Symptoms, Causes, and Prevention of Iron Deficiency

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Iron deficiency can occur for a variety of reasons, from related medical conditions to blood loss and dietary choices. If the case is severe, left untreated, and / or prolonged, iron deficiency anemia (a decrease in the number, size, and function of red blood cells) can have several notable consequences. At the very least, low iron levels can make you tired and weak, reduce its concentration, and cause dry skin and nails. But it can also cause heart palpitations, shortness of breath, an increased risk of infections, and more.

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Iron and your body

Iron is necessary for the production of hemoglobin and myoglobin, two proteins that carry oxygen to the blood. When you don't have enough iron in your system, this important function becomes difficult, depriving your cells of what they need to give you the energy they need. This is iron deficiency anemia.

It takes time for symptoms of iron deficiency anemia to develop because your body uses stored and processed iron to form new blood cells when you don't get enough iron from your diet. When iron stores begin to deplete, your body actually slows down red blood cell production and potential disease becomes a reality.

Causes

There are several possible causes of low iron levels and therefore iron deficiency anemia.

Diet and absorption

Iron deficiency can occur if you don't eat enough iron-containing foods or have trouble absorbing it. Vegetarians and vegans may be more prone to iron deficiency (especially in premenopausal women) because the form of iron found in plants (non-heme iron) is not absorbed in the same way as the iron found in meat, poultry and fish (heme iron) .

Several diseases interfere with iron absorption, including irritable bowel syndrome, lupus, and celiac disease. Gastric bypass, which often removes parts of the stomach or intestines, can also interfere with proper iron absorption .

Foods rich in phytic acid found in legumes, rice, and cereals can contribute to iron deficiency anemia by inhibiting iron absorption .

Additional hardware requirements

In pregnant women, the blood volume is greater and the developing fetus also needs oxygen-rich red blood cells for energy. Therefore, they need more iron. Some expectant mothers, especially those who do not take prenatal vitamins, may not achieve this goal .

Growing infants, children, teens, and athletes also need additional iron to provide the actively growing body with energy for the additional metabolism that cells need to grow and develop.

Loss of blood

Normal or heavy menstrual bleeding can lead to iron deficiency anemia, and for this reason, women generally need more iron than men .

Ulcers, hemorrhoids, polyps, colon cancer, or other conditions that cause chronic bleeding can also lead to blood loss that, if rapid, can cause low blood volume, as well as iron deficiency anemia. The symptoms in these cases are more significant .

Bleeding from surgery, childbirth, or injury can also cause excessive blood loss .

For several days after donating blood, you may have low levels of red blood cells and therefore iron. But in healthy people who do this, the volume of red blood cells is usually corrected without noticeable consequences.

Related conditions

Some situations are associated with iron deficiency, but do not cause it.

  • Lead poisoning is often associated with, but not the cause of, iron deficiency anemia. Anemia caused by lead poisoning aggravates the symptoms of other types of anemia, such as iron deficiency anemia .
  • Insufficient weight . Calories, whether they are carbohydrates, protein or fat, do not affect absorption or iron content. However, people who are underweight, whether due to health problems, anorexia or diet, often suffer from iron deficiency because they do not get enough iron in their diet .
  • Kidney disease Erythropoietin, a hormone produced by the kidneys, plays an important role in stimulating the production of red blood cells. If you have kidney disease, you may need an erythropoietin replacement to stimulate red blood cell production, even if you have sufficient iron stores. Dialysis does not solve this hormonal problem, and erythropoietin deficiency cannot be treated with dialysis .
  • Certain types of cancer. Certain types of cancer, especially those associated with white blood cells such as leukemia or lymphoma, which increase the risk of infections, are also associated with low red blood cell counts. iron to do its job. Also, most cancer treatments suppress red blood cell production. As with leukemia, this does not lower iron levels, but it prevents the iron in the body from doing what it was supposed to do.

Symptoms

Iron deficiency anemia is the first manifestation of low iron levels. If you have iron deficiency anemia, it can cause various symptoms that can progress rapidly or appear over weeks or months .

  • Fatigue
  • Soft spot
  • Memory and thinking problems
  • I am cold
  • Headaches or dizziness
  • Dry and brittle hair, skin and nails.
  • Pica (strange cravings for metal, dirt, paper, or starchy foods)
  • Glossitis (red and sore tongue)
  • Frequent infections
  • Cardiopalmus
  • Difficulty breathing
  • Restless Leg Syndrome

If you are severely deficient in iron or have experienced rapid blood loss, your symptoms may appear more quickly than if you were moderately deficient in iron.

