Iron deficiency anemia is one of the most common nutritional disorders caused due to low iron intake or insufficient absorption of iron in the body. A common cause of microcytic anemia, iron deficiency anemia is also referred to as sideropenic anemia.

Iron is one of the most important constituents of red blood cells as it plays a crucial role in energy metabolism, gene regulation, cell growth and differentiation, oxygen binding and transport, muscle oxygen use and storage, enzyme reactions, neurotransmitter synthesis and protein synthesis.

Adequate quantity of iron is necessary to make hemoglobinwhich is an important constituent in the red blood cells, responsible for transport of oxygen. Red blood cells carry oxygen to the body’s tissues, giving energy and skin a healthy color. Lack in hemoglobin can lessen the oxygen binding ability of each hemoglobin molecule, resulting in anemia. This deficiency causes the red blood cells to appear abnormal and unusually small (microcytic) and pale (hypochromic).

A most common form of anemia, on an average 3.5 million people in America alone are affected by iron deficiency anemia. The numbers for iron deficiency anemia are even higher in developing countries, especially in very poor areas where people suffer from malnutrition.

Children and pregnant women are at a higher risk of developing iron deficiency anemia. Iron deficiency in children can cause behavioral disturbances, developmental delays, failure to thrive and infections. There is an increased risk of delivering a low birth weight baby and preterm delivery in pregnant women. Many people who have pre-existing iron deficiency anemia run the risk of being infected with malaria.

Generally a proper balanced diet, foods rich in iron content such as fresh fruits and vegetables, as well as iron supplements can help in overcoming iron deficiency anemia.

Iron deficiency anemia causes

  • Inadequate intake & insufficient absorption of iron – The major causes that lead to iron deficiency anemia are inadequate consumption of iron and insufficient absorption of iron.  If iron content is very low, our body is unable to produce hemoglobin. Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout the body. Small intestine plays a vital role in the absorption of iron from the food; if the small intestine has been surgically removed or bypassed it may have an effect on intestines ability to absorb iron and other nutrients.
  • Loss of Blood – As blood contains iron, excessive blood lossor chronic bleeding can prove to be more dangerous as there is loss of iron and it is the most common cause of iron deficiency anemia. As women lose a lot of blood during heavy periods, they are at a higher risk of developing this disease.
  • Other infections and diseases – Iron deficiency anemia can also be caused by peptic ulcer, colorectal cancer, kidney or bladder tumor, uterine fibroids etc. Intestinal disorders such as Crohn’s disease or celiac disease affects iron absorption from the digested food and this disorder generally leads to iron deficiency anemia.
  • Drugs & Medications – Regular use of aspirin and other anti-inflammatory drugs (NSAIDs) can lead to gastrointestinal bleeding which may cause iron deficiency anemia. Excessive blood loss is generally due to loss of blood, surgery or accidents.
  • Less iron content in diet – A healthy diet plays a key role in maintaining adequate iron level in our body. Hence if we consume diet less in iron, body can become iron deficient. Infants and children need iron from their diet for proper growth and development.
  • Unhealthy habits – Cigarette smoking also increases the chances for anemia because carboxyhemoglobin formed from carbon monoxide during smoking has no oxygen-carrying capacity.
  • Pregnancy – Pregnant or breast feeding women often test positive for iron deficiency anemia because during the phase of pregnancy, the requirement of iron increases and generally it is not met through their regular diet. Iron is crucial for the growing fetus to develop red blood cells, muscle and blood vessels.

Iron deficiency anemia symptoms

There are many signs and symptoms associated with iron deficiency anemia, although if the anemia is of the milder variety, it may be difficult to detect. In cases of chronic anemia, initially the body may adapt and compensate for the change, displaying fewer symptoms until the anemia becomes more severe.

Children suffering from iron deficiency anemia have poor concentration and can have a negative effect on the child’s growth, causing behavioral and learning difficulties. Iron deficiency anemia is more common in infants and adolescents, particularly girls.

Some common symptoms include

  • fatigue & weakness
  • lack of physical energy
  • shortness of breath
  • lightheadedness
  • palpitations
  • paleness
  • dizziness
  • sore tongue
  • brittle nails
  • loss of appetite especially in children etc

People suffering from this disease may also have an uncomfortable tingling or crawling feeling in legs or unusual cravings for non-nutritive substances, such as ice, dirt or pure starch.

