Anemia is a health condition when your body doesn’t have adequate hemoglobin in your red blood cells. Red blood cells carry oxygen, which is vital for living cells, from lungs to the body’s tissues.
Iron deficiency anemia is a very common type of anemia where your body is low in iron. Apart from physical growth, iron is an essential component of hemoglobin that binds & carries oxygen to the organs.
So, if there is not enough of the mineral iron in your bloodstream, it fails to carry the required amount of oxygen needed to the body. Which eventually leaves you tired, weak & short of breath.
Doctors usually treat Iron deficiency anemia with iron supplements & change in diet.
Who is more prone to Iron deficiency Anemia?
Pregnant Women
Due to the increase of maternal red blood cell production pregnant women are at high risk of Iron deficiency anemia.
Women with heavy menstrual bleeding
Women suffering from menorrhagia or heavy bleeding during menstruation are at high risk of iron deficiency anemia.
Individuals with Gastrointestinal(GI) condition
Individuals with certain gastrointestinal diseases like Crohn’s disease, ulcerative colitis, celiac disease, autoimmune gastritis, helicobacter pylori or had gone through gastrointestinal surgical procedures (such as gastrectomy or intestinal resection) have an increased risk of iron deficiency because of these conditions may cause malabsorption or increased blood loss.People with cancer
A high rate of iron deficiency has been found in people living with pancreatic cancer, followed by colon & lung cancer due to chronic blood loss.People with heart failure
Poor nutrition, the inability of enough iron absorption, uses of aspirin & anti-coagulants of People with heart failure causes gastrointestinal bleeding leads to Iron deficiency.
People with Chronic Kidney Disease
Frequent blood donors
Although an adult can donate blood as often as every 8 weeks but it was found that around 30% of frequent blood donors develop iron deficiency.As it was mentioned iron deficiency anemia is the most common type of anemia but it is often ignored and under-diagnosed. Initially, iron deficiency anemia can be so mild that it may go completely unnoticed. But when it gets more severe, the signs & symptoms become discernable. Below are some signs & symptoms that may give you a clue that your body is deficient in iron.
Signs:
Koilonychia or Brittle nails or spooning of the nails:
It is a nail disease and can be a sign of iron deficiency anemia. In this disease, the nails (usually of the hand) get thinner in shape and lose its convexity and become concave. Nails become brittle or easily breakable.
Angular cheilitis or Cracks at the sides of the mouth:
It is a skin condition that causes swollen red patches to one or both corners of the mouth. It can also be itchy or painful.
It was found that people who have a deficiency in iron are more prone to suffer from Angular cheilitis. The reason is that iron deficiency causes immunocompromise (the immune system’s ability to fight against infectious diseases & cancer decreased) which further allows bacteria & fungi to cause infections.
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Pale skin:
If you find that your skin looks very white or pale then it may indicate that you are suffering from iron-deficiency anemia. This can be caused by a reduced amount of oxyhemoglobin in your body.
And if this paleness is found in lips, tongue, palms, mouth conjunctivae of the eyes and skin under and around your nails then your body is giving you an acute signal of a low count of hemoglobin in your system.
Glossitis or Swelling or soreness of the tongue:
It refers to inflammation of the tongue. Glossitis is often caused by nutritional deficiencies and mainly iron deficiency. It leaves the tongue a bald and shiny appearance with tenderness or burning. So if you are suffering from soreness or swelling in tongue associates with paleness in the skin then it is time you should visit a Doctor as it is a sign of Iron deficiency anemia.
Symptoms:
Chest pain:
Studies have shown that women with chest pain are more likely to be suffering from iron deficiency anemia. A low count of hemoglobin fails to carry adequate oxygen to the organs. This loss of oxygen saturation is directly involved in vascular abnormalities that could potentially lead to adverse cardiovascular events.
Coldness in the hands and feet:
Although it is normal to feel cold hands and feet on a cold day but on a warm day it can be a symptom of iron deficiency anemia. Because of the low count of hemoglobin body unable to send blood and warmth to them. And you feel a little colder at hands and feet than the rest of the body.
Headache accompanied by dizziness:
Do you often experience a headache accompanied by dizziness?
If yes then don’t ignore it as it may be a symptom of iron deficiency. What happens here is as the body can’t properly carry the oxyhemoglobin to all the essential organs, blood vessels inflamed and stimulate pain.
Fatigue, or feeling tired:
This is the most common symptom of iron deficiency anemia if you feel tired or fatigued most of the time. Although it is natural to feel weak or fatigued after a long tiring day without proper resting. But even after a good night’s sleep if you find your energy level still exhausted and it continues for a longer period then it’s time to get an appointment for a Doctor.
This is also the reason why women feel lazy during their period. The iron-deficient body is not getting adequate oxygen and thus the energy level remains depleted. To avoid this, you should consume iron supplements or iron-rich foods.
Arrhythmia or irregular heartbeat:
Iron deficiency anemia can also lead to arrhythmia or irregular heartbeat. Your heart pumps more blood just to supply enough oxygen to fill the inadequacy occurred by iron deficiency anemia. Which further leads to heart attack and heart failure.
