Anemia Due To Iron Deficiency
is the general name for a range of disorders affecting the Red
Blood Cells. In
all types, of anemia there is a shortage of a chemical called hemoglobin that
carries the oxygen from the lungs to all parts of the body via these cells. It
is unusual in the body in that it contains iron. Because a good supply of oxygen
is so vital, anemia has widespread effects, which differ between the different
types of anemia.
Anemia affects many women at
some time in their lives, but it is most common in women who smoke, have heavy
periods or an eating disorder such as anorexia.
Simple iron deficiency anemia
causes weakness, fatigue, tiredness and breathlessness on slight effort. Your
skin may appear pale and you are more likely than average to pick up various
anemia causes soreness of the tongue, loss of weight, skin pallor often
with a lemon tint, and intermittent diarrhea. In untreated cases the nervous
system may be affected, causing tingling of the fingers and toes, muscle
weakness, staggering, calf tenderness and confusion.
anemia also causes pale skin, often with a yellowish tinge. The spleen,
high up on the right side of the tummy, will be enlarged, as it is stuffed with
so many ruptured red cells. Your doctor will be able to feel this.
the general symptoms of anemia there will be unique symptoms in pronounced and
long-term cases of iron deficiency. These will be especially noticeable in the
tongue and throat and include:
burning sensation in the tongue.
in the mouth and throat.
at the corners of the mouth.
altered sense of touch.
extreme cases the nails can become brittle and spoon shaped with vertical
stripes and a tendency to fray.
a 'pica' can arise - an insatiable craving for a specific food, eg liquorice.
CAUSES OF IRON DEFICIENCY
There are six main causes of iron
INCREASE DEMAND FOR IRON
Your body may at certain times
start to require a little more iron than it previously needed. This may be as a
result of a growth spurt, where the tissues within the body are rapidly
dividing, athletic training, where your body are rapidly dividing, athletic
training, where your muscles, heart and lungs are put under greater strain, or
when you are pregnant or breast-feeding. Between 500 and 600 mg of iron are
needed in total for each pregnancy, to satisfy the baby's growth requirements
and the blood loss experienced at childbirth.
LOSS OF BLOOD
For many women this occurs when
they are experiencing heavy or lengthy menstrual periods. Between 15 and 30 mg
of iron are lost each month through menstruation, so it can be quite easy to
become a little anemic if you are not careful about replenishing these losses
with a well balanced diet.
women become anemic because their diet is just not rich enough in the
essential nutrients. If you have anemia (Hemoglobin levels below the normal
range – females 11.5 –15.5 g/dL) you should discuss treatment options
with your doctor.
INHIBITED IRON ABSORPTION
substances common in the diet are known to inhibit the body's absorption
of iron and other vitamins and minerals from your food. The chief culprits are
tannins and caffeine, found chiefly in coffee, tea and cola-based drinks.
Vitamin C helps your body absorb
iron from food. If you don't have enough vitamin C in your diet the iron will
stay in the gut and won't be absorbed; a useless situation.
CORRECTING THE BALANCE
The two most important nutrients
involved in iron deficiency anemia are iron and vitamin C:
two sorts of iron in food. Haem iron (from the Greek word haema, blood), found
in animal foods such as lean red meat and offal, is easily absorbed by the body.
Non-haem iron, derived from 'bloodless' foods such as plants and grains is
absorbed less efficiently because of various 'salts' (oxalates and phytates)
found in these foods. You therefore need to eat a lot more of these foods to
obtain sufficient iron. Eggs also contain substances that decrease the amount of
iron the body can absorb and are considered in the same way as vegetable
In addition to looking at the
iron content of foods it is also important to address the vitamin C issue.
Vitamin C helps your body to absorb iron. You therefore need to concentrate on
having plenty of citrus fruits, kiwi fruits, strawberries, blackcurrants,
cranberries and other 'tangy' fruits. Potatoes, red and green peppers and green
vegetables also supply vitamin C in the diet.
EAT FRESH FRUIT OR DRINK JUICE
The ideal is to have a small
glass of juice or a fruit shake before or after every meal, as this will help
the absorb the iron from your body. Freshly squeezed fruit and vegetable juices
contain large amounts of vitamin C and other natural nutrients, but some carton
juices can also have a high vitamin C content: cranberry juice has one of the
If you feel that citrus fruits
are a little acid, have another fruit, such as strawberries, after your meal as
Keep your vitamin C topped up by
including some dark green leafy vegetables with each of your main meals. This
could be a soup, a salad, or perhaps steamed broccoli tossed in a light olive
oil with freshly chopped root ginger.
EAT ONE OF THE RICH SOURCES OF
IRON TWO OR THREE TIMES A WEEK
If you eat meat this could be
either lean red meat, game or offal such as liver, kidney, oxtail.
Remember that the body absorbs
20-40% of the iron available in meat sources, but only 5-20% of the iron from
vegetable sources and eggs. If we eat a mixed diet including fruit, vegetables,
meat and fish we are thought to absorb approximately 15-20% of the iron in the
EAT PLENTY OF
OF IRON MOST DAYS
This means eggs, green leafy
vegetables such as spinach, Savoy cabbage, curly kale, watercress, broccoli,
baked beans Soya- beans and other pulses, black treacle, nuts an dried fruits
(especially apricots). Vegetarians and vegans, who eat very few or no animal
products, should include a rich source of non-haem iron everyday.
It is especially important for
vegetarians and vegans to have a glass of freshly squeezed fruit juice with each
meal, as you really need the vitamin C to help your body absorb the iron. Some
vegetarians may need to take an iron supplement if they cannot get enough iron
from the diet.
