Iron Deficiency Anemia: Causes, Risk Factors, Symptoms, and Diagnosis

Overview

Iron deficiency is the most common nutritional disorder worldwide.  One third of the world’s population is affected by anemia, and half of those cases are due to iron deficiency. Iron deficiency anemia (IDA) develops when body stores of iron are too low to support production of hemoglobin (abbreviated Hgb or Hg), a critical protein in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs. Hemoglobin is a protein molecule comprised of four peptide subunits, each containing an iron atom bound to a heme group, allowing a single hemoglobin molecule to bind four oxygen molecules. Iron deficiency leads to abnormal hemoglobin formation, thereby reducing the red blood cells’ ability to efficiently transport oxygen. Hemoglobin - Iron Deficiency Anemia

Symptoms

Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify. Symptoms of Iron Deficiency Anemia Iron deficiency anemia signs and symptoms may include: Extreme fatigue Weakness Pale skin Chest pain, fast heartbeat or shortness of breath Headache, dizziness or lightheadedness Cold hands and feet Inflammation or soreness of your tongue Brittle nails Unusual cravings for non-nutritive substances, such as ice, dirt or starch Poor appetite, especially in infants and children with iron deficiency anemia

When to see a doctor

If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your doctor. Iron deficiency anemia isn’t something to self-diagnose or treat. So see your doctor for a diagnosis rather than taking iron supplements on your own. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications.

Causes of Iron Deficiency Anemia

Iron deficiency anemia occurs when your body doesn't have enough iron 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 your body.

Risk factors

These groups of people may have an increased risk of iron deficiency anemia:
  • Women. Because women lose blood during menstruation, women in general are at greater risk of iron deficiency anemia.
  • Infants and children. Infants, especially those who were low birth weight or born prematurely, who don’t get enough iron from breast milk or formula may be at risk of iron deficiency. Children need extra iron during growth spurts. If your child isn’t eating a healthy, varied diet, he or she may be at risk of anemia.
  • Vegetarians. People who don’t eat meat may have a greater risk of iron deficiency anemia if they don’t eat other iron-rich foods.
  • Frequent blood donors. People who routinely donate blood may have an increased risk of iron deficiency anemia since blood donation can deplete iron stores. Low hemoglobin related to blood donation may be a temporary problem remedied by eating more iron-rich foods. If you’re told that you can’t donate blood because of low hemoglobin, ask your doctor whether you should be concerned.
Risk Factors - Iron Deficiency Anemia

Complications

Mild iron deficiency anemia usually doesn’t cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following:
  • Heart problems. Iron deficiency anemia may lead to a rapid or irregular heartbeat. Your heart must pump more blood to compensate for the lack of oxygen carried in your blood when you’re anemic. This can lead to an enlarged heart or heart failure.
  • Problems during pregnancy. In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies. But the condition is preventable in pregnant women who receive iron supplements as part of their prenatal care.
  • Growth problems. In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development. Additionally, iron deficiency anemia is associated with an increased susceptibility to infections.
Complications of Iron Deficiency Anemia

Prevention

You can reduce your risk of iron deficiency anemia by choosing iron-rich foods. Food Sources of Iron Rich Food for Iron Deficiency Anemia

Preventing iron deficiency anemia in infants

To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow’s milk isn’t a good source of iron for babies and isn’t recommended for infants under 1 year. After age 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children don’t drink more than 20 ounces (591 milliliters) of milk a day. Too much milk often takes the place of other foods, including those that are rich in iron.

Diagnosis

Iron deficiency anemia can be diagnosed with a simple blood test. Your healthcare provider should discuss the test with you and may suggest treatment involving iron supplementation. Serum Ferritin is the diagnostic test of choice. Your doctor may order additional tests as appropriate to rule out other types of anemia. Reduced ferritin reflects depleted total iron body stores and a decompensated ability to meet requirements for producing new red blood cells. Serum Ferritin Chart - For Diagnosis of Iron Deficiency Anemia

Additional diagnostic tests

If your bloodwork indicates iron deficiency anemia, your doctor may order additional tests to identify an underlying cause, such as:
  • Endoscopy. Doctors often check for bleeding from a hiatal hernia, an ulcer or the stomach with the aid of endoscopy. In this procedure, a thin, lighted tube equipped with a video camera is passed down your throat to your stomach. This allows your doctor to view the tube that runs from your mouth to your stomach (esophagus) and your stomach to look for sources of bleeding.
  • Colonoscopy. To rule out lower intestinal sources of bleeding, your doctor may recommend a procedure called a colonoscopy. A thin, flexible tube equipped with a video camera is inserted into the rectum and guided to your colon. You’re usually sedated during this test. A colonoscopy allows your doctor to view inside some or all of your colon and rectum to look for internal bleeding.
  • Ultrasound. Women may also have a pelvic ultrasound to look for the cause of excess menstrual bleeding, such as uterine fibroids.

You may also find the following links interesting: Iron Deficiency Anemia: https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/diagnosis-treatment/drc-20355040 Health Link BC: https://www.healthlinkbc.ca/health-topics/hw166953 Huffington Post on IDA: https://www.huffingtonpost.co.uk/entry/iron-deficiency-anaemia-symptoms-and-treatment-explained_uk_59d39811e4b06557815588cd ____________________________________________________________________________________________________________________________________

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