Diagnosis and Treatment: Anemia – Iron deficiency

Anemia – Iron deficiency



Iron deficiency anemia is a decrease in the red cells of the blood caused
by too little iron. Iron deficiency anemia is the most common form of anemia.
Iron is an essential component of hemoglobin, the oxygen carrying pigment
in the blood. Iron is normally obtained through the food in the diet and by
the recycling of iron from old red blood cells.

Babies are born with about 500mg of iron in their bodies; by the time they
reach adulthood they need to have accumulated about 5000mg.

Children need to absorb an average of 1mg per day of iron to keep up with
the needs of their growing bodies. Since children only absorb about 10% of
the iron they eat, most children need 8-10mg per day of iron. (Breast-fed
babies need less, because iron is absorbed 3 times better when it is in breast
milk.)

Drinking too much cow's milk is a classic cause of iron deficiency in young
children.

A common time for iron deficiency is between 9 and 24 months of age. All babies
should have a screening test for iron deficiency at this age. The adolescent
growth spurt is another high-risk period.

It can also be related to lead poisoning in children.

Symptoms & Signs

• Pale skin color (pallor)

• Fatigue

• Irritability

• Weakness

• Shortness of breath

• Sore tongue

• Brittle nails

• Unusual food cravings (called pica)

• Decreased appetite (especially in children)

• Headache - frontal

• Blue tinge to sclera (whites of eyes)

Treatment

Oral iron supplements are in the form of ferrous sulfate. The best absorption
of iron is on an empty stomach, but many people are unable to tolerate this
and may need to take it with food. Milk and antacids may interfere with absorption
of iron and should not be taken at the same time as iron supplements. Vitamin
C can increase absorption and is essential in the production of hemoglobin.

Supplemental iron is needed during pregnancy and lactation because normal
dietary intake rarely supplies the required amount.

The hematocrit should return to normal after 2 months of iron therapy, but
the iron should be continued for another 6 to 12 months to replenish the body's
iron stores, contained mostly in the bone marrow.

Intravenous or intra-muscular iron is available for patients when iron taken
orally is not tolerated.

Iron-rich foods include raisins, meats (liver is the highest source), fish,
poultry, eggs (yolk), legumes (peas and beans), and whole grain bread.

Iron supplementation significantly improves learning, memory, and cognitive
test performance in iron-deficient adolescents. Iron supplementation also
measurably improves the performance of iron-deficient, anemic athletes.

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