The most common nutritional deficiency in the world is iron deficiency anemia.  The number of people with this condition is estimated at 2 billion – over 30% of the world’s population – primarily affecting women and children.  If it occurs, it can be treated reducing any long-term health effects.

What is iron-deficiency anemia?

Iron-deficiency anemia is a condition in which the body doesn’t have enough iron to produce a protein called hemoglobin.  Hemoglobin is the part of red blood cells giving blood its red color and allows blood to carry oxygenated blood to the cells of the body which is necessary for muscles and tissue to perform effectively. 

Causes of iron-deficiency anemia

There are numerous reason why a person may develop iron deficiency anemia.  Many people may have it without knowing it or have symptoms but not realize what is causing them.  Causes include:

·      Blood loss during menstruation or pregnancy

Women with heavy menstrual cycles each month or excessive blood loss during childbirth can be a common cause for women in the child-bearing years.

·      Infants and children

Babies born prematurely or with a low birth weight (less than 5.5 lbs) or who don’t get enough iron from breastmilk or formula can be at an increased risk.  Older children who are picky eaters or are not eating a varied diet will be at a greater risk particularly during growth spurts where extra iron is needed.

·      Diet lacking sufficient iron intake

Not eating enough iron over a long time can bring about a shortage in the body.  Vegetarians who don’t eat any meat or other iron-rich foods can have a greater risk. Elderly people who have poor appetites are also at risk.

·      Internal bleeding

Excessive or prolonged internal bleeding from an ulcer or using a pain reliever such as aspirin causing bleeding in the stomach can be a cause of iron deficiency anemia.

·      Reduced ability to absorb iron

      There can be many situations where a person may not be absorbing enough iron –    

      intestinal surgeries, celiac disease, gastric bypass surgery, all can lower the amount of

      iron absorbed.                 

·      Donating blood frequently

Giving blood can deplete iron stores if it’s done on a routine basis.  Hemoglobin levels are always checked before a blood donation and you are only allowed to give blood if the stores are adequate. 

·      Hookworm infection

In other parts of the developing world, hookworms can be a problem when people walk barefoot on soil infested with the larvae of hookworms.  Hookworms live in the lumen of the small intestine where they attach to the intestinal wall resulting in chronic blood loss leading to anemia and malnutrition. 

Symptoms

Often the symptoms can be very mild as to go unnoticed but once the body stores of iron become more depleted, symptoms will begin to become more apparent:

·      Extreme fatigue

·      Pale skin

·      Weakness

·      Shortness of breath

·      Headache

·      Dizziness or lightheadedness

·      Cold hands and feet

·      Brittle nails

·      Fast heartbeat

·      Unusual craving for nonfood substances also known as pica – may include cravings for ice, dirt, laundry starch or other nonfood items.

·      Poor appetite

·      Frequent infections

·      Restless leg syndrome

Complications from iron deficiency anemia

Several health problems can occur if anemia is left untreated:

·      Pregnant women are at risk of delivering a premature or low birth weight baby.

·      Infants and children can have delayed growth and brain development along with an increased risk of infections.

·      Can affect the heart by leading to a rapid or irregular heartbeat which can lead to an enlarged heart or heart failure since the heart has to pump more blood to make up for the lack of oxygen in the blood. 

Treating iron deficiency anemia

Iron deficiency anemia is easily treated but treatment needs to begin as soon as possible once it is discovered.  Here’s how it is treated:

·      Iron supplements.  These are usually over-the-counter and may need to be taken for several months.  Infants and small children will be given a liquid form.  Absorption of iron pills is increased if taken on an empty stomach unless it causes an upset stomach which then it can be taken with a meal.  Avoid taking an antacid with an iron supplement as it will interfere with the absorption.  Iron pills should be taken with a good source of vitamin C as vitamin C helps improve the absorption of iron. Drinking a small glass of orange juice when you take the iron pill is advised. 

  ·      Iron supplements may cause side effects such as constipation, dark stools, stomach irritation and heartburn.  A stool softener may need to be taken to help with constipation.

·      Eat more iron rich foods.  The best source of iron is heme iron which is found in animal foods.  Our body absorbs iron better (20-30%) from animal sources as opposed to plant sources or iron. 

Animal sources of iron that are better absorbed include:

*red meat especially beef and liver

*chicken and turkey

*fish and shellfish

*pork

Plant sources of iron contain nonheme iron which is not as well absorbed (1-10%).  Plant sources include:

*Iron-fortified breakfast cereals and bread

*Peas, lentils, beans such as red, kidney, pinto and soybeans

*Dried fruit such as prunes, raisins, and apricots

*Spinach and other dark green leafy vegetables

*Tofu

*Prune juice

·      Include a vitamin C rich food at each meal.  Vitamin C not only helps absorb iron from an iron supplement but also food sources of iron.  Vitamin C rich foods include citrus fruits such as oranges, grapefruit, tangerines, also kiwi fruit, strawberries, tomatoes, broccoli, cabbage, potatoes, peppers, spinach and other leafy green vegetables. 

.       Compounds called phytates and tannins can interfere with the absorption of iron.  Phytates are found in whole grains, bran and soy products and will bind with iron carrying it on out the body.  Tannins are found in black tea and some grains and also reduce absorption of iron.  It is advised to not drink tea with a meal.