Iron deficiency

Iron-deficiency anaemia is a prevalent health concern that affects individuals of all ages and backgrounds. As a medical professional, it is crucial to raise awareness about this condition, its causes, symptoms, and available treatment options. By understanding the complexities of iron-deficiency anaemia, patients can take proactive steps towards maintaining their health and well-being.

What is Iron-Deficiency anaemia?

Iron-deficiency anaemia is a condition in which the body lacks sufficient iron to produce haemoglobin, a vital component of red blood cells responsible for transporting oxygen to various tissues and organs. When iron levels are depleted, the body struggles to produce enough healthy red blood cells, leading to anaemia. This can be caused by several factors, including inadequate dietary iron intake, chronic blood loss, or impaired iron absorption. Recognising the signs and symptoms of iron-deficiency anaemia is essential for prompt diagnosis and treatment.

The symptoms of iron-deficiency anaemia can vary in severity and may develop gradually over time. Some individuals may experience mild symptoms, while others may have more severe manifestations of the condition.

Mild Symptoms

• Fatigue and weakness, particularly during physical exertion
• Headaches and dizziness
• Heart palpitations
• Difficulty concentrating or cognitive impairment

Severe Symptoms

• Brittle or spoon-shaped nails
• Bluish tint to the whites of the eyes
• Pica (craving non-food items like ice or dirt)
• Lightheadedness upon standing
• Pale skin
• Shortness of breath
• Glossitis (inflamed or sore tongue)
• Mouth ulcers
• Restless leg syndrome (uncontrolled leg movements during sleep)
• Hair loss

In some cases, iron-deficiency anaemia may be a symptom of an underlying condition, such as:

• Gastrointestinal bleeding (indicated by dark, tar-coloured stools or visible blood in the stool)
• Heavy menstrual bleeding
• Peptic ulcers (causing pain in the upper abdomen)

Recognising these symptoms and seeking medical attention is crucial for receiving an accurate diagnosis and appropriate treatment for iron-deficiency anaemia.

Iron deficiency anaemia can develop due to various reasons, but the primary cause is an insufficient amount of iron in the body. Iron is a crucial component in the production of haemoglobin, the protein in red blood cells that carries oxygen throughout the body. Some of the main causes of iron deficiency anaemia include:

• Inadequate Dietary Iron: Consuming a diet that is low in iron-rich foods, such as meat, poultry, and fortified cereals, can lead to iron deficiency. It's important to note that the body only absorbs a small percentage of the iron consumed through food.
• Blood Loss: Chronic blood loss is a common cause of iron deficiency anaemia. This can occur due to heavy menstrual periods, gastrointestinal bleeding from conditions like ulcers or cancers, frequent use of medications like aspirin and ibuprofen, or regular blood donations.
• Increased Iron Demand: Certain life stages, such as pregnancy and breastfeeding, increase the body's need for iron, making these individuals more susceptible to developing iron-deficiency anaemia.
• Malabsorption: Some health conditions, like celiac disease or gastric bypass surgery, can impair the body's ability to absorb iron from food. Certain medications can also interfere with iron absorption.
• Chronic Diseases: Chronic illnesses, infections, and malignancies can contribute to iron deficiency by affecting the body's ability to absorb and utilize iron effectively.

Understanding the causes of iron deficiency anaemia is crucial for identifying risk factors and implementing appropriate preventive measures.

While anyone can develop iron deficiency anaemia, certain factors can increase an individual's risk. These risk factors include:

• Women who experience heavy menstrual periods as they lose a significant amount of blood each month
• Pregnant women, due to the increased demand for iron to support fetal development
• Vegetarians and vegans, as plant-based iron sources, are less easily absorbed by the body compared to animal-based sources
• People with certain gastrointestinal disorders, such as celiac disease or inflammatory bowel disease, which can impair iron absorption
• Individuals who have undergone weight loss surgery, as it can affect the body's ability to absorb nutrients, including iron
• Endurance athletes, particularly runners, as they may lose iron through sweat and the breakdown of red blood cells due to the impact of running
• People with chronic conditions like kidney disease, heart failure, or cancer, as these illnesses can affect iron metabolism and absorption

By understanding these risk factors, individuals can take proactive steps to prevent iron deficiency anaemia or seek early intervention if they suspect they may be affected.

If left untreated or not managed properly, iron deficiency anaemia can lead to several complications that affect various aspects of health.

