Your Health - Iron-Deficiency Anemia

Iron-Deficiency Anemia

(Reduced Iron in Blood)

Definition

This condition results from reduced iron stores in the blood. This happens when you do not eat enough iron to replace the iron that your body uses. Your body uses iron to produce hemoglobin. This is part of red blood cells that carries oxygen to tissues and muscles. Bleeding a lot can also cause anemia .

Red Blood Cells

Iron makes a critical component of red blood cells.

Causes

Factors that play a role include:

Iron that is poorly absorbed in the digestive tract (may occur due to intestinal diseases or surgery)
Chronic bleeding (eg, heavy menstrual bleeding, bleeding in the gastrointestinal [GI] tract)
Not enough iron in the diet (common cause in infants, children, and pregnant women)

Risk Factors

These factors increase your chance of developing this condition. Tell your doctor if you have any of these risk factors:

Rapid growth cycles (infancy, adolescence)
Heavy menstrual bleeding or chronic blood loss from the GI tract
Pregnancy
Diets that contain insufficient iron (rare in the United States)
Breastfed infants who have not started on solid food after six months of age
Babies who are given cow’s milk prior to age 12 months
Alcoholism

Symptoms

While most people with mild anemia have no symptoms, when present, symptoms may include:

Fatigue
Pale skin
Fingernail changes
Weakness
Headache
Decreased work capacity
Heart palpitations
Infection
Craving to eat things that are not food (called a pica), such as ice or clay
Hair loss
Shortness of breath during or after physical activity

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

Serum iron
Transferrin iron binding capacity
Serum ferritin level
Microscope examination of a blood smear
Fecal occult blood test —to look for hidden blood in the stool

Treatment

Treatments may include:

Iron Supplements

Iron can be taken as a supplement or as part of a multivitamin. Iron comes in many "salt" forms. Ferrous salts are better absorbed than ferric salts. Ferrous sulfate is the cheapest and most commonly used iron salt. Slow-release or coated products may cause less stomach problems. But, they may not be absorbed as well. Some products contain vitamin C to improve absorption. Talk to your doctor, though, because your iron level could get too high.

Iron-Fortified Cereal

Your doctor may recommend that you feed your baby iron-fortified cereal.

Prevention

To help reduce your chance of getting this condition, take the following steps:

Eating a diet rich in iron (eg, oysters, meat, poultry, fish)
Avoiding foods that interfere with iron absorption, like black tea
Asking your doctor if your infant is getting enough iron

RESOURCES:

American Academy of Pediatrics
http://www.aap.org/

American College Obstetrics and Gynecology
http://www.acog.org/

CANADIAN RESOURCES

Canada Health Portal
http://chp-pcs.gc.ca/CHP/index_e.jsp/

Dietitians of Canada
http://www.dietitians.ca/

References:

American Academy of Pediatrics. Committee on Nutrition. Iron fortification of infant formulas. Pediatrics . 1999;104:119-123. Pediatrics website. Available at: http://pediatrics.aappublications.org/cgi/content/full/104/1/119 . Accessed July 15, 2007.

Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy . 17th ed. Hoboken, NJ: John Wiley & Sons; 1999.

Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy . 18th ed. Hoboken, NJ: John Wiley & Sons; 2006.

Iron. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=114 . Updated December 2007. Accessed July 15, 2008.

Schroeder K. Good food sources of iron. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated December 2006. Accessed July 15, 2008.

US Preventive Services Task Force. The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force . 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2002.

US Preventive Services Task Force. The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force . AHRQ Publication No. 06-0588; Rockville, MD: 2006.

Last reviewed September 2009 by Igor Puzanov, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.