Complications

In extreme situations, iron deficiency anemia can cause tachycardia (heart palpitations) and low blood pressure. This can contribute to learning and concentration problems in children .

Iron-deficient pregnant women have low energy levels and are at increased risk for low-birth-weight babies and preterm delivery .

Diagnostics

It is rare to detect or evaluate iron deficiency itself based solely on symptoms, as anemia is often the first sign.

A complete blood count (CBC) can only indicate iron deficiency anemia as the cause of low hemoglobin / hematocrit. Usually, if iron deficiency anemia is suspected based on a complete blood count, the doctor tries to determine the cause based on the history and examination. If there is a high degree of suspicion of latent blood loss due to an altered gastrointestinal tract, the patient will undergo a colonoscopy and / or upper gastrointestinal endoscopy.

If concerns about gastrointestinal blood loss are low, the physician usually begins empirical studies of iron supplementation with close monitoring. If there is no improvement after several weeks, or if the initial history and examination lead to an unclear cause of anemia, the doctor will perform "iron studies," which usually include serum ferritin, serum iron, serum transferrin, and transferrin saturation. . If they are not sure, there are other blood tests and finally an iron-stained bone marrow biopsy, which is the gold standard for diagnosis.

Physical exam

Although the physical examination is often the most valuable part of diagnostic testing for many conditions, manifestations of iron deficiency, including pale skin, palpitations, and orthostatic hypotension (a significant drop in blood pressure when standing) are very late effects that appear after a few weeks. … or a few months after the blood tests become abnormal.

Post tests

After identifying iron deficiency anemia, it is very important to find the cause. Typically, if a blood test reveals iron deficiency anemia, the next steps often include looking for a blood disorder or latent blood loss, which is subtle or latent blood loss .

The most common cause of latent blood loss is bleeding from the colon, and a stool sample is usually sent to a laboratory for blood testing. Even if the stool sample is negative (no blood), if there is no obvious cause or iron deficiency, an additional examination with colonoscopy or endoscopy may be required, depending on the risk. Colon polyps, bleeding ulcers, and even gastrointestinal cancers are the causes of iron deficiency.

After colonoscopy / endoscopy, the next step is to look for Helicobacter pylori, celiac sputum, and possible autoimmune gastritis .

Watch out

Treatment of iron deficiency relies on two important approaches: eliminating underlying problems and restoring iron levels .

Iron level replacement

Iron levels can be adjusted by increasing the amount of iron in the diet, taking iron supplements in tablet form, or, in situations not improved by these options, a parenteral (muscular) injection of iron may be necessary. If your iron deficiency is caused by a bowel problem, pills and food generally cannot solve the problem because you still cannot absorb iron even if you take enough iron by mouth.

Medical or surgical intervention

Depending on the cause, you may need an intervention to stop the iron deficiency process. A bleeding polyp in the colon may need to be removed (and biopsied to make sure it is not cancer). If you have stomach bleeding from blood thinners, you may need a lower dose or a completely different blood thinner. And if you've had a severe episode of blood loss due to an event like surgery or injury, you may need a blood transfusion instead of an iron replacement.

Prophylaxis

In general, you can prevent iron deficiency by getting the right amount of iron in your diet . Healthy adult men need about 8 mg of iron a day, healthy premenopausal adults need 18 mg a day, and healthy pregnant women need 27 mg a day. After menopause, healthy women only need about 8 mg per day because they do not experience bleeding due to menstruation.

If you have a situation that affects your iron levels, you may need more iron through diet or oral supplementation. If oral supplements do not improve iron levels, parenteral injections may be needed.

Meat, poultry, beans, oysters, tuna, pork, nuts, dark green vegetables, tomato juice, and potatoes are good sources of iron in the diet.

You can increase the amount of non-heme iron you absorb by combining vegan sources of iron with foods rich in vitamin C. For example, you can drink a glass of orange juice with a bowl of spinach or add green bell peppers to beans.

Nutritional supplements

Prenatal vitamin supplements generally contain iron, and women with heavy periods may also need iron supplements. Most postmenopausal men and women get enough iron from their diet and should not take iron supplements unless directed by their doctor. If you need to take iron supplements, do not take more than 45 mg per day unless directed by your healthcare professional.

Iron supplements can cause unpleasant constipation even at recommended doses. They can also cause more serious side effects , such as iron poisoning. Iron supplements are especially dangerous for people with hemochromatosis, a condition characterized by iron overload.

Iron supplements for adults can be toxic to young children, so iron supplements should be stored in tightly closed containers that are out of the reach of children.

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