AVOID HAVING EXCESSIVE AMOUNTS
OF FOODS AND DRINKS THAT INHIBIT IRON
Coffee, tea and cola-based drinks
will prevent the body from absorbing iron effectively because they contain
tannins and caffeine. You should keep your tea and coffee intake down to a
maximum of two to three cups a day and allow at least one hour between drinking
tea or coffee before or after a meal, to give your gut a chance to absorb the
iron from the food. Anemic women should make a real effort to cut out the
excessive, needless consumption of these drinks; it is far better to make a
really good cup of coffee or tea and enjoy it at a suitable time of day.
Remember that chocolate, although
it contains iron, also contains substances that prevent efficient iron
absorption, so don't over-indulge, even though you may feel as if you need an
energy boost; chocolate is not the answer. Choose a zingy piece of fresh citrus
fruit or a glass of mango juice instead.
KEEP THE BULK DOWN
While you are trying to boost
your iron and vitamin C intakes, try to keep the amount of cereal fiber such as
wholegrain cereals and wholegrain bread low. High-fiber food
contain 'salts' (oxalates and phytates) that inhibit the absorption some of the
Try to make sure that you have
plenty of rest and don't allow yourself to become psychological run down by
putting unrealistic demands on your time. It amazed me to hear women complain of
extreme tiredness, which may be partially attributable to anemia, but is just
as likely to be the result of being driven to do too much. If your lifestyle
normally demands a lot of physical exertion you should try to cut this down, as
you will be putting your body under too much physical stress.
CUT DOWN ON STRENUOUS EXERCISE
Although it is good to include
some regular gentle cardiovascular exercise such as swimming or dancing to help
the body tick over, I often a word of warning for those of you who are following
intensive training programs. When you are anemic you should just concentrate
on the gentler exercises, rather than the full training schedule. Remember that
the major function of hemoglobin is to carry oxygen around the body, so if you
are anemic you may find it difficult to exercise to your usual degree. Your
body is below par and therefore needs to be treated with care.
If you are unable to eat as much
iron as your body requires, either because you do not like the appropriate foods
or because your iron status is a little too low to be corrected by diet alone,
you may need to take an iron supplement.
It is generally a good idea to
choose a supplement that incorporates some vitamin C with the iron. A supplement
that provides a daily 12 mg of iron with 500-1000 mg of vitamin C should be
adequate for most women, but if you are unsure about the dose ask your doctor or
some iron supplements can cause a
little indigestion, diarrhoea or constipation. Try to avoid taking them on an
empty stomach as this can make the problem of indigestion worse.
If you find that you experience frequent stomach problems with your regular iron supplements, talk to your doctor about a Carbonyl iron supplement. Rather than a blend of iron salts (which are the most commonly prescribed iron supplements), carbonyl iron is composed of pure iron micro particles. It is 100% elemental iron and may be gentler on the system than supplements utilizing iron salts.
recombinant human erythropoietin (recombinant erythropoietin) to stimulate
the growth of red blood cells
transfusion if there is a sudden drop in hemoglobin level. Before
recombinant human erythropoetin became available, this was the only
treatment for severe anemia.
is a natural human hormone made by the kidneys. New technology has now allowed researchers to make enough erythropoietin artificially to treat patients with
anemia. This is achieved by using the genetic code, or gene, for human
erythropoietin, which is then placed in specially modified cells. This produces
erythropoietin in large amounts. The product is called recombinant
erythropoietin. Recombinant human erythropoietin was one of the first medicines
made in this way, and first became available in 1989. Because of the way it is
made, recombinant human erythropoietin looks and acts very much like the
'natural' erythropoietin in your body. This is important, because people often
have to take recombinant human erythropoietin for many years.
Hoffbrand, Pettit J, Moss P (eds).Essential Haemotology 4th edn. Oxford,
Blackwell Science: 2001.
FORMS OF ANEMIA
When you are tested for anemia
you should be informed whether your anemia is due to iron deficiency alone, or is
related to a lack of vitamin B12 or folic acid, two nutrients from the vitamin B
Lack of vitamin B12 can cause
pernicious anemia. The symptoms of lethargy, depression, extreme tiredness and
paleness are virtually identical to iron deficiency anemia, and a vitamin B12
deficiency can mask iron deficiency anemia and vice versa. VitaminB12
deficiency may be caused either by a poor intake of foods rich in the vitamin,
or by the lack of a substance known as 'intrinsic factor'. This substance is
present in the digestive juices produced by the glands surrounding your stomach
and is needed for the body to be able to use vitamin B12.
Your body needs only a very small
amount of vitamin B12, which is found in foods of animal origin-meat, poultry,
fish, dairy products-and yeast extract. Vegetarians and vegans may need to take
a supplement of B12, best incorporated in a general B complex supplement, as all
the B vitamins help each other to be absorbed. You can also buy soya milk
fortified with vitamin B12. Pernicious anemia is most commonly due to a lack of
intrinsic factor in the body.
You will need a course of vitamin
B12 injections, as this delivers the B12 directly into the blood, bypassing the
intestine. However, in addition to the injections it is important to maintain a
good dietary intake of vitamin B12.
FOLATE DEFICIENCY ANEMIA
Folic acid is found naturally in
many foods in the form of folate. Unfortunately it is easily lost in cooking and
storage time and in processing. In addition, various medications such as aspirin
and contraceptive pills hinder the absorption of folic acid. Since folic acid is
needed by the body for the absorption of iron, a deficiency of this vitamin may
result in anemia. The major sources of folic acid
are vegetables such as
asparagus, Savoy cabbage, Brussels sprouts, curly kale, spinach, fresh oranges
and wheat germ, which is found in whole-meal bread and cereals.
In order to prevent or correct a
deficiency of folic acid try to eat two to three servings of fresh vegetables
every day as part of a good, well-balanced diet.
Anemia may Lead to Physical Decline (July