Understanding Iron Deficiency Anaemia

Haemoglobin is the protein in red blood cells that is responsible for transporting oxygen. Iron deficiency anaemia occurs when the body does not have enough iron to produce sufficient haemoglobin. The lack of haemoglobin will result in fewer and smaller red blood cells to be produced, leading to various symptoms and health problems.

Iron deficiency anaemia symptoms

Individuals with iron deficiency anaemia often do not show any symptoms. However, some common symptoms include fatigue, headache, weakness, irritability, shortness of breath or tiredness that induces difficulty during exercise, brittle nails, sore tongue, restless legs syndrome.

Some unusual symptoms include pica (an unusual craving for non-food items like cornstarch, paper products, clay, or dirt) and pagophagia (a form of pica in which there is an unusual craving to consume or chew on ice).

Causes

Iron is needed to allow your body to produce healthy red blood cells. Factors related to low in iron can raise your risk of developing the condition, they can include:

Low iron diet	This is more common among vegetarians or vegans that are not including enough plant-based iron sources in their diet or not taking supplements, which can eventually lead to insufficient iron in the body.
Poor iron absorption	There are certain conditions that can hinder the body’s ability to absorb iron effectively. These include Crohn’s disease, an inflammation of the digestive tract that disrupts nutrient absorption, and celiac disease which damages the intestine and reduces iron absorption. People who went through gastric bypass surgery are susceptible as well due to it reducing the stomach’s ability to absorb nutrients.
Increased iron demand	During life stages such as pregnancy, childhood growth spurts, and adolescence, the body’s need for iron increases. For pregnant women, anaemia in pregnancy can occur as the growing foetus and placenta demand more iron.
Blood loss	Iron levels can be reduced by heavy menstruation, colorectal cancer, gastrointestinal tract bleeding from peptic ulcers, and significant injuries or surgeries that result in blood loss.

Diagnosis

Usually includes examination of medical history, a physical examination, and relevant investigations.

Complete blood count (CBC)	Haemoglobin (Hb) - low haemoglobin levels are a sign of anaemia. Haematocrit (Hct) - refers to the proportion of red blood cells in the blood; low percentages suggest anaemia. Red Blood Cell (RBC) count - refers to the number of red blood cells; low in RBC may indicate anaemia. Mean Corpuscular Volume (MCV) - refers to the measurement of the average size of RBC; iron deficiency anaemia patients usually have smaller than normal RBCs, which is a condition called microcytic. Mean Corpuscular Haemoglobin (MCH) - refers to the average amount of haemoglobin per red blood cell; low amounts may be found in individuals with iron deficiency anaemia.
Serum ferritin test	Measures the amount of iron in the body. Low ferritin level is a reliable marker of iron deficiency.
Serum iron test	Measure how much iron is in the blood serum. Low level suggests iron deficiency.
Total iron-binding capacity (TIBC) test	Evaluates the blood’s ability to attach iron with transferrin. High TIBC levels typically indicate iron deficiency.
Transferrin saturation test	Measures the percentage of transferrin (iron transport protein) that is saturated with iron. Low percentage may be a sign of iron deficiency anaemia.

Other tests might be necessary if the cause of iron deficiency anaemia is unknown, including:

Endoscopy or colonoscopy	Identify the bleeding sources or gastrointestinal conditions.
Stool occult blood test	Check for hidden blood loss in the gastrointestinal tract.
Celiac disease screening	Might be necessary if poor absorption is suspected.
Bone marrow biopsy	May be done to evaluate the iron stores in the bone marrow under rare circumstances where the diagnosis is unclear.

Treatment and prevention

Both the underlying cause and the iron deficiency itself will be addressed during the treatment of iron deficiency anaemia.

Dietary changes	Eat more iron-rich foods such as fish, poultry, red meat, beans, tofu, spinach, lentils, and fortified cereals. Include foods rich in vitamin C (citrus fruits, tomatoes, and bell peppers) alongside iron-rich foods in your diet to improve iron absorption. Substances or foods that can hinder iron absorption, such as high-fibre foods, tea, coffee, and calcium supplements, should not be consumed around the time of iron-rich meals.
Iron administration	Oral iron supplements The recommended treatment for the majority of cases of iron deficiency anaemia and iron deficiency without anaemia. However, some people may experience side effects from iron tablets, including heartburn, stomach pain, constipation or diarrhoea, nausea, vomiting, and darker-than-usual stools. For individuals who may find it difficult to remember to take iron supplements daily, taking them every other day or on specific days of the week can still be beneficial. To improve iron absorption, it is recommended to take Vitamin C supplements on an empty stomach. Intravenous (IV) iron May be administered if oral iron is ineffective, poorly tolerated, or if rapid replenishment is necessary, such as in cases of severe anaemia, malabsorption conditions, or chronic kidney disease.
Treating underlying causes	Managing severe menstrual bleeding, gastrointestinal bleeding, and other causes of chronic blood loss, as well as chronic diseases like Crohn's disease, celiac disease, or chronic kidney disease that may reduce iron absorption are some possible treatment options.
Blood transfusions	May be required for rapid correction in cases of severe anaemia accompanied by symptoms such as shortness of breath, chest pain, or extreme fatigue. To ensure the treatment is effective, your doctor will perform follow-up blood tests to check your ferritin, haemoglobin, and haematocrit levels.

Schedule an appointment at Gleneagles Hospitals

Should you have any concerns regarding iron deficiency anaemia, contact us to make an appointmenttoday for a consultation, or stop by our Haematology Department at your nearest Gleneagles Hospitals.

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