Iron-Deficiency Anemia

What is iron-deficiency anemia?

Iron-deficiency anemia is a common blood disorder that affects your red blood cells. It’s the most common form of anemia. It happens when there’s a lack of iron in your blood, usually caused by bleeding.

When you don’t have enough iron, your bone marrow can’t make hemoglobin, the molecule in your red blood cells that carries oxygen in your blood. And when you don’t have enough hemoglobin, your blood can’t carry oxygen throughout your body.

As a result, you might feel tired. You may notice pale skin and cold hands and feet. Iron-deficiency anemia can also make you feel dizzy or lightheaded. Occasionally, it can cause chest pain, a fast heartbeat and shortness of breath. Or it can cause you to crave non-food items like ice, dirt or paper. These are all signs of iron-deficiency anemia.

The good news is that treatment can help iron-deficiency anemia. Your healthcare provider can design a plan tailored to your needs.

Stages of iron-deficiency anemia

Normally, your body absorbs iron from the foods you eat. Your body stores iron so it’s available to make hemoglobin. Iron-deficiency anemia develops when your body uses the iron stores faster than they can be replaced, or when the flow of iron into your system slows.

This occurs in three stages:

• First stage. Iron stores decrease. Your low iron supply hasn’t affected your red blood cells yet.
• Second stage. When iron stores are low, your body alters the way it processes red blood cells. Your bone marrow makes red blood cells without enough hemoglobin.
• Third stage. Hemoglobin drops below the normal range. You may develop signs of iron-deficiency anemia.

What are the symptoms of iron-deficiency anemia?

Iron-deficiency anemia symptoms usually start out mild but worsen over time. They can include:

• Fatigue
• Headaches
• Irritability
• Muscle cramps
• Pallor (pale skin)
• Pica
• Shortness of breath (dyspnea)
• Sore tongue
• Spoon-shaped fingernails and toenails (koilonychia)
• Tachycardia (fast heart rate)

What causes iron-deficiency anemia?

Causes of iron-deficiency anemia may include:

• Blood loss from your period or from gastrointestinal conditions like esophageal reflux disease, ulcerative colitis or Crohn’s disease
• Malabsorption, in which iron can no longer be absorbed through your stomach (This is more common in people with celiac disease or in those who’ve had weight loss surgery.)
• Not getting enough iron in the foods you eat

Risk factors of iron-deficiency anemia

Statistically, you’re more likely to develop iron-deficiency anemia if you:

• Are pregnant or have recently given birth
• Breastfeed (chestfeed)
• Donate blood frequently
• Have a history of major surgery (especially gastrointestinal or weight loss surgery)
• Menstruate (especially if you have heavy periods)

What are the complications of this condition?

Severe or untreated iron-deficiency anemia can lead to complications like:

• Brain fog
• Growth or developmental delays (in children)
• Heart conditions like enlarged heart or heart failure
• Restless legs syndrome

How is iron-deficiency anemia diagnosed?

Healthcare providers use blood tests to diagnose iron-deficiency anemia. In addition to measuring iron levels, they check your levels of ferritin and total iron-binding capacity (TIBC) to confirm that you have a deficiency.

Your healthcare provider may run different lab tests depending on your situation.

How is iron-deficiency anemia treated?

Healthcare providers use iron supplementation or replacement to treat iron-deficiency anemia. They do this with:

• Oral iron supplements: Capsules or tablets that you take by mouth
• Iron infusions: Iron that you receive intravenously (through a vein)

Your healthcare provider can determine which type of iron-deficiency anemia treatment is right for you. Most importantly, they’ll also try to figure out why you’re low in iron so they can treat the underlying cause.

Side effects of treatment

Iron supplementation might cause a metallic taste in your mouth or gastrointestinal side effects like:

• Constipation
• Dark bowel movements
• Diarrhea
• Nausea and vomiting

Tell your healthcare provider if you develop these side effects. They may be able to reduce them by adjusting your iron dosage or regimen.

How soon after treatment will I feel better?

It depends on the treatment you receive and how low your iron was to begin with. People who take iron supplements may notice a difference in about two to three weeks. If you have iron infusions, you might start to feel better a little sooner.

Can iron-deficiency anemia be prevented?

Yes, you may be able to prevent iron-deficiency anemia if it’s detected and treated early enough. If you’ve already developed iron-deficiency anemia, a healthcare provider can easily correct the condition with treatment.

What’s the outlook for people with iron-deficiency anemia?

The outlook is good with treatment, but your healthcare provider will need to address any underlying conditions that cause iron-deficiency anemia. Iron supplementation is only a temporary fix because it doesn’t address the actual cause.

Suddenly becoming iron-deficient might point to conditions like stomach ulcers or colon polyps. In some cases, it can be a sign of gastrointestinal cancer. It’s important to figure out why you’re iron-deficient so you can get the right treatment.

How do I take care of myself?

Here are some ways to make sure you’re getting enough iron:

• Ask your healthcare provider about testing for iron.
• Eat iron-rich foods like beans, red meat, beef or chicken livers and dark leafy greens.
• See your provider for regular blood tests.
• Talk to your provider if you have conditions that cause blood loss (like heavy menstrual periods or gastrointestinal disorders).

What should I eat with iron-deficiency anemia?

You can increase your body’s iron stores by eating an iron-rich diet. Here are some foods to consider:

• Animal proteins: Beef, poultry, eggs, liver and fish
• Breads and cereals: Whole wheat bread, enriched white bread, rye bread, bran cereals and cereals with wheat
• Fruits: Figs, dates and raisins
• Legumes: Peas, beans, tofu and tempeh
• Vegetables: Spinach, broccoli, string beans, dark leafy greens, potatoes, cabbage and tomatoes

Can I get rid of iron-deficiency anemia naturally?

Eating fortified, iron-rich foods is always a good idea. But it won’t necessarily keep you from getting iron-deficiency anemia. If you have extremely low iron, you’ll likely need to see a healthcare provider for recommendations regarding iron supplements or iron infusions.

I follow a vegan or vegetarian diet. What should I do to boost my iron intake?

If you follow a vegan or vegetarian diet, look for iron-fortified breads and cereals. There are several non-meat options for boosting your iron intake, like beans, tofu, dried fruits and dark leafy greens.

You can also try iron supplements. Always talk to your healthcare provider before adding any supplement to your regimen.

When should I see my healthcare provider?

You should see your healthcare provider regularly so they can monitor your iron levels and your overall health. You might see your healthcare provider every three months for a year or longer if you’re being treated for iron-deficiency anemia. You may also need to see another specialist like a gynecologist or gastroenterologist if bleeding is determined to be the cause.

What questions should I ask my healthcare provider?

If you’ve received an iron-deficiency anemia diagnosis, here are some questions you might want to ask your healthcare provider:

• What can you tell me about the iron levels in my blood?
• How severe is my condition?
• Do I need to see another specialist?
• What type of treatment will I need?
• How long will I need iron supplementation?
• What side effects should I expect?
• When will I start to feel better?