. The underlying cause of the anemia will still need to be treated. If you are suffering from a severe form of iron deficiency anemia and cannot take iron supplements by mouth, you may need iron therapy. Iron therapy involves injecting, either with a syringe or intra vernacular, iron directly into a muscle or blood vessel.
Prevention of Iron Deficiency Anemia
The best way to prevent iron deficiency anemia is to eat a balanced diet that included foods that are rich in iron. When you are not able to get enough iron from your diet, a supplement may be needed. The two groups with the highest risk of this type of anemia are women and infants. Babies should not drink cow’s milk until they are at least a year old because it does not provide them with adequate iron. It is recommended that women of child bearing age get tested for iron deficiency anemia if they have risk factors for this condition.
Coping with Iron Deficiency Anemia
When you have iron deficiency anemia, you should continue with ongoing care to ensure that your iron levels are improving. It can take months for the condition to resolve completely and till then it is possible that patients will be experiencing fatigue. If you are taking supplements, make sure that you are following your doctors instructions because excessive iron intake can cause you harm.
Where to Find More Information: American Society of Hematology