Hair Loss:
Studies have shown that women who have a deficiency in iron are more likely to experience hair loss. Iron is an essential component in an enzyme called ribonucleotide reductase that stimulates cell growth. If your body lacks iron they can’t properly act. And as a result, you may experience hair loss.
A low level of iron prevents hair follicle cells to grow new cells. According to some researches, iron deficiency may be related to alopecia areata, androgenetic alopecia, telogen effluvium, and diffuse hair loss.
You may experience the following signs if your hair follicle cells are affected by iron deficiency.
• More hair accumulating in the shower drain when you’re taking a bath
• More strands of hair filling up your brush than usual
• Unusual falling hair whenever you’re grooming
• Receding hairline
• Bald spots
• Thinning hair
• Dry and damaged hair
• Weak hair strands
Restless legs syndrome:
RLS or Rest leg syndrome is an unpleasant feeling on your legs that temporarily limits your movement. Sometimes even the arms get affected. This sensation may vary from pain or aching in the muscles, to "an itch you can't scratch", a "buzzing sensation", an unpleasant "tickle that won't stop", a "crawling" feeling, or limbs jerking while awake. Sometimes even the arms get affected.
This condition commonly takes place while you are relaxing or sitting for a longer period or even at night while trying to sleep. Apart from other causes like hemodialysis, magnesium deficiency, sleep apnea, diabetes, and Parkinson's disease, Restless legs syndrome is commonly caused by iron deficiency anemia.
Iron supplement and iron-rich food effectively reduce the occurrence of restless leg syndrome.
Pica Disorder:
Pica is a psychological disorder which refers to an appetite for substances that are non-nutritive, such as ice (pagophagia); toothpaste, clay, hair (trichophagia); paper (xylophagia); drywall or paint; sharp objects (acuphagia); metal (metallophagia); stones (lithophagia) or soil (geophagia); glass (hyalophagia); feces (coprophagia); and chalk.
Although it sounds strange it can be often seen in pregnant women, small children, and persons with developmental disabilities such as autism.
Pica mainly caused by mineral deficiencies. People who develop cravings for such non-nutritive substances are more likely to be suffering from iron deficiency anemia and have low hemoglobin concentration in their blood.
How Iron deficiency anemia diagnosed?
To diagnose Iron deficiency anemia there are some blood tests and tests that detect gastrointestinal bleeding.
Blood Test:
1. Complete blood count (CBC): to check if you have lower than normal red blood cell counts, hemoglobin or hematocrit levels.
2. Ferritin: measure to find out how much iron is stored in your body. Ferritin is a protein that helps to store iron in your body.
3. corrected reticulocyte count (CRC): to check the numbers of these (reticulocyte) very young red blood cells. If you have iron-deficiency anemia, your reticulocyte count is usually low because your body is not producing many new red blood cells.
4. Peripheral blood smear: This test done to determine the size shape and color of your red blood cells. In iron deficiency anemia, red blood cells are smaller and paler than normal.
5. Total iron-binding capacity (TIBC): This test measures the blood's capacity to bind iron with transferrin.
Gastrointestinal Test:
1. Fecal occult blood test to check for blood in the stool. Blood in the stool would suggest bleeding in the GI tract and require further tests to find the actual cause of bleeding.
2. Endoscopy: This test is done to look for bleeding in the esophagus, stomach, and small intestine.
3. Colonoscopy: to detect bleeding or other abnormalities, such as growths or cancer of the lining of the colon.
Treatment:
Iron supplements:
The most common treatment for iron deficiency is to take iron supplements. Doctors recommend to take it for a period ranges from 3months to 6 months. But do not start taking it on your own just because you think you are suffering from Iron deficiency anemia. As too much iron can damage several organs.
Also, it is always recommended not to stop taking iron supplements without consulting with your doctor. If you are experiencing side effects like vomiting, diarrhea, constipation, or upset stomach then contact your doctor immediately. Your doctor may advise you to take the supplement with foods or prescribe a new supplement or even your dose may get lowered.
Iron-rich Food:
Increase your daily intake of foods that are high on iron to help treat your iron-deficiency anemia.
