General Health

Iron deficiency anemia: A common female health issue

Iron deficiency anemia is a medical condition in which blood has insufficient hemoglobin– a substance that enables red blood cells to deliver oxygen to tissues of the human body, the production of which requires iron.

Signs and Symptoms

  1. General fatigue and weakness
  2. Pale skin (pallor)
  3. Chest pain, shortness of breath
  4. Increased heart rate and/or irregular heartbeat
  5. A tingling or crawling sensation in the legs
  6. Headache, lightheadedness or dizziness
  7. Cold hands and feet
  8. Inflammation or soreness of your tongue (anemic glossitis)
  9. Brittle nails
  10. Poor appetite, particularly in infants and children
  11. Unusual cravings for non-nutritive substances, such as dirt, ice, or starch

Causes

Lack of hemoglobin and resultant iron deficiency anemia may occur either due to insufficient iron consumption or excessive loss of iron.

  • Loss of blood. Blood contains iron within the erythrocytes or RBCs (red blood cells) and therefore blood loss results in loss of iron. Women with heavy menstrual periods are at an increased risk of iron deficiency anemia due to blood loss during menstruation. Chronic, slow blood loss in the body — such as from peptic ulcers, hiatal hernia, a colon polyp or colorectal cancer are other causes. Gastrointestinal tract bleeding could occur due to regular use of over-the-counter (OTC) pain relievers, particularly aspirin.
  • Inadequate iron intake. Inadequate consumption of iron could make the body iron deficient. Examples of iron-containing foods include eggs, meat, green leafy vegetables and iron-fortified foods.
  • Iron absorption inability. Iron from food is absorbed into the bloodstream in the small intestine. Intestinal disorders such as celiac disease affect the intestine’s ability to absorb nutrients from food, and can therefore lead to iron deficiency anemia. Surgical removal of a part of the small intestine may affect iron absorption too.
  • Genetics. Conditions such as like celiac disease make it difficult to absorb enough iron that is passed down through families. The TMRPSS6 mutation causes excessive hepcidin production, which can block iron absorption in the intestines. Other genetic conditions may contribute to anemia by causing abnormal bleeding including hemophilia and Von Willebrand disease.
  • Pregnancy. Iron deficiency anemia occurs in many pregnant women since their iron stores need to serve not only their increased blood volume but also be a source of hemoglobin for the growing fetus.

Risk factors

  1. Female gender. Since women lose blood during menstruation, females, in general, are more prone to iron deficiency anemia.
  2. Infants and children. Infants, particularly those with low birth weight or premature births, who don’t receive enough iron from breast milk/formula may be at increased risk of iron deficiency. Children need extra iron during growth spurts and if they don’t consume healthy meals, they may be at risk of anemia.
  3. Vegetarian diet. Vegetarians may be at an increased risk of iron deficiency anemia due to a lack of iron-rich foods such as meat in their diet.
  4. Frequent blood donation. Routine blood donors may have an increased risk of iron deficiency anemia as the donation of blood could deplete iron stores. Low hemoglobin associated with blood donation may be a transient issue resolved by consuming iron-rich foods.

Complications

  1. Cardiovascular issues. Iron deficiency anemia may lead to irregular or rapid heartbeat since the heart needs to pump more blood for compensating for the lack of oxygen in anemia. This can lead to heart failure.
  2. Pregnancy issues. Severe iron deficiency anemia has been associated with low-birth-weight babies and premature births.
  3. Growth issues. In infants and children, severe iron deficiency could delay growth and development and increase their susceptibility to infections.

Diagnosis, treatment and prevention

Iron deficiency anemia is diagnosed with tests that evaluate complete blood counts (CBC), RBC colour and size, hematocrit, hemoglobin counts and serum ferritin levels. since RBCs in iron deficiency anemia are microcytic and hypochromic. Hematocrit is a measure of the percentage of blood volume comprising RBCs and may be lowered in iron deficiency anemia. Hemoglobin levels and serum ferritin levels are reduced in anemia. Other tests that may be performed include endoscopy or colonoscopy to locate the source of bleeding. A pelvic ultrasound may be performed for the cause of excessive menstrual bleeding, such as uterine fibroids.

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Consume iron-rich foods such as red meat, pork and poultry, seafood, beans, green leafy vegetables such as spinach, dried fruit, such as raisins and apricots, iron-fortified cereals, bread and pasta and peas. In addition, Vitamin-C rich foods such as oranges, grapefruit, kiwi, melons, strawberries, tangerines, tomatoes etc must be consumed since Vitamin C enhances iron absorption.

To prevent iron deficiency anemia in infants, babies must be fed breast milk or iron-fortified formula in the first year. After six months of age, babies must be fed pureed meats or iron-fortified cereals at least twice daily for boosting iron intake. After one year, children must not consume more than 591 millilitres of milk per day since too much milk often takes the place of other foods.

Iron supplements may be prescribed for several months to replenish iron stores in the body but must not be taken along with antacids. Medications, such as oral contraceptives may be taken to reduce menstrual flow. In case of peptic ulcers, antibiotics may be prescribed and surgery may be performed in case of a fibroid, tumour or a bleeding polyp. In case of severe iron deficiency, blood transfusions may be required for a quick increase in iron and hemoglobin levels.

Author

Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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