Iron Deficiency Anemia

Treatment Overview
Treatment for iron deficiency anemia focuses on increasing your iron stores so they reach normal levels and identifying and controlling any conditions that caused the anemia. If your anemia is caused by:

A disease or condition, such as bleeding, your doctor will take steps to correct the problem. Not having enough iron in your diet or being unable to absorb iron, your doctor will work with you to develop a plan to increase your iron levels.

Taking iron supplement pills and eating more foods high in iron will correct most cases of iron deficiency anemia. You usually take iron pills 1 to 3 times a day. To get the most benefit from the pills, take them with vitamin C (ascorbic acid) pills or orange juice. Vitamin C helps your body absorb more iron. Recommended Related to Blood Disorders Atransferrinemia Important It is possible that the main title of the report Atransferrinemia is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. Read the Atransferrinemia article > > Most people start to feel better within a few days of beginning treatment. Even though you feel better, you will need to keep taking the pills for several months to build up your iron stores. Sometimes it takes up to 6 months of treatment with iron supplements before iron levels return to normal. You may need to have iron replacement shots if you have an iron absorption problem and are not able to increase your iron levels by taking pills or increasing the amount of iron in your diet. You may need these shots throughout your life. If your anemia is severe, your doctor may give you a blood transfusion to correct your anemia quickly and then have you start on iron supplement pills and a diet high in iron. To watch your condition, your doctor will use blood tests, such as:

A complete blood count (CBC), to look at the shape, color, number, and size of your blood cells. Iron tests, which measure the amount of iron in your blood. A reticulocyte count, to see how well treatment is working. Reticulocytes are immature red blood cells produced by the bone marrow and released into the bloodstream. When reticulocyte counts increase, it usually means that iron replacement treatment is effective. A ferritin level test, which reflects how much iron may be stored in the body.

Usually, people can eliminate iron deficiency anemia by taking iron as pills or shots and adding iron in their diet. If your anemia is not corrected with these treatments, your doctor will do more testing to look for other causes of your anemia, such as new bleeding or difficulty absorbing iron from pills. These tests may be the same as those initially used to diagnose your anemia. What To Think About If you suspect you have iron deficiency anemia, do not take iron pills without consulting your doctor. Taking iron pills could delay the diagnosis of a serious problem such as colorectal cancer or a bleeding ulcer. If the anemia is not due to iron deficiency, taking iron pills will not relieve the anemia and could cause poisoning (iron toxicity). It could also cause an iron overload condition called hemochromatosis, especially in people who have a genetic tendency toward storing too much iron in their bodies.

In some people, iron pills cause stomach discomfort, nausea, diarrhea,constipation, and black stool. Iron is best absorbed if taken on an empty stomach. But if you are having stomach problems, you may need to take the pills with food. Do not take iron pills with milk, caffeinated drinks, or antacids. If the side effects of your iron pills make you feel too sick, talk to your doctor. He or she may know of another type of iron pill you can take. Iron supplement shots can cause side effects. Shots given in a vein (intravenously, IV) pose the risk of an allergic reaction. Shots given in the muscle of the buttock (intramuscularly, IM) may produce permanent marks on the skin that look like a tattoo.

Top 10 Iron-Rich Foods

It used to be called "iron-poor blood," but now we know it as anemia. Whatever you call it, one way to help treat it is to eat foods rich in iron (most doctors recommend taking a supplement, too). To boost the amount of iron in your diet, try these foods:

Red meat Egg yolks Dark, leafy greens (spinach, collards) Dried fruit (prunes, raisins) Iron-enriched cereals and grains (check the labels) Mollusks (oysters, clams, scallops) Turkey or chicken giblets Beans, lentils, chick peas and soybeans Liver Artichokes

And here's a tip: If you eat iron-rich foods along with foods that provide plenty of vitamin C, your body can better absorb the iron.

How do I prevent anemia?

There are steps you can take to help prevent some types of anemia.
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Eat foods high in iron: Cereal/breads with iron in it (100% iron-fortified is best. Check food label.) Liver Lentils and beans Oysters Tofu Green, leafy vegetables such as spinach Red meat (lean only) Fish Dried fruits such as apricots, prunes, and raisins For more sources of iron, visit http://ods.od.nih.gov/factsheets/iron.asp

Eat and drink foods that help your body absorb iron, like orange juice, strawberries, broccoli, or other fruits and vegetables with vitamin C. Don't drink coffee or tea with meals. These drinks make it harder for your body to absorb iron. Calcium can hurt your absorption of iron. If you have a hard time getting enough iron, talk to your doctor about the best way to also get enough calcium. Make sure you consume enough folic acid and vitamin B12. Make balanced food choices. Most people who make healthy, balanced food choices get the iron and vitamins their bodies need from the foods they eat. Food fads and dieting can lead to anemia.

Talk to your doctor about taking iron pills (supplements). Do not take these pills without talking to your doctor first. These pills come in two forms: ferrous and ferric. The ferrous form is better absorbed by your body. But taking iron pills can cause side effects, like nausea, vomiting, constipation, and diarrhea. Reduce these side effects by taking these steps: Start with half of the recommended dose. Gradually increase to the full dose. Take the pill in divided doses. For example, if you are prescribed two pills daily, take one in morning with breakfast and the other after dinner. o Take the pill with food. o If one type of iron pill is causing problems, ask your doctor for another brand.
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What foods provide iron?

