Anemia: When Low Iron Is the Cause
What is anemia?
Anemia occurs when your blood doesn't have enough hemoglobin. Hemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. A common cause of anemia is not having enough iron. Your body needs iron to make hemoglobin.
What can cause low iron levels?
A number of things can cause your body to be low in iron:
Lack of iron in the diet. This is mostly a problem for children, young women and people who are vegetarian. Children who drink a lot of milk but don't eat iron-rich foods, young women who follow "fad" diets, and people who don't eat meat may be at risk for iron deficiency.
Growth spurts. Children under age 3 are growing so fast that their bodies may have a hard time keeping up with the amount of iron they need.
Pregnancy. Women who are pregnant or who are breast feeding need 2½ times as much iron as men. That's why pregnant women are often tested for anemia and why they need to eat more iron-rich foods or take a daily iron pill.
Blood loss. This is a common reason for iron deficiency anemia in adults. Heavy periods may cause anemia. Blood loss can also be caused by internal bleeding, usually in the digestive tract. A stomach ulcer, ulcerative colitis, cancer, or taking aspirin or similar medicine for a long time can cause bleeding in your stomach or intestines. That's why it's important to find the reason for a low iron level.
What are the symptoms of anemia?
Often, no symptoms
- Paleness
- Feeling tired
- Unusual shortness of breath during exercise
- Fast heartbeat
- Cold hands and feet
- Brittle nails
- Headaches
- Dizziness or lightheadedness
How is anemia diagnosed?
Talk to your doctor if you think you might have anemia. A blood test will probably be done to diagnose anemia. Other tests may be needed to find out what's causing the anemia.
Can anemia be prevented?
Some types of anemia can be prevented, such as those caused by diet. You can help prevent this type of anemia by making sure you eat foods that have iron. See the box below for a list of iron-rich foods.
Foods high in iron:
- Liver and other meat
- Seafood
- Dried fruits like apricots, prunes and raisins
- Nuts
- Beans, especially lima beans
- Green leafy vegetables, such as spinach and broccoli
- Blackstrap molasses
- Whole grains
- Iron-fortified breads and cereals (check the label)
How is anemia treated?
It depends on what's causing the anemia. For example, if anemia results from losing too much blood, the cause of the blood loss will need to be treated. If anemia results from a diet that's low in iron, your doctor may recommend a change in your diet or iron pills.
How can I increase the iron in my diet?
Your body best absorbs iron that comes from meat. Eating a small amount of meat along with other sources of iron, such as certain vegetables, can help you get even more iron out of these foods. Taking vitamin C pills or eating foods high in vitamin C, such as citrus fruits or juice, at the same time you eat iron- rich foods or take your iron pill can help your body absorb the iron better.
Some foods block the absorption of iron. These include coffee, tea, egg whites, milk, fiber and soy protein. Try to avoid these when you're eating food high in iron.
Can iron pills cause problems?
Iron pills can cause stomach upset, heartburn and constipation. Be sure to tell your doctor about any discomfort you notice. The tips below may help reduce discomfort.
Anemia (Normocytic Anemia)
What is normocytic anemia?
Normocytic anemia (say: normo-sit-tic a-neem-ee-a) is a blood problem. It is the most common type of anemia. Having it means you have normal-sized red blood cells, but you have a low number of them. The presence of normal-sized red blood cells tells your doctor that you have normocytic anemia rather than another kind of anemia.
What causes normocytic anemia?
Normocytic anemia can be a problem you were born with (called congenital) or it can be caused by an infection or disease (called acquired).
The most common cause of the acquired form of normocytic anemia is a long-term (chronic) disease. Chronic diseases that can cause normocytic anemia include kidney disease, cancer, rheumatoid arthritis and thyroiditis. Some medicines can cause you to have normocytic anemia, but this does not happen often.
What are the signs of normocytic anemia?
