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Reticulocytes
Reticulocytes


Blood cells
Blood cells


Definition:

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Iron deficiency anemia is a decrease in the number of red cells in the blood caused by too little iron.

See also: Iron-deficiency anemia - children



Alternative Names:

Anemia - iron deficiency



Causes, incidence, and risk factors:

Iron deficiency anemia is the most common form of anemia . About 20% of women, 50% of pregnant women, and 3% of men do not have enough iron in their body.

Iron is a key part of hemoglobin , the oxygen-carrying protein in the blood. Your body normally gets iron through diet and by recycling iron from old red blood cells. Without iron, the blood cannot carry oxygen effectively. Oxygen is needed for every cell in the body to function normally.

The causes of iron deficiency are:

It can also be related to lead poisoning in children.

Anemia develops slowly after the normal iron stores in the body and bone marrow have run out. In general, women have smaller stores of iron than men because they lose more through menstruation. They are at higher risk for anemia than men.

In men and postmenopausal women, anemia is usually caused by gastrointestinal blood loss from:

  • Certain types of cancer (esophagus, stomach, colon )
  • Long-term use of aspirin or nonsteroidal anti-inflammatory medications (NSAIDS)
  • Peptic ulcer disease
  • Ulcers

Iron deficiency anemia may also be caused by poor absorption of iron in the diet, due to:

High-risk groups include:

  • Infants, children, and adolescents who are growing quickly
  • People who do not get enough iron in their diet
  • People who use aspirin, ibuprofen, or other arthritis medicines long-term
  • Pregnant or breastfeeding women who need extra iron
  • Seniors
  • Women of child-bearing age who have lost blood through heavy menstrual periods


Symptoms:

Note: There may be no symptoms if the anemia is mild.



Signs and tests:

Treatment:

The cause of the iron deficiency must be found, especially in older patients who face the greatest risk for gastrointestinal cancers.

Iron supplements (ferrous sulfate) are available. For the best iron absorption, take these supplements with an empty stomach. However, many people cannot tolerate this and may need to take the supplements with food.

Patients who cannot tolerate iron by mouth can take it through a vein (intravenous ) or by an injection into the muscle.

Milk and antacids may interfere with the 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.

Pregnant and breastfeeding women will need to take extra iron because their normal diet usually will not provide the required amount.

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

Iron-rich foods include:

  • Eggs (yolk)
  • Fish
  • Legumes (peas and beans)
  • Meats (liver is the highest source)
  • Poultry
  • Raisins
  • Whole-grain bread


Support Groups:



Expectations (prognosis):

With treatment, the outcome is likely to be good. Usually, blood counts will return to normal in 2 months.



Complications:

There are usually no complications. However, iron deficiency anemia may come back. Get regular follow-ups with your health care provider.

Children with this disorder may be more likely to get infections.



Calling your health care provider:

Call for an appointment with your health care provider if:

  • You have symptoms of this disorder
  • You notice blood in your stool


Prevention:

Everyone's diet should include enough iron. Red meat, liver, and egg yolks are important sources of iron. Flour, bread, and some cereals are fortified with iron. If you aren't getting enough iron in your diet (uncommon in the United States), take iron supplements.

During periods when you need extra iron (such as pregnancy and breastfeeding), increase the amount of iron in your diet or take iron supplements.



References:

Brotanek JM, Gosz J, Weitzman M, Flores G. Iron deficiency in early childhood in the United States: risk factors and racial/ethnic disparities. Pediatrics. 2007;120(3):568-575.

Ginder GD. Microcytic and hypochromic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 163.

Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med. 2008;121:943-948.

Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am Fam Physician. 2007;75(5):671-678.




Review Date: 4/5/2009
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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