There are two forms of dietary iron: heme and nonheme. Heme iron is derived from hemoglobin, the protein in red blood cells that delivers oxygen to cells. Heme iron is found in animal foods that originally contained hemoglobin, such as red meats, fish, and poultry. Iron in plant foods such as lentils and beans is arranged in a chemical structure called nonheme iron [9]. This is the form of iron added to iron-enriched and iron-fortified foods. Heme iron is absorbed better than nonheme iron, but most dietary iron is nonheme iron [ 8]. A variety of heme and nonheme sources of iron are listed in Tables 1 and 2.

Table 1: Selected Food Sources of Heme Iron [10]

Food Chicken liver, cooked, 3 ounces Oysters, breaded and fried, 6 pieces Beef, chuck, lean only, braised, 3 ounces Clams, breaded, fried, cup Beef, tenderloin, roasted, 3 ounces Turkey, dark meat, roasted, 3 ounces Beef, eye of round, roasted, 3 ounces Turkey, light meat, roasted, 3 ounces Chicken, leg, meat only, roasted, 3 ounces Tuna, fresh bluefin, cooked, dry heat, 3 ounces Chicken, breast, roasted, 3 ounces Halibut, cooked, dry heat, 3 ounces Crab, blue crab, cooked, moist heat, 3 ounces Pork, loin, broiled, 3 ounces Tuna, white, canned in water, 3 ounces Shrimp, mixed species, cooked, moist heat, 4 large Milligrams % DV* per serving 12.8 4.5 3.2 3.0 3.0 2.3 2.2 1.6 1.3 1.1 1.1 0.9 0.8 0.8 0.8 0.7 70 25 20 15 15 10 10 8 6 6 6 6 4 4 4 4

Table 2: Selected Food Sources of Nonheme Iron [10]

Food Ready-to-eat cereal, 100% iron fortified, cup Milligrams % DV* per serving 18.0 100

Oatmeal, instant, fortified, prepared with water, 1 cup Soybeans, mature, boiled, 1 cup Lentils, boiled, 1 cup Beans, kidney, mature, boiled, 1 cup Beans, lima, large, mature, boiled, 1 cup Beans, navy, mature, boiled, 1 cup Ready-to-eat cereal, 25% iron fortified, cup Beans, black, mature, boiled, 1 cup Beans, pinto, mature, boiled, 1 cup Molasses, blackstrap, 1 tablespoon Tofu, raw, firm, cup Spinach, boiled, drained, cup Spinach, canned, drained solids cup Black-eyed peas (cowpeas), boiled, 1 cup Spinach, frozen, chopped, boiled cup Raisins, seedless, packed, cup Whole wheat bread, 1 slice White bread, enriched, 1 slice

10.0 8.8 6.6 5.2 4.5 4.5 4.5 3.6 3.6 3.5 3.4 3.2 2.5 1.8 1.9 1.5 0.9 0.9

60 50 35 25 25 25 25 20 20 20 20 20 10 10 10 8 8 6 6

Grits, white, enriched, quick, prepared with water, 1 cup 1.5

*DV = Daily Value. DVs are reference numbers developed by the Food and Drug Administration (FDA) to help consumers determine if a food contains a lot or a little of a specific nutrient. The FDA requires all food labels to include the percent DV (%DV) for iron. The percent DV tells you what percent of the DV is provided in one serving. The DV for iron is 18 milligrams (mg). A food providing 5% of the DV or less is a low source while a food that provides 10-19% of the DV is a good source. A food that provides 20% or more of the DV is high in that nutrient. It is important to remember that foods that provide lower percentages of the DV also contribute to a healthful diet. For foods not listed in this table, please refer to the U.S. Department of Agriculture's Nutrient Database Web site: http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl.

Iron Rich Foods

http://www.healthcastle.com/iron.shtml

What affects iron absorption?

Iron absorption refers to the amount of dietary iron that the body obtains and uses from food. Healthy adults absorb about 10% to 15% of dietary iron, but individual absorption is influenced by several factors [ 1,3,8,11-15]. Storage levels of iron have the greatest influence on iron absorption. Iron absorption increases when body stores are low. When iron stores are high, absorption decreases to help protect against toxic effects of iron overload [1,3]. Iron absorption is also influenced by the type of dietary iron consumed. Absorption of heme iron from meat

proteins is efficient. Absorption of heme iron ranges from 15% to 35%, and is not significantly affected by diet [ 15]. In contrast, 2% to 20% of nonheme iron in plant foods such as rice, maize, black beans, soybeans and wheat is absorbed [16]. Nonheme iron absorption is significantly influenced by various food components [1,3,11-15]. Meat proteins and vitamin C will improve the absorption of nonheme iron [1,17-18]. Tannins (found in tea), calcium, polyphenols, and phytates (found in legumes and whole grains) can decrease absorption of nonheme iron [1,19-24]. Some proteins found in soybeans also inhibit nonheme iron absorption [1,25]. It is most important to include foods that enhance nonheme iron absorption when daily iron intake is less than recommended, when iron losses are high (which may occur with heavy menstrual losses), when iron requirements are high (as in pregnancy), and when only vegetarian nonheme sources of iron are consumed. The absorption of Non-heme iron can be improved when a source of heme iron is consumed in the same meal. In addition, the iron absorption-enhancing foods can also increase the absorption of non-heme iron. While some food items can enhance iron absorption, some can inhibit or interfere iron absorption. Avoid pairing these ironinhibiting foods when you're eating the iron-rich foods in the same meal.
Iron Absorption Enhancers Iron Absorption Inhibitors

Meat/fish/poultry Fruits: Orange, Orange Juice, cantaloupe, strawberries, grapefruit etc Vegetables: Broccoli, brussels sprouts, tomato, tomato juice, potato, green & red peppers White wine

Red Wine, Coffee & Tea Vegetables: Spinach, chard, beet greens, rhubarb and sweet potato Whole grains and bran Soy products