Some examples of foods rich in iron include:
|
Food
|
Serving
|
Iron contains
|
|
Breakfast cereals, fortified with 100% of
the DV for iron,
|
1
serving
|
18
|
|
Oysters, eastern, cooked with moist heat,
|
3 ounces
|
8
|
|
White beans, canned,
|
1 cup
|
8
|
|
Chocolate, dark, 45%–69% cacao solids,
|
3 ounces
|
7
|
|
Beef liver, pan fried,
|
3 ounces
|
5
|
|
Lentils, boiled and drained,
|
½ cup
|
3
|
|
Spinach, boiled and drained,
|
½ cup
|
3
|
|
Tofu, firm,
|
½ cup
|
3
|
|
Kidney beans, canned,
|
½ cup
|
2
|
|
Sardines, Atlantic, canned in oil, drained
solids with bone,
|
3 ounces
|
2
|
|
Chickpeas, boiled and drained,
|
½ cup
|
2
|
|
Tomatoes, canned, stewed,
|
½
cup
|
2
|
|
Beef, braised bottom round, trimmed to 1/8”
fat,
|
3 ounces
|
2
|
|
Potato, baked, flesh and skin,
|
1 medium potato
|
2
|
|
Cashew nuts, oil roasted,
|
1 ounce (18 nuts)
|
2
|
|
Chicken, roasted, meat and skin,
|
3 ounces
|
1
|
|
Rice, white, long grain, enriched,
parboiled, drained,
|
½ cup
|
1
|
|
Bread, whole wheat,
|
1 slice
|
1
|
|
Bread, white,
|
1 slice
|
1
|
|
Raisins, seedless,
|
¼
cup
|
1
|
|
Green peas, boiled,
|
½ cup
|
1
|
|
Spaghetti, whole wheat, cooked,
|
1 cup
|
1
|
|
Tuna, light, canned in water,
|
3
ounces
|
1
|
|
Turkey, roasted, breast meat and skin,
|
3
ounces
|
1
|
|
Nuts, pistachio, dry roasted,
|
1
ounce (49 nuts)
|
1
|
|
Broccoli, boiled and drained,
|
½
cup
|
1
|
|
Egg, hard boiled,
|
1
large
|
1
|
|
Rice, brown, long or medium grain, cooked,
|
1 cup
|
1
|
Iron Needs
|
Age
|
Male
|
Female
|
Pregnancy
|
Lactation
|
|
Birth to 6 months
|
0.27 mg*
|
0.27 mg*
|
|
|
|
7–12 months
|
11 mg
|
11 mg
|
|
|
|
1–3 years
|
7 mg
|
7 mg
|
|
|
|
4–8 years
|
10 mg
|
10 mg
|
|
|
|
9–13 years
|
8 mg
|
8 mg
|
|
|
|
14–18 years
|
11 mg
|
15 mg
|
27 mg
|
10 mg
|
|
19–50 years
|
8 mg
|
18 mg
|
27 mg
|
9 mg
|
|
51+ years
|
8 mg
|
8 mg
|
|
|
Vitamin C:
Sometimes, however, even if you eat plenty of iron-rich foods, your body might have a hard time absorbing this nutrient. Try eating foods rich in vitamin C because of this can help enhance body absorption.
Sometimes it can be seen that even if you are consuming plenty of iron-rich foods, your body fails to absorb this nutrient. This is when you need to eat foods that are rich I Vitamin-C. Vitamin c helps your body to absorb iron.
Some examples of foods rich in Vitamin C include:
|
Food
|
Serving size
|
Milligrams (mg) per serving
|
Percent of 90 mg daily value (DV)
|
|
Guava, raw
|
1 cup, raw
|
377
|
419%
|
|
Sweet red pepper, raw
|
1 cup, raw
|
190
|
211%
|
|
Tomato juice
|
1 cup, canned
|
170
|
188.9%
|
|
Orange juice
|
1 cup
|
124
|
137.8%
|
|
Sweet green pepper
|
1 cup, raw
|
120
|
133%
|
|
Hot green chili pepper, raw
|
1 pepper, raw
|
109
|
121%
|
|
Oranges
|
1 large fruit
|
97.5
|
108.8%
|
|
Strawberries
|
1 cup, sliced
|
97.6
|
108%
|
|
Papaya
|
1 small fruit
|
95.6
|
106.2%
|
|
Pink grapefruit juice
|
1 cup
|
93.9
|
104.3%
|
|
Broccoli
|
1 cup, raw
|
81.2
|
90.2%
|
|
Pineapple chunks
|
1 cup, raw
|
78.9
|
87.7%
|
|
Potato
|
1 large vegetable
|
72.7
|
80.8%
|
|
Brussels sprouts
|
1 cup, raw
|
74.8
|
79.8%
|
|
Kiwifruit
|
1 fruit
|
64
|
71.1%
|
|
Mango
|
1 cup, raw
|
60.1
|
66.7%
|
|
Cantaloupe
|
1 cup
|
57.3
|
63.7%
|
|
Cauliflower
|
1 cup, raw
|
51.6
|
57.3%
|
|
Lemon
|
1 fruit
|
44.5
|
49.4%
|
|
White grapefruit
|
½ medium fruit
|
39
|
43.3%
|
Clinical procedures:
If supplements & iron-rich foods are not helping you then Doctors may go with few clinical procedures. Those are listed below:
- Iron therapy, or intravenous (IV) iron.
This procedure is used to deliver iron through a blood vessel to increase the iron levels in the bloodstream. Patients with severe iron-deficiency anemia is often treated with this procedure.
The benefit of this procedure is that it quickly replenishes the amount of iron in your body although it has some side effects like headache or vomiting. But that usually goes away within a day or two.
- Red blood cell transfusions.
These may be used for people with severe iron-deficiency anemia to quickly increase the number of red blood cells and iron in the blood. Your doctor may recommend this if you have serious complications of iron-deficiency anemia, such as chest pain.
This method is also used to treat people with severe iron deficiency anemia. In this process, red blood cells are transferred into one's circulation intravenously to increase iron levels.
- Surgery:
if you have an ulcer, tumor, or other growth, then it may need to be treated with surgery.
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