Iron Deficiency Anemia: Learn About Symptoms, Causes, and Treatments

Definition, Symptoms, Causes, and Treatments of Iron Deficiency Anemia

Screening for Anemia
Screening for Anemia. Murat Sarica/E+/Getty Images

Iron deficiency is the most common nutritional deficiency in the world.  As the name suggests it results from a low amount of iron in the body.  Hemoglobin, a protein in the red blood cell that carries oxygen, contains iron.  Without iron, the body cannot make the amount of hemoglobin needed.  

Symptoms of Iron Deficiency Anemia

Iron deficiency anemia has the same symptoms as other forms of anemia.  In general, iron deficiency occurs slowly over time so they may have severe anemia before experiencing any symptoms.

 These include:

  • Fatigue or tiredness
  • Pale appearance of skin
  • Shortness of breath
  • Dizziness
  • Rapid heart beat

Who Is at Risk?

  • Infants and toddlers
  • Menstruating women
  • Pregnant women
  • People with blood loss from the gastrointestinal (GI) tract.  
  • Persons undergoing gastric bypass surgery

Infant and toddlers who consume large amounts of cow's milk are at risk for iron deficiency anemia. Cow's milk does not contain much iron and it also blocks the absorption of iron in the small intestine.  When children drink large amounts of milk, they often don't eat enough iron rich foods.  Because infants and toddlers are at increased risk of iron deficiency anemia, the American Academy of Pediatrics recommends that all babies be screened for anemia around 12 months of age.  

Women can develop iron deficiency anemia due to blood loss during their menstrual cycles.   Normally the body recycles iron from aging red blood cells, but when red blood cells are lost during menstrual bleeding, the body is unable to recycle the iron.

   

Pregnant women need to increase production of red blood cells to support the growing fetus.  During this rapid expansion of red blood cells, the woman may become anemic. Obstetricians, physicians that take care of pregnant women, attempt to prevent iron deficiency anemia by recommending prenatal vitamins that contain iron.

 

Similar to blood loss during menstrual bleeding, bleeding from the GI tract can cause iron deficiency. This bleeding may be subtle and not visible to the naked eye.  There are numerous reasons to have bleeding from the GI tract including, gastric ulcers, hemorrhoids, and colon cancer.  In developing countries, the most common cause of GI bleeding is an infection with worms.  

People who undergo bariatric surgery, or gastric bypass, are at risk of developing iron deficiency because the surgery removes the major site of iron absorption in the intestine.  

How Is Iron Deficiency Anemia Diagnosed?

Iron deficiency anemia is initially found on complete blood count (CBC), a commonly ordered laboratory test. The CBC would show a low hemoglobin (or hematocrit) with small red blood cells as indicated by low mean corpuscular volume (MCV).  If iron deficiency anemia is suspected, the physician may also send iron studies for confirmation.  These include a test called ferritin, which reflects the amount of iron stored in the body.

 A low ferritin level is consistent with iron deficiency.  

Treatment of Iron Deficiency Anemia

The primary treatment for iron deficiency anemia, is iron supplementation. In general, iron supplementation is given via oral medications.  If the iron deficiency is severe or if the person cannot absorb iron appropriately in the intestine, intravenous (IV) iron may be used.  

If the anemia from iron deficiency is severe, the person may require a blood transfusion.  Generally enough blood is given to person to reach a "safe" level rather than correcting the anemia completely.

If iron deficiency is a result of blood loss it is important to investigate the cause and treat it if possible.  Some women who have excessive bleeding during menstrual bleeding may need to be evaluated for a bleeding disorder.  

Sources:

Robert D. Baker, Frank R. Greer and The Committee on Nutrition. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 Years of Age). Pediatrics 2010;126;1040 

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