Earlier we gave you a brief idea about what is anemia. Thought if you don’t know what is anemia? Here is the simple answer. Anemia is the condition in which there is a low level of red blood cells (RBCs) in your blood that is lower than normal range required for the body.
Now here we will move on to one of the most common types of anemia that is, Iron Deficiency Anemia.
I guess from the name itself you can come to know that it is caused by decreased or lack of iron in the blood.
Yes, that’s true! Now, let’s see what it is?
Iron in blood is mainly responsible for carrying and storing oxygen in the blood. In iron deficiency anemia the amount of iron in the blood reduces that in turn reduces the number of red blood cells. This condition is known as Iron Deficiency Anemia (IDA). Medically, it is defined as “Decreased in the oxygen-carrying capacity of the blood.”
Causes of Iron Deficiency Anemia
Iron deficiency anemia can be caused due to blood loss, more physiologic demands of iron by body and mal-absorption.
Now, let’s first talk about iron deficiency anemia due to blood loss:
Commonly seen in men and post-menopausal women due to gastrointestinal blood loss. This condition occurs due to:
- Occult gastric or colorectal malignancy
- Peptic ulceration
- Inflammatory bowel disease
- Angiodysplastic lesions
Gastrointestinal blood loss can be worsened by the use of certain drug groups like Aspirin or NSAIDS (Non-Steroidal Anti-Inflammatory Drugs). These drugs worsen the condition by causing impaired platelet function and erosions in the intestine.
The case where there is:
- Pregnancy or menstrual blood loss,
- Childbearing-aged women or
- A breastfeeding woman
are at a risk of Iron deficiency anemia as these conditions require more blood and thus there is depletion of iron stores in the body. In rare cases, it is found that chronic hematuria can often lead to blood loss.
Now, the second cause is iron deficiency anemia due to more physiologic demands of iron by the body:
Physiologic demand means the period of rapid growth such as infancy and puberty. During these times the body demands more iron and the demand may be more than the iron stores in the body. In a pregnant lady, Iron demand is more because, during pregnancy, the iron produced in the body reaches the fetus and the placenta thus shows an increased demand for iron and even the increased maternal red cell mass. This blood is lost with the amount of blood loss during parturition.
The third cause is iron deficiency anemia due to Mal-absorption:
A person with very few amount of food intake or not having proper healthy diet may suffer from Iron deficiency anemia. For such case,
- Iron intake of all the patients should be measured and a diet plan should be assessed.
- The main hero here is gastric acid, yes this gastric acid helps to release iron from the food and also keeps an iron insoluble ferrous state.
Iron Deficiency Anemia Symptoms
Symptoms of iron deficiency anemia are:
- Weakness in body
- Muscles get fatigue
- Difficulty in breathing or shortness of breathing
- Pale skin tone due to low Hb (Hemoglobin)
- Cold hands and feet
- A burning or creeping sensation in the legs
- Skull feels lighter
- Loss of appetite or decreased appetite
- Distension of tongue
- Body feels cold
As you can see, symptoms of iron deficiency anemia range from mild to severe. Sometimes, it is impossible to detect iron deficiency anemia due to its asymptomatic nature. Various diagnostic aids are described here below, so don’t forget to check out them.
Diagnosis of Iron Deficiency Anemia
Diagnosis of iron deficiency anemia is done on two levels. First one is the confirmation if iron deficiency and a second one is to rule out the cause for iron deficiency.
So, confirmation of iron deficiency can be done by the presence of plasma ferritin, a form of iron stores in the tissues. Reduction in plasma ferritin levels can be in the case of iron deficiency, hypothyroidism or vitamin C deficiency. An increase in plasma ferritin levels can be seen in the case of liver disease or as an acute phase response, these levels can be raised up to 100 micrograms per liter. The measure of iron availability can be done on the basis of plasma iron and total iron binding capacity, and these levels are affected by many factors except iron stores.
Plasma iron shows diurnal and day to day variations, it can be low in case of an acute phase response and high in case of liver disease and hemolysis.
A protein called transferrin also shows lower levels in case of malnutrition, nephrotic syndrome, and liver disease, and it can also increase in case of pregnancy or the one on contraception.
Poor iron stores in the body that can be measured by immunoassay test that helps distinguish storage iron depletion during any acute phase response or in the liver disease state, in which there is raised iron levels that indicate iron deficiency.
Now, let’s discuss how to know the cause of iron deficiency?
Basically, the cause can be decided on the basis of the age and sex of the person.
As in the case of men and post-menopausal women that have routine diet, the upper and lower GI tract should be examined by endoscopy or barium milk study.
A duodenal biopsy like serum endomysial antibodies are indicated for the detection of coeliac disease in iron deficient patients that show Mal-absorption or in a case of young men with normal dietary habits and regularly menstruating women and diet.
Iron Deficiency Anemia Treatment
Oral iron supplements in form of ferrous sulfate should be given 200 mg 8 hourly and should be continued for 3 to 6 months. Only in cases of patients with heart disease or cerebral hypoxia, transfusion becomes necessary.
In case, if the patient is intolerant to ferrous sulfate like in dyspepsia or bowel disease you need to reduce the dose to 200 mg 12 hourly or use ferrous gluconate 300 mg 12 hourly.
After giving supplements you need to check for the rise in hemoglobin levels every 7 to 10 days should be checked and a rise of 10 g per liter should be evident.
Parenteral iron therapy may be required in case of mal-absorption or patients with the chronic gut disease. They can also be given intravenous iron therapy or dextran.
You need to check for anaphylaxis during the test dose.
How to prevent Iron Deficiency Anemia?
You can prevent iron deficiency anemia by intake of high iron rich diet. Foods that are high in iron are:
Foods high in iron include:
- Squash and Pumpkin Seeds
- Seafood such as Oysters, Clams, etc.
- Liver of a chicken
- Beef and Lamb
- Dry fruits such as Cashew, Hazelnut, Almond, Apricots etc.
- Whole Grains, Cereals, and Wheat Bran
- Dark Chocolate or Cocoa Powder
- Pulses and Beans
- Green leaves such as Spinach
These all are high iron rich diet so add them to your diet and feel free from Iron deficiency anemia.
Eat a healthy diet and say no to iron deficiency. Correct diet at a correct time and with good exercise is the best cure to iron deficiency.