• One of the primary concerns is the impact on the heart. The condition can cause a rapid or irregular heartbeat, as the heart has to work harder to pump more blood to compensate for the lack of oxygen carried in the blood. This increased workload can result in an enlarged heart or even heart failure.
• Pregnant women with severe iron deficiency anaemia are at a higher risk of pregnancy complications, including premature births and low birth weight babies. Iron supplementation as part of prenatal care can help prevent these issues.
• In infants and children, severe iron deficiency can lead to delayed growth and development, as well as an increased susceptibility to infections due to a weakened immune system.
• Untreated iron deficiency anaemia can also cause cognitive and motor problems in children and make individuals more prone to illnesses such as colds and flu.

To prevent iron deficiency anaemia, it is essential to maintain a diet rich in iron-containing foods. Some excellent sources of dietary iron include:

• Red meat, pork, and poultry
• Seafood, especially shellfish
• Beans and legumes
• Dark green leafy vegetables, such as spinach and kale
• Iron-fortified cereals and breads

Consuming foods high in vitamin C, like citrus fruits, broccoli, and leafy greens, alongside iron-rich foods can enhance the absorption of iron from plant-based sources.

The primary method for diagnosing iron-deficiency anaemia involves blood tests, which measure various parameters such as:

• Haemoglobin levels
• Haematocrit
• Iron levels in the blood

A complete blood count (CBC) can help identify low haemoglobin and haematocrit levels, which are indicative of anaemia. Specific tests to assess iron levels include serum iron, transferrin saturation, and ferritin levels, with low ferritin being a key indicator of iron deficiency.

If internal bleeding is suspected, endoscopy or colonoscopy may be performed to identify the source of bleeding, such as ulcers, polyps, or cancer. While mild iron deficiency anaemia often goes unnoticed, symptoms become more apparent as the condition progresses.

A proper diagnosis should be made by a healthcare professional rather than through self-diagnosis, as specific tests are required to confirm the condition and rule out other potential causes.

1. Iron Supplements

The most common treatment for iron deficiency anaemia is the use of iron supplements, which can be taken orally in the form of tablets, capsules, or liquids. The dosage and duration of treatment depend on the severity of the deficiency and the individual's response to the supplements. It is essential to follow the healthcare provider's instructions and not exceed the recommended dose, as excessive iron intake can lead to side effects such as constipation, nausea, and stomach discomfort.

2. Dietary Changes

In addition to iron supplements, dietary changes can help manage and prevent iron deficiency anaemia. Incorporating iron-rich foods into the diet, such as lean red meat, poultry, fish, beans, lentils, and dark leafy greens, can help boost iron intake. Combining these foods with sources of vitamin C, like citrus fruits, berries, and bell peppers, can enhance iron absorption. It is also important to limit the consumption of foods and beverages that can inhibit iron absorption, such as tea, coffee, and calcium-rich dairy products, especially when taken with iron-rich meals.

3. Treating Underlying Causes

Identifying and treating the underlying causes of iron deficiency anaemia is crucial for long-term management. If the condition is caused by heavy menstrual bleeding, hormonal treatments or surgical interventions may be necessary. In cases of gastrointestinal bleeding, treating conditions like ulcers, polyps, or cancer can help resolve the anaemia. If the deficiency is due to malabsorption disorders, such as celiac disease or inflammatory bowel disease, appropriate management of these conditions can improve iron absorption and overall health.

Regular follow-up with a healthcare provider is essential to monitor the progress of treatment and ensure that iron deficiency anaemia is being effectively managed. With proper treatment and management, most people with iron deficiency anaemia can recover and maintain healthy iron levels.

If you experience symptoms of iron deficiency anaemia, such as fatigue, weakness, shortness of breath, hair loss, or brittle nails, it is crucial to consult a healthcare provider promptly.

You should see a doctor if you:

• Experience heavy menstrual bleeding or frequent blood donations
• Are pregnant or breastfeeding and suspect inadequate iron intake
• Have a condition that affects iron absorption, like celiac disease
• Notice any signs of anaemia, especially if you belong to a high-risk group such as infants, children, or teenagers undergoing growth spurts

Early diagnosis and treatment can address the underlying causes of iron deficiency. Seeking medical advice at the right time can help manage iron deficiency anaemia effectively and prevent long-term health consequences.

• Maintain a diet rich in iron-containing foods, such as red meat, seafood, beans, and dark green leafy vegetables
• Consume vitamin C-rich foods to enhance iron absorption from plant-based sources
• High-risk groups, including women, infants, children, vegetarians/vegans, and frequent blood donors, should take extra precautions
• Manage chronic conditions affecting iron absorption and maintain healthy hygiene practices
• Consult a healthcare provider if you experience symptoms of iron-deficiency anaemia or belong to a high-risk group
• Early diagnosis and treatment can prevent complications and address the underlying causes of iron deficiency