Anemia, Iron-Deficiency

General Illness Information


Common Name:

ANEMIA, IRON-DEFICIENCY

Medical Term: None Specified

Description:

Anemia is caused due to lack of iron. Small, pale red blood cells and depletion of iron stores characterize it.

Iron is an essential mineral, and is used by the body to produce hemoglobin, the red pigment protein in the red blood cells (erythrocytes). Lack of iron causes low hemoglobin, which decreases the oxygen-carrying capacity of the blood.

Iron deficiency anemia is the most common cause of anemia.

The body recycles iron – when red blood cells die, the iron from the red blood is transported to the bone marrow where it is used in the production of new red blood cells. Therefore blood loss is virtually the only cause of iron deficiency anemia in adults. However, in infants and children, who need more iron because they are growing, iron deficiency anemia is usually due to diet low in iron.

Causes:

In Infants and Children:

  • Poor nutrition: between 6 months and two years of age, children may consume large quantities of milk, but iron containing foods are often excluded;
  • Premature Birth: premature babies often have low stores of iron at birth.

In Adolescents and Adults:

  • Rapid growth spurts;
  • Lack of dietary iron;
  • Heavy menstrual bleeding;
  • Pregnancy;
  • Malabsorption;
  • Gastrointestinal disease with bleeding, including cancer of the bowel.

Prevention:

  • Maintain an adequate iron intake through a well balanced diet or iron supplements;
  • Provide iron-fortified formula for bottle-fed infants.

Signs & Symptoms

  • Paleness, especially in the hands and lining of the lower eyelids;
  • Tiredness and weakness;
  • Tongue inflammation (glossitis);
  • Cracks at the side of the mouth (cheilosis);
  • Spoon-like deformity of finger nails (koilonychia);
  • Fainting;
  • Breathlessness;
  • Rapid heartbeat;
  • Appetite loss;
  • Abdominal discomfort;
  • Susceptibility to infection;
  • Unusual quietness or withdrawal in a child;
  • Cravings for ice, paint or dirt (pica).

Risk Factors

  • Poor socio-economic conditions;
  • Adults over 60;
  • Recent illness, such as an ulcer, diverticulitis, colitis, hemorrhoids or gastrointestinal tumors.

Diagnosis & Treatment

General Measures:

  • Usually curable with iron supplements if the underlying cause can be identified and cured;
  • Diagnostic tests may include laboratory studies of serum iron, total iron-binding capacity and ferritin levels. The most important part of treatment for iron deficiency anemia is to correct the underlying cause. Iron deficiency can be treated well with iron supplements. Blood transfusions are sometimes prescribed, but they should be unnecessary, except in rare cases. Avoid risk of infections.

Medications:

Iron Supplements:

Take iron on an empty stomach (at least half an hour before meals) for best absorption. If it upsets your stomach, you may take it with a small amount of food (except milk) If you take other medications, wait at least two hours after taking iron before taking them. Antacids and tetracyclines especially interfere with iron absorption. Because liquid iron supplements may discolor the teeth, a child should drink any liquid iron preparations through a straw. Iron supplements may also cause black bowel movements, diarrhea or constipation. Continue iron supplements until 2 to 3 months after blood tests return to normal. Too much iron is dangerous. A bottle of iron tablets can poison a child. Keep iron supplements out of the reach of children. Rarely, iron may have to be given by injections. This is reserved for patients who cannot tolerate iron tablets or are unable to absorb iron or for those who are continuing to lose a lot of blood from ongoing bleeding.

Activity:

No restrictions. You may need to pace activities until symptoms of fatigue are gone.

Diet:

Adults should ideally limit milk to one pint a day. It interferes with iron absorption. Eat protein and iron containing foods, including meat, beans and leafy green vegetables Increase dietary fiber to prevent constipation. Babies should be fed iron fortified formula.

Prognosis

Depends on the underlying cause of iron deficiency anemia. Once the underlying problem is treated then supplemental iron will correct the anemia.

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