Iron Deficiency Anaemia
Iron deficiency is a common cause of anaemia
Clare Thompson was diagnosed with iron deficiency anaemia after being hospitalised with gastroenteritis. The doctor ordered a complete blood count which revealed that Clare’s haemoglobin level was low.
“In hindsight, I had many of the symptoms of iron deficiency anaemia including extreme fatigue, daily headaches and a crazy urge to eat ice,” says Clare. “I was going through a rough patch at work and thought the tiredness was due to stress.”
Clare’s doctor prescribed iron tablets and a blood test three months later showed a significant improvement in her haemoglobin and ferritin levels.
Like Clare, iron deficiency anaemia is often diagnosed when a complete blood count for another medical issue reveals low haemoglobin, haematocrit and ferritin levels.
- In women, a haemoglobin level of 12 to 16g/dL (grams per decilitre) is considered normal. For men, normal levels are 13.5 to 18g/dL.
- The haematocrit level determines the percentage of blood consisting of red blood cells. Normal levels are between 34.9 and 44.5% for women and 38.8 to 50% for men.
- Ferritin is a protein that stores iron in the body and releases it when needed. A low ferritin level indicates low iron stores.
Iron and red blood cells
Your body needs iron (a mineral) to make haemoglobin, a protein in your red blood cells. It’s the job of haemoglobin to carry oxygen from your lungs to all cells in your body. When you don’t get enough iron, your body can’t make haemoglobin and subsequently begins to make less, smaller and/or malformed red blood cells. This means that your cells can’t get the oxygen they need to function properly.
Symptoms
- extreme tiredness
- weakness – shortness of breath
- difficulty concentrating
- pale skin
- pale gums
- cravings for substances like ice, starch or soil
- brittle nails
- cold hands and feels
- headaches
- feeling lightheaded
- dizziness – especially when you stand up quickly (stars)
- chest pains and/or fast heartbeat
Causes of anaemia
- Blood loss – any blood loss within the body can cause anaemia
This includes heavy menstrual bleeding, or bleeding from gastrointestinal issues like ulcers, hernias or colon cancer.
- Diet related – a diet poor in iron-rich foods, including vegetarian diets
In order to get the iron you need, your diet should include iron-rich foods like red meat, leafy greens, eggs or fortified grains. The Recommended Daily Allowance (RDA) of iron is 15mg for menstruating women and 10mg for men/non-menstruating women.
- An inability to absorb iron – poor absorption of iron in gut
usually caused by a gastro-internal disease, like celiac or Crohn’s disease which results in poor abortion of iron and other nutrients in the intestines.
- Pregnancy
Your body needs iron to keep up with the demand for additional red blood cells. The RDA for pregnant women is 30mg. Your doctor will prescribe a pre-natal vitamin which contains the iron you require.
Diagnosing your cause
Your doctor may choose to investigate the cause of your iron deficiency anaemia. He or she may:
- ask you to see a dietician to review your diet (if a poor diet is the suspected cause)
- (if you are female) request an ultrasound to determine if there is a gynaecological reason for the anaemia for example, heavy menstrual periods caused by uterine fibroids or endometriosis.
- order a gastroscopy (upper digestive tract) and colonoscopy (large intestine) to check for bleeding in the gastro-internal system.
Treatment
Your doctor will make a dignosis based on your test results. Treatment depends on the cause of your anaemia and what is revealed during the diagnostic process.
Taking iron tablets
You will likely be asked to increase iron-rich foods in your diet and may be prescribed iron tablets. In order to properly absorb iron and limit the side-effect of constipation while taking iron tablets, follow these guidelines:
- Try to take your tablets on an empty stomach, usually first thing in the morning. Some people experience nausea or cramps after taking iron tables. If you do, rather take them with a meal.
- Take your tablet with orange juice, never with tea or coffee as caffeine hinders proper absorption. You can take it with vitamin C to further increase absorption.
- Don’t take your iron supplement with milk or calcium supplements.
- If you take medication for acid or heartburn, wait four hours after before taking your iron tablet, or take your iron tablets first and your antacids two hours later.
- If you do develop constipation, speak to your doctor about changing your tablet or try a liquid iron supplement.
Important: Do not self-diagnose. If you have the symptoms noted above, see your doctor for a blood test to determine if your iron levels are low. Taking too much iron can be harmful to your health.
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