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 occurs when your body does not have enough iron. Iron helps
make red blood cells.

Causes
Iron deficiency anemia is the most common form of anemia.
Red blood cells bring oxygen to the body's tissues. Healthy red blood cells are made in
your bone marrow. Red blood cells circulate through your body for 3 to 4 months. Parts
of your body, such as your spleen, remove old blood cells.
Iron is a key part of red blood cells. Without iron, the blood cannot carry oxygen
effectively. Your body normally gets iron through your diet. It also reuses iron from old
red blood cells.
You get iron deficiency anemia when your body's iron stores run low. This can occur
because:

You lose more blood cells and iron than your body can replace

Your body does not do a good job of absorbing iron

Your body is able to absorb iron, but you are not eating enough foods that contain
iron

Your body needs more iron than normal (such as if you are pregnant or
breastfeeding)
Bleeding can cause iron loss. Common causes of bleeding are:

Heavy, long, or frequent menstrual periods

Cancer in the esophagus, stomach, small bowel, or colon

Esophageal varices, usually from cirrhosis

The use of aspirin, ibuprofen, or arthritis medicines for a long time, which can
cause gastrointestinal bleeding

Peptic ulcer disease

The body may not absorb enough iron in your diet due to:

Celiac disease

Crohn disease

Gastric bypass surgery

Taking too many antacids that contain calcium

You may not get enough iron in your diet if:

You are a strict vegetarian

You are an older adult and do not eat a full diet

Symptoms
You may have no symptoms if the anemia is mild.
Most of the time, symptoms are mild at first and develop slowly. Symptoms may
include:

Feeling grumpy

Feeling weak or tired more often than usual, or with exercise

Headaches

Problems concentrating or thinking

As the anemia gets worse, symptoms may include:

Blue color to the whites of the eyes

Brittle nails

Desire to eat ice or other non-food things (pica)

Light-headedness when you stand up

Pale skin color

Shortness of breath

Sore tongue
Symptoms of the conditions that cause iron deficiency anemia include:

Dark, tar-colored stools or blood

Heavy menstrual bleeding (women)

Pain in the upper belly (from ulcers)

Weight loss (in people with cancer)

Exams and Tests

To diagnose anemia, your doctor may order these blood tests:

Hematocrit and hemoglobin (red blood cell measures)

RBC indices

Tests to check iron levels in your blood include:

Bone marrow exam (rare)

Iron binding capacity (TIBC) in the blood

Serum ferritin

Serum iron level

Tests that may be done to look for the cause of iron deficiency:

Colonoscopy

Fecal occult blood test

Upper endoscopy

Treatment
Treatment may include taking iron supplements and eating iron-rich foods.
Iron supplements (most often ferrous sulfate) are needed to build up the iron stores in
your body. Most of the time, your doctor or nurse will measure your iron levels before
starting supplements.
If you cannot take iron by mouth, you may need to take it through a vein (intravenous)
or by an injection into the muscle.
Pregnant and breastfeeding women will need to take extra iron because they often
cannot get enough iron from their normal diets.
Your hematocrit should return to normal after 2 months of iron therapy. You will need to
keep taking iron for another 6 to 12 months to replace the body's iron stores in the bone
marrow.

Iron-rich foods include:

Chicken and turkey

Dried lentils, peas, and beans

Fish

Meats (liver is the highest source)

Peanut butter

Soybeans

Whole-grain bread
Other sources include:

Oatmeal

Raisins, prunes, and apricots

Spinach, kale, and other greens

Outlook (Prognosis)
With treatment, the outcome is likely to be good. However, it does depend on the
cause.

When to Contact a Medical Professional

Call your health care provider if:

You have symptoms of iron deficiency

You notice blood in your stool

Prevention
A balanced diet should include enough iron. Red meat, liver, and egg yolks are high
sources of iron. Flour, bread, and some cereals are fortified with iron. If advised by your
doctor, take iron supplements if you are not getting enough iron in your diet.

References
Brittenham GM. Disorders of iron homeostasis: iron deficiency and overload. In: Hoffman
R, Benz EJ Jr, Silberstein LE, et al., eds.Hematology: Basic Principles and Practice

Update Date 2/24/2014

Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists &
Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also
reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

Taken from:

Gersten, T., .2014. Iron Deficiency Anemia.

https://www.nlm.nih.gov/medlineplus/ency/article/000584.htm. Accessed 16th
September 2015