Normocytic anemia usually starts slowly. It doesn't have many signs at first. You may find yourself getting tired easily. You may look pale. If the anemia starts suddenly or gets really bad, you might feel dizzy or weak.
How does my doctor find out that I have normocytic anemia?
Most often, normocytic anemia is found by routine tests that are part of a physical exam. It might be found by a blood test you get for some other reason. A complete blood count (also called a CBC) can show if you have normocytic anemia.
If your CBC shows a low number of normal-sized red blood cells, your doctor might want you to get more tests to see what is causing the anemia. If you were born with it, other family members may also need to be tested.
How is normocytic anemia treated?
Managing the condition that is causing the anemia is the most important part of treating it. This might mean you would stop taking a particular medicine, or your doctor might treat a chronic illness or look for something that is causing you to lose blood.
If your normocytic anemia is very bad, you might get shots of erythropoietin. Erythropoietin (say: air-rith-ro- po-et-in) helps your bone marrow make more red blood cells.
Talk to your doctor before you take extra iron pills or vitamins. Lack of iron in your diet may not be the cause of your anemia and too much iron is not good for you.
Anemia During Pregnancy
Why do pregnant women need more iron?
When you're pregnant, your body makes more blood to share with your baby. You may have up to 30% more blood than when you’re not pregnant. If you don’t have enough iron, your body can't make the red blood cells that it needs to make this extra blood.
If you are pregnant and are not getting enough iron, you are at risk of developing iron-deficiency anemia. Most doctors recommend that pregnant women take a supplement that contains 30 mg of iron each day. (Most prenatal vitamins contain at least this amount.)
What increases my risk of anemia during pregnancy?
- Vomiting a lot from morning sickness.
- Not getting enough iron-rich foods (See the box below for a list of these foods.)
- Having heavy periods before pregnancy
- Having 2 pregnancies close together.
- Being pregnant with twins, triplets or more.
- Becoming pregnant as a teenager.
- Losing a lot of blood (for example, from an injury or during surgery).
What are the symptoms of anemia?
Sometimes, anemia does not have any symptoms. If you do have symptoms, they may include:
- Feeling tired or weak all the time
- Dizziness
- Paleness
- Shortness of breath
- Fast or irregular heartbeat
- Cold, numb or tingling hands and feet
- Pica: an abnormal craving for things like ice, dirt, paint, or clay
How will my doctor check for anemia?
During your first prenatal visit, you’ll have a blood test to check for anemia. Even if you don’t have anemia during your early pregnancy, your doctor will probably want to check you again in your second or third trimester.
How can anemia be treated?
If you have iron-deficiency anemia, your doctor will probably prescribe iron pills. You will likely take these pills for your whole pregnancy. And you’ll probably have more blood tests to make sure that treatment is working.
How can I prevent iron-deficiency anemia?
You can’t always prevent anemia during pregnancy, but eating foods rich in iron (see below) can help. Doctors recommend that pregnant women eat at least 27 mg of iron daily. (This is in addition to what you’re taking in your prenatal vitamin.)
Foods with vitamin C—such as strawberries and citrus fruits—help your body absorb iron. Eat these foods with foods that are high in iron to help with absorption. For example, if you’re taking an iron pill, take it with orange juice or another food high in vitamin C. Some foods can block iron absorption. These include milk, soy protein, egg yolks, coffee and tea. Avoid these foods when eating iron-rich foods. Antacids and some other medicines that contain calcium also block iron absorption. Your doctor can tell you more about which medicines to avoid if you’re trying to boost your iron levels.
Iron-rich foods include:
- Dark green, leafy vegetables, such as spinach and broccoli
- Red meat and pork
- Seafood (Not all seafood is safe during pregnancy.)
- Dried fruits
- Whole grains
- Beans
- Iron-fortified cereals, pastas and breads
- Blackstrap molasses
- Nuts
What problems does anemia cause during pregnancy?
