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Iron deficiency anemia

Anemia is a condition in which the body


does not have enough healthy red blood
cells. Red blood cells provide oxygen to
body tissues. There are many types of
anemia. Iron deficiency anemia is a
decrease in the number of red cells in
the blood caused by too little iron.
Causes
Iron deficiency anemia is the most common
form of anemia. About 20% of women, 50% of
pregnant women, and 3% of men do not have
enough iron in their body.
Iron is a key part of hemoglobin, the
oxygen-carrying protein in the blood.
Your body normally gets iron through diet
and by recycling iron from old red blood
cells. Without iron, the blood cannot
carry oxygen effectively. Oxygen is
needed for every cell in the body to
function normally.
The causes of iron deficiency are:
Blood loss
Poor absorption of iron by the body
Too little iron in the diet
It can also be related to lead
poisoning in children.
Anemia develops slowly after the normal
iron stores in the body and bone marrow
have run out. In general, women have
smaller stores of iron than men because
they lose more through menstruation. They
are at higher risk for anemia than men.
In men and postmenopausal women, anemia
is usually caused by gastrointestinal
bleeding due to:
Certain types of cancer (esophagus,
stomach, colon)
Esophageal varices
Long-term use of aspirin or
nonsteroidal anti-inflammatory
medications (NSAIDS)
Peptic ulcer disease
Iron deficiency anemia may also be caused
by poor absorption of iron in the diet,
due to:
Celiac disease
Crohn's disease
Gastric bypass surgery
Taking antacids
Other causes of iron deficiency anemia
include:
Heavy, long, or frequent menstrual
bleeding
Not receiving enough iron in the
diet (for example, if you are a
strict vegetarian)
Adults at high-risk for anemia include:
Those who use aspirin, ibuprofen,
or arthritis medicines for a long
time
Women who are pregnant or
breastfeeding who have low iron
levels
Seniors
Women of child-bearing age
Symptoms
Blue color to whites of the eyes
Brittle nails
Decreased appetite (especially in
children)
Fatigue
Headache
Irritability
Pale skin color
Shortness of breath
Sore tongue
Unusual food cravings (called pica)
Weakness
Note: There may be no symptoms if
the anemia is mild.
Exams and Tests
Fecal occult blood test
Hematocrit and hemoglobin (red blood
cell measures)
Iron binding capacity (TIBC) in the
blood
RBC indices
Serum ferritin
Serum iron level
Treatment
The cause of the iron deficiency must be
found, especially in older patients who
face the greatest risk for
gastrointestinal cancers.
Iron supplements (ferrous sulfate) are
available. For the best iron absorption,
take these supplements with an empty
stomach. However, many people cannot
tolerate this and may need to take the
supplements with food.
Patients who cannot tolerate iron by
mouth can take it through a vein
(intravenous) or by an injection into the
muscle.
Milk and antacids may interfere with the
absorption of iron and should not be
taken at the same time as iron
supplements. Vitamin C can increase
absorption and is essential in the
production of hemoglobin.
Pregnant and breastfeeding women will
need to take extra iron because their
normal diet usually will not provide the
required amount.
The hematocrit should return to normal
after 2 months of iron therapy. However,
iron should be continued for another 6 -
12 months to replenish the body's iron
stores in the bone marrow.
Iron-rich foods include:
Eggs (yolk)
Fish
Legumes (peas and beans)
Meats (liver is the highest source)
Poultry
Raisins
Whole-grain bread
Outlook (Prognosis)
With treatment, the outcome is likely to
be good. Usually, blood counts will
return to normal in 2 months.
Possible Complications
There are usually no complications.
However, iron deficiency anemia may come
back. Get regular follow-ups with your
health care provider.
Children with this disorder may be more
likely to get infections.
Prevention
Everyone's diet should include enough
iron. Red meat, liver, and egg yolks are
important sources of iron. Flour, bread,
and some cereals are fortified with iron.
If you aren't getting enough iron in your
diet (uncommon in the United States),
take iron supplements.
During periods when you need extra iron
(such as pregnancy and breastfeeding),
increase the amount of iron in your diet
or take iron supplements.
Alternative Names
Anemia - iron deficiency

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