What is iron deficiency anaemia?
Anaemia is a condition where the body does not have adequate number of red blood cells for transporting oxygen. The component of red blood cells that carries oxygen, haemoglobin, needs iron to carry out its function. When there is an iron deficit, the body is unable to form healthy red blood cells with adequate amounts of haemoglobin, resulting in anaemia.
Does my body produce iron?
What are the causes of iron deficiency?
Iron deficiency results when the dietary intake of iron is inadequate to meet the iron requirements of the body. This can be caused by –
- Blood loss
– Heavy menstrual bleeding
– Bleeding from the gastrointestinal tract due to ulcers, polyps or colon cancer
– Bleeding from the urinary tract
– Heavy blood loss due to injury or surgery
- Hookworm infestation (Helminthiasis)
- Pregnancy: Pregnant women risk developing iron deficiency as their bodies’ iron reserves are utilised for supporting their increased blood volume and the growth requirements of the foetus
- Inflammation due to conditions such as chronic kidney disease or chronic heart failure
- Medicines: Continuous use of over-the-counter painkillers like aspirin and ibuprofen causes gastrointestinal bleeding and iron deficiency anaemia
- Medicines used for treating acidity, such as omeprazole, can also cause iron deficiency as they affect iron absorption
- Diet: People on restrictive diets such as vegans or vegetarians are at a higher risk of developing iron deficiency due to inadequate intake of iron
- Growth: A greater amount of iron is used up during growth spurts in children
- Impaired absorption: Iron is absorbed from the small intestine. Hence, conditions that affect the absorption capacity of the small intestine, such as celiac disease, can
- cause iron deficiency. Bariatric surgery (weight loss surgery or gastric bypass surgery) is also a risk factor for iron deficiency due to poor intestinal absorption of iron
Frequent blood donations
What are the symptoms of iron deficiency anaemia?
Mild iron deficiency anaemia may go unnoticed, but severe cases present with the following symptoms –
- Fatigue and exhaustion
- Paleness of skin
- Shortness of breath
- Memory loss
- Pica – craving to eat raw food grains such as raw rice and non-nutritious or non-food substances such as ice, clay, chalk, ash, charcoal
- Rapid heartbeat or palpitations
- Brittleness of nails
- Soreness or burning sensation of the tongue with loss of papillae (glossitis)
- Cracks or soreness at the corners of the mouth (angular cheilitis)
Who’s at risk of developing iron deficiency anaemia?
The risk of iron deficiency anaemia is greater in –
- Infants who haven’t had breastmilk or iron-fortified formula
- Menstruating women
- Pregnant and breastfeeding women
- Individuals with poor diets or crash dieters
- Vegans and vegetarians
How do I prevent iron deficiency anaemia?
Iron is not synthesised in the body and our requirements are normally met through food. Having a diet rich in iron will help in preventing iron deficiency anaemia.
Iron-rich food substances include –
- Red meat
- Green leafy vegetables
- Sea food
- Peas and beans
- Dry fruits
- Iron fortified bread and breakfast cereals.
Vitamin C enhances the absorption of iron. Hence it’s important to include citrus fruits such as gooseberries, lemons, oranges, and strawberries in the diet.
How do I test for iron deficiency anaemia?
If you have the symptoms of iron deficiency anaemia, the first step is to consult a physician. You may be advised to undergo a variety of blood tests to confirm the diagnosis. These include –
- Complete blood count
- Blood haemoglobin levels
- Peripheral smear
- Blood iron levels and ferritin levels
What is the normal red blood cell count and haemoglobin level?
The range of normal values may vary based on the labs.
Red blood cells –
- Men: 4.5 to 5.5 mill/ mm3
- Women: 3.8 to 4.8 mill/mm3
- Men: 13.8 to 17.2 g/dl
- Women: 12.1 to 15.1 g/dl
- Pregnant women: 11 to 15.1 g/dl
- Children: 11 to 16 g/dl
What is the treatment of iron deficiency anaemia?
- Iron supplements (oral iron or iron pills) – It usually takes three to six months to restore normal iron levels
- Intravenous iron (IV iron) – this is useful in people with severe iron deficiency anaemia
- Blood transfusions – used in people with very serious or life-threatening iron deficiency anaemia
- Surgery to stop internal bleeding (if any)
Are there any side effects to iron supplement tablets?
How will iron deficiency anaemia impact my pregnancy?
There is an increased risk for iron deficiency anaemia during pregnancy, due to increased body and foetal requirements.
This risk for iron deficiency anaemia further increases in the following conditions –
- Closely spaced pregnancies (Pregnancies which are spaced less than 12 months apart)
- Multiple pregnancies
- Frequent vomiting due to morning sickness
- Inadequate intake of iron through diet
- History of anaemia before becoming pregnant
Anaemia can impact pregnancy in the following ways –
- Premature delivery
- Low birth weight baby
- Growth retardation of the foetus
- Increased risk of infections
- Increased risk of pre-eclampsia (Dangerous complication of pregnancy characterised by high blood pressure, protein in the urine and swelling of legs, feet and hands) and bleeding
Anaemia in pregnant mothers can be prevented by iron supplementation and incorporation of iron-rich food substances into the diet.
What are the complications of iron deficiency anaemia?
Long-standing iron deficiency anaemia can lead to –
- Tiredness and lethargy
- Compromised immune system leading to increased risk of infections
- Heart complications leading up to heart failure
- Developmental delay in children
- Complications in pregnancy
- Restless leg syndrome
- Plummer Vinson syndrome (it is characterised by difficulty in swallowing due to web-like growth in the oesophagus. It can increase the risk of developing esophageal cancer)