If anemia isn’t treated, it can increase your risk of having your baby too early or having a baby who doesn’t weigh enough. You’ll also be at risk of needing a blood transfusion if you lose a lot of blood during delivery. Anemia may also be associated with postpartum depression (depression after delivery) in new mothers.
Rarely, mothers who have severe iron-deficiency anemia may pass along problems associated with low iron to their babies. This can lead to growth problems and mental delays. However, developing babies usually take as much iron as they need from their mothers. Getting treatment for your iron-deficiency anemia can almost always prevent these problems.
What else causes anemia?
Anemia can also occur when your body doesn't have enough of the vitamins—including vitamin C and some B vitamins—it needs to make red blood cells. This can be caused by poor diet, certain medicines or medical conditions, and stomach or intestinal problems. This type of anemia can usually be treated by taking vitamins and eating a healthy diet.
Some genetic diseases can also cause anemia. If you have sickle cell disease or thalassemia, your body has trouble producing healthy red blood cells, which can lead to anemia. You’re also at risk of passing these diseases on to your unborn baby. If you or someone in your family has one of these diseases, talk to your doctor about how to prevent or treat anemia while you’re pregnant
Iron Deficiency Anemia in Infants and Children:
What is iron deficiency anemia?
Anemia occurs when your blood doesn't have enough hemoglobin. Hemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. A common cause of anemia is not having enough iron. Children can get iron deficiency anemia when there is not enough iron in their diet to make a normal amount of hemoglobin in their blood. Growth spurts can also lead to low iron levels. Children under age 3 grow so fast that their bodies may have a hard time keeping up with the amount of iron they need.
What are the symptoms of iron deficiency anemia?
Often, iron deficiency anemia does not cause any symptoms. However, some of the symptoms children who have iron deficiency anemia may experience include:
- Weakness and tiredness
- Pale skin
- Not feel hungry
- Dizziness
- Fast heartbeat
- Irritability
- Unusual shortness of breath during exercise
- Cold hands and feet
What problems can iron deficiency anemia cause?
Iron deficiency anemia can cause your infant or toddler to have mental, motor or behavior problems. These problems can be long lasting even after treatment fixes the anemia.
Who gets iron deficiency anemia and how do I prevent it?
Infants who drink cow's milk in the first year of life are at risk for iron deficiency anemia. Cow’s milk does not have enough of the iron infants need to grow and develop, and.it is the most common dietary cause of iron deficiency in infants. Do not give cow's milk to your infant in the first year of life.
Breastfed infants who do not eat iron-rich foods like iron-fortified cereal or take an iron supplement after the fourth month of life are also at risk of iron deficiency anemia. If your child is breastfed, talk to your doctor about adding some form of iron, such as iron-fortified cereal or vitamin drops with iron, to your child's diet starting at 4 to 6 months of age.
Toddlers (12 to 24 months of age) who drink a lot of cow's milk, have a diet low in iron, or already had iron deficiency as an infant are also at risk.
If you use iron-fortified formula, do not give your child vitamin drops with iron. This combination provides too much iron and is not healthy. If you decide to stop breastfeeding before your infant is 12 months of age, use iron-fortified formula. Do not use low-iron formula.
After your child is 12 months old, if you stop breastfeeding or using iron-fortified formula, you should feed your toddler meat, chicken, fish, whole grains, enriched bread and cereal, dark green vegetables, and beans. Vitamin C is also important because it helps the body absorb iron. You should limit your child to less than 24 oz of cow's milk per day. (That's 3 cups of milk.) You might try giving your child yogurt and cheese. Ask your doctor if you should continue to give your child vitamins with iron.
Should my child be tested for iron deficiency?
If you’re worried and think your child might have iron deficiency anemia, talk to your doctor. Infants at risk for iron deficiency should be checked with a blood test at 9 to 12 months of age. Toddlers should be checked 6 months later and at 24 months.
Warning:
Keep all products with iron stored out of the reach of your child because they can be poisonous if taken in large amounts.