Iron deficiency anaemia

Iron deficiency anaemia is the most common type of anaemia which leads to a reduction in number of red blood cells and haemoglobin which is responsible for the exchange of oxygen and carbon dioxide between the blood and tissue cells.

Causes of iron deficiency anaemia

The possible causes of iron deficiency anaemia are

• Inadequate iron intake as a result of poor diet for example vegetarian diet with insufficient heme iron.
• Inadequate absorption as a result of diarrhoea, drug reaction and gastritis.
• Increased iron requirement during childhood, pregnancy and lactation.
• Increased excretion as a result of blood loss due to injury, haemorrhoids, ulcers or parasites.

Symptoms of iron deficiency anaemia

Anaemia occurs as a result of long term iron deficiency, the symptoms generally represent the malfunction of various body functions. Most common symptoms of iron deficiency anaemia are:

• Decrease work performance and exercise tolerance.
• Fatigue
• Lack of appetite
• Pica ( persistent eating of substances with little or no nutritive value) for example ice and mud eating.
• Breathlessness
• Ulcers on the corner of mouth.

Diagnosis

Iron deficiency can be evaluated by different measurements from your complete blood test.

• Ferritin level in your blood determines the iron stores.
• TIBC level below 16 % are considered as inadequate for iron supply to tissues.
• Haemoglobin level less than 8g/dL can indicate anaemia. However the value of haemoglobin vary widely among individuals.

Treatment

Treatment should primarily focus on determining the exact cause of iron deficiency leading to anaemia. Repletion of iron stores is necessary in order to cure anaemia in the long run.

Supplementation

The main treatment of iron deficiency anaemia is through supplements . Doctors normally prescribe oral administration of inorganic iron in ferrous form such a s ferrous sulphate. However patients on iron supplements are often complaining about the side effects associated with iron supplements as these supplements tend to cause, abdominal discomfort, diarrhoea, constipation, excessive bleeding, heart burn and nausea.

These side effects can be minimised if you take the supplements in an empty stomach or between meals. Iron is best absorbed with vitamin C. Take supplements with a glass of orange juice or lemonade.

Diet

In addition to supplements, attention should be given to the amount of iron consumed.

The rich sources of iron are

• Liver
• Kidney
• Beef
• Egg yolks
• Dried fruits
• Beans
• Nuts
• Dark green, leafy vegetables
• Whole-grains and iron fortified cereals

Iron from animal sources is called heme iron is much better absorbed as compared to non heme iron which is present in eggs, grains, vegetables and fruits.

Factors that inhibits iron absorption

Iron absorption can be inhibited by number of factors. This includes

• Carbonates, oxalates, phosphates and phytates present in unleavened bread, unrefined cereals and soya beans and fibre in vegetables may inhibits non heme iron.
• Tea can reduce iron absorption up to 50 %.
• Calcium found in dairy products also inhibits iron absorption.

Factors that maximise iron absorption

To maximise iron absorption it is important to :

• include a source of vitamin C in every meal.
• Avoid drinking too much coffee and tea specially with meals.
• Improve food choices to increase dietary iron.
• Include meat, fish or poultry in every meal if possible.