Pregnant women have an increased risk of fetal growth retardation. Women suffering from iron deficiency anemia, especially those in the age group 40 and above, develop a condition known as Plummer-Vinson syndrome, in which they have difficulty swallowing due to small web-like growths in the food pipe. In cases of severe anemia, the symptoms may involve rapid heart rate, low blood pressure or even a heart failure.

Iron deficiency anemia in children

Growing children need to absorb an average of 1 mg of iron per day to keep up with their rapid growth and development. As a result children are often more prone to developing iron deficiency anemia due to inadequate consumption of iron content.

Iron deficiency anemia is a decrease in the number of red blood cells due to a lack of iron and in children it may lead to behavioral disturbances, developmental delays, failure to thrive and infections.

Babies, toddlers, preschoolers and teenagers are at a risk of developing iron deficiency anemia because their need for increased iron intake may not be met through their diet.

Recent studies have shown that children only absorb about 10% of the iron from their diet. These studies also indicate that most children should receive 8-10 mg of iron per day for steady growth and mental development.

Children suffering from mild iron deficiency anemia may suffer from sore throat, headache, decreased appetite, irritability pale skin color, unusual food cravings, etc. The white part of the eyes can take on a bluish tint.

In severe cases, iron deficiency in children can lead to poisoning or slow bleeding. Excessive milk intake can lead to iron deficiency as it irritates the intestines and leads to iron loss. Cow’s milk also can cause problems in the intestine that lead to blood loss and increased risk of anemia.

Iron deficiency anemia Ferritin

Most of the iron which is absorbed or consumed by the body passes through the plasma for re-utilization. However, the excess iron content is stored in the body as ferritin or hemosiderin.

Ferritin act as buffer against iron deficiency as, its structure is extremely important for the protein’s capability to store and release iron in a controlled fashion. If blood has low iron count, Ferritin can release more iron and it can also help store and manage excess iron in the body.

When a person is iron deficient but has a normal hemoglobin level, then he is said to be iron deficient without anemia. Iron deficiency with anemia is when a person has low values of both serum Ferritin and hemoglobin.

Iron deficiency, infection, chronic inflammation, malignancy or conditions causing organ or tissue damage may cause ferritin levels to be normal or elevated, since it is an acute phase protein.

Low hemoglobin in addition to a low serum ferritin (<15uL) may result in iron deficiency anemia. Serum Ferritin is the most crucial and important lab test for iron deficiency anemia. Anemia in menstruating women, a low serum iron level, high total iron binding capacity (TIBC), an elevated transferrin levels can be diagnosed by serum ferritin lab test.

How can we prevent Iron deficiency anemia?

A healthy diet as well as regular exercise goes a long way in keeping a person healthy. In addition consumption of nutritious foods also boosts the overall immunity of the body helping keep iron deficiency anemia as well as other ailments at bay.

  • Iron deficiency anemia Diet

Iron deficiency anemia can be best avoided by eating a wide variety of healthy foods which are rich in iron content. Fruits such as apples, bananas, apricots and plums; vegetables such as yams, squash, asparagus, broccoli and leafy vegetables, tofu, whole grains etc. all help in building the body’s resistance against this disease. Beef, pork, lamb, liver, and other organ meats, chicken, duck, turkey, liver are the best sources of iron. Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans provide enough iron in the diet.
Iron absorption

To prevent iron deficiency anemia, iron absorption in the body is vital. Iron rich foods, high in vitamin C, should be included in the regular diet. Sugar consumption should be reduced considerably or even omitted. Avoid using any antacids as they interfere with iron absorption. Coffee and black tea should also be avoided as they contain polyphenols and tannin which interfere with iron absorption. Skipping meals and irregular dietary habits should be discouraged.

  • Iron deficiency anemia  supplements

If the diet lacks in iron content, taking iron supplements can lower the risk of iron deficiency anemia,. To boost iron absorption, iron supplements should be taken with liquids other than milk, coffee, tea or phosphate-containing carbonated beverages such as soft drinks. Iron supplements also minimize side effects caused due to gastrointestinal intolerance and these supplements can correct low iron levels within months.

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