Definition

Anemia occurs when the body's hemoglobin level decreases in the red blood cells. Hemoglobin is a protein in red blood cells responsible for transporting oxygen to the tissues. Iron deficiency anemia is the most common form of anemia when the body lacks sufficient iron to produce hemoglobin.

When the body lacks iron in the blood, it affects its ability to transport oxygen, leading to symptoms such as shortness of breath or fatigue. These symptoms can develop over time

Causes

The most common cause of iron deficiency anemia in patients is blood loss. Other causes include:

• Bleeding in the gastrointestinal tract may result in red or black stools (melena). Medical conditions such as ulcers, polyps, and colon cancer are common causes of gastrointestinal bleeding. Long-term use of aspirin or NSAIDs can also lead to gastrointestinal bleeding.
• Bleeding in the urinary tract.
• Bleeding due to injury or surgery.
• Long menstrual periods (menorrhagia).
• Frequent blood donation.
• Recurrent blood tests, particularly in infants and children.

In addition, other conditions that can lead to iron deficiency anemia if the body does not obtain sufficient iron from food or if iron absorption is impaired due to medical conditions include:

• Digestive disorders such as Celiac disease, autoimmune gastritis, gastrointestinal irritation (e.g., ulcers), or Crohn's disease.
• H. pylori infection in the stomach.
• Recent gastrointestinal surgery, including weight loss surgery, may hinder the body's ability to absorb necessary nutrients.
• Other genetic conditions that interfere with iron absorption.

Read more: Crohn's Disease - Definition, Cause, Symptom, And Treatment

Risk factor

Everyone is at risk of developing iron deficiency anemia, but certain groups are more vulnerable than others. Women with long menstrual cycles, during pregnancy, or while breastfeeding are at higher risk compared to women who have gone through menopause or men.

Some groups at risk of iron deficiency anemia include:

• Infants aged 6-12 months: Newborns have iron reserves acquired during pregnancy, which are depleted after 4-6 months. Breastfed babies or those consuming formula milk may not adequately meet their iron needs.
• Children aged 1-2 years: Children consuming excessive cow's milk may not receive enough iron.
• Adolescents: Rapid growth during adolescence may require more iron, sometimes leading to deficiency.
• Elderly individuals over 65 years old: Reduced food intake in elderly individuals may result in inadequate iron consumption.
• Individuals with medical conditions such as bone marrow disorders or autoimmune diseases.

Symptoms

The symptoms of iron deficiency anemia may not be immediately apparent but can develop gradually over time. These symptoms can worsen if left untreated, leading to more severe complications.

Some symptoms of iron deficiency include:

• Fatigue and weakness
• Shivering
• Shortness of breath (dyspnea)
• Chest pain
• Difficulty concentrating
• Headaches and dizziness
• Easy bruising
• Pica, an eating disorder involving consuming non-food items such as paper, ice, and hair
• Restless leg syndrome
• Spoon-shaped and brittle nails (koilonychia)
• Pale or paler-than-usual skin
• Pale conjunctiva

Read more: Pica - Definition, Cause, Symptom, And Treatment

Diagnosis

Diagnosis of iron deficiency anemia involves a thorough assessment comprising medical history, physical examination, and diagnostic tests.

Medical interview

During the medical interview session, the doctor engages in a question-and-answer discussion with the patient, covering areas such as current symptoms, past medical history, family medical history, and relevant details such as pregnancy and menstrual history for women, as well as developmental history for infants and children.

Physical examination

Following the medical history, a physical examination evaluates vital signs including blood pressure, respiratory rate, pulse, and body temperature. Additionally, the doctor may examine the patient's eyes for signs of paleness in the conjunctiva.

Diagnostic tests

The doctor will recommend blood tests as the primary diagnostic method for iron deficiency anemia. These tests may include:

• Examination of red blood cells under a microscope: Red blood cells typically appear paler than usual and smaller in iron deficiency anemia. Additionally, the doctor may assess levels of iron, transferrin (a protein that carries iron), and ferritin (a protein that stores iron) to confirm the diagnosis further.
• Additional tests to identify the underlying cause: If iron deficiency anemia is confirmed, the doctor may conduct further investigations to determine the cause of the condition. This may involve procedures such as colonoscopy or other examinations to detect sources of gastrointestinal bleeding, which can contribute to low iron levels.

Read more: Feritin Examination - Indication, Contraindication, Results And Suggestions

Management

The primary treatment for iron deficiency anemia involves supplementing iron, typically administered orally through pills or intravenously. When iron deficiency anemia is secondary to an underlying condition, doctors prioritize treating the root cause while concurrently prescribing iron supplements to replenish iron stores.

Complications

In most cases, iron deficiency anemia is easily treatable, and complications are rare. However, if left untreated, it can lead to various health issues, including:

• Irregular heartbeat: Anemia forces the heart to work harder to compensate for the reduced oxygen levels, which may result in irregular heartbeats. In severe cases, it can lead to heart failure or enlargement.
• Pregnancy complications: Iron deficiency during pregnancy may increase the risk of premature birth or low birth weight in babies. Pregnant women are often advised to ensure adequate iron intake to mitigate these risks.
• Stunted growth in infants and children

Read more: Low Birth Weight - Definition, Cause, Symptom, And Treatment

Prevention

If you're experiencing iron deficiency anemia due to factors like bleeding or poor iron absorption from your diet, discussing prevention strategies with your doctor is essential.

For those without these underlying conditions, reducing the risk of anemia can be achieved by incorporating iron-rich foods into your diet, including:

• Grains such as beans, tofu, and tempeh
• Breads and cereals like whole wheat bread, iron-fortified white bread, and whole grain cereals
• Vegetables such as spinach, broccoli, green beans, dark leafy greens, potatoes, cabbage, and tomatoes
• Animal proteins such as meat, chicken, eggs, liver, and fish
• Fruits such as dates and raisins

When to see a doctor?

If you're experiencing symptoms of iron deficiency anemia, as described above, it's crucial to consult your doctor promptly. They can conduct a thorough assessment, including routine examinations, to monitor your iron levels and overall health holistically.

Looking for more information about other diseases? Click here!