Iron Deficiency Anemia - What Is It? Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Iron deficiency anemia: what is it and how is it treated?

Iron deficiency anemia is a decrease in the level of iron in the body, which leads to a drop in the level of hemoglobin in the blood. Hemoglobin is found in red blood cells, which are red blood cells that carry oxygen to organs and tissues. Without hemoglobin, this process becomes impossible. Among the people, anemia is better known under the name "anemia", since in past years this disorder was called in this way even by doctors.

The level of red blood cells in iron deficiency anemia may remain within the normal range. However, they are unable to perform their function if they lack hemoglobin. As a result, organs and tissues begin to suffer from oxygen starvation (this condition is called hypoxia).

Among other anemias, iron deficiency anemia is the most common. This is easily explained by the fact that a variety of factors and reasons can lead to its development, which will be considered below.

Iron (Fe) is a trace element, without which the human body is unable to function normally.

Normally, a healthy adult average man has about 4-5 g of iron in his body:

• Hemoglobin contains 2.5-3.0 g of iron.
• In tissues, its level is equal to 1.0-1.5 g. This iron is contained in them as reserves in case of emergencies. It comes in the form of a substance called ferritin.
• Respiratory enzymes and myoglobin consume about 0.3-0.5 g of iron.
• Also, a small amount of iron is found in proteins that transport this trace element. These proteins are called transferrins.

Every day, the body of an adult male with the help of the intestines removes about 1.0-1.2 g of iron.

The body of an adult woman contains 2.6-3.2 g of iron. Moreover, the reserves of organs and tissues contain only 0.3 g of this trace element. Every day, the female body excretes iron through the intestines. During menstruation, the loss of this trace element is also carried out with menstrual blood. During menstruation, 1 g of iron will be excreted daily. Therefore, it is quite logical that it is women who most often suffer from such a violation as iron deficiency anemia.

In childhood, normal iron levels are equivalent to those for women. This is true for children and adolescents under the age of 14.

Unfortunately, the human body is not able to produce iron on its own. He can only receive it from the outside (with food or medicines). Iron absorption occurs in the duodenum and in the small intestine. With the help of the large intestine, this trace element is only excreted.

A person should not be afraid that the active use of iron with food can lead to its excessive accumulation in tissues and organs. The body has a number of mechanisms that will simply block excess Fe from food.

Content:

• The first signs of iron deficiency anemia
• The main symptoms
• Factors and causes of development
• Degree of iron deficiency anemia
• Diagnostics
• Treatment for iron deficiency anemia

The first signs of iron deficiency anemia

In the early stages of its development, iron deficiency anemia does not manifest itself in any way, that is, a person may not even suspect that there is a latent iron deficiency in his body. Changes at the initial stage of development of this disorder are insignificant. Nevertheless, the first signs of IDA are still there, another question that few people think that they are provoked precisely by a drop in the level of iron in the blood.

So, it is imperative to see a doctor and take a biochemical blood test if a person begins to worry about the following disorders:

• Appetite decreases. The person continues to eat food, but does so without much desire.
• Distortion of taste, the emergence of new food addictions is possible. You may want to eat something unusual, such as clay, chalk, flour, tooth powder.
• In the epigastric region, uncomfortable sensations often occur, disturbances with swallowing food are possible.
• The body temperature rises to subfebrile levels and remains at this level for a long period of time. At the same time, there are no visible symptoms of an infectious disease.
• It is possible that weakness increases when doing familiar things.
• During physical activity, the heart rate increases.
• Noise and ringing may appear in the ears.
• Sometimes patients complain of painful sensations in the region of the heart.

It is not at all necessary that the patient will experience the entire listed symptom complex. Sometimes anemia can have a latent course, and it is discovered by chance, during a medical examination.

The main symptoms

As the disease progresses, its clinical manifestations become more pronounced. In addition to circulatory hypoxic syndrome (headaches, weakness, fatigue) and problems with the digestive system, the patient develops sideropenic syndrome. When a patient describes his complaints at a doctor's appointment, the doctor will first of all suspect anemia.

The main symptoms that indicate iron deficiency include:

• Deterioration of the condition of the nail plate. It becomes thin, dull and begins to exfoliate.
• By paying attention to what kind of skin the patient has, certain conclusions can be drawn. With iron deficiency anemia, it becomes very dry and flaky.
• Seizures appear in the corners of the mouth, the lips become cracked.
• Salivation increases at night.
• Hair loses its former attractiveness. They begin to split, do not shine and grow poorly.
• The patient's tongue becomes cracked, there may be a feeling of discomfort in it.
• Even minor injuries to the skin will regenerate for a long time.
• Immune defenses are reduced. The person will get sick often and for a long time.
• Muscles lose their previous strength, and their weakness increases.
• Urinary incontinence is possible. It is secreted in small portions during strong laughter, coughing or straining. This is due to the weakening of the sphincters.
• The mucous membranes of the intestines and stomach become inflamed, and in some places even atrophy.
• There is an imperative urge to empty the bladder.
• A person's mood is always depressed, he becomes gloomy and apathetic.
• In a stuffy room, the patient feels very bad.
• Sleepiness follows a person even in the daytime.
• The face is slightly swollen all the time.

The course of anemia with the occurrence of the above symptoms can last for quite a long time - about 10 years. Sometimes the hemoglobin level rises somewhat, which helps to eliminate most of the pathological signs, and the person does not go to the doctor. However, the cause that causes iron deficiency cannot be eliminated on its own (unless it is caused by physiological factors, such as pregnancy). Therefore, iron deficiency anemia will continue to progress. Tachycardia will be present on an ongoing basis, in addition to it, severe shortness of breath will appear. Muscle weakness is constantly growing, a person's ability to work is significantly reduced.

The course of the disease in childhood is most often latent. By the age of 3, when the baby is transferred to a more varied diet, cases of IDA are diagnosed less often.

Iron deficiency often affects premature babies, babies who were born with multiple pregnancies, overweight children, and children who quickly gain weight. Frequent infectious diseases, intestinal diseases, artificial feeding contribute to the development of anemia in childhood.

The course of anemia in a child largely depends on how far this disorder has gone. What matters is the severity of the compensatory capabilities of the crumbs' organism. The lower the level of iron in the blood and the faster the hemoglobin falls, the more intense the symptoms of the disease will be. Sometimes, anemia can last for years without any treatment. However, the symptoms of iron deficiency will be subtle.

The following symptoms will indicate anemia in a child:

• Pale mucous membranes.
• White auricles.
• Dry and thin skin.
• Poor condition of hair and nails.
• Lack of appetite.
• Weight loss.
• Lagging in physical development.
• Subfebrile body temperature.
• Frequent ARVI and ARI.
• Enlargement of the spleen and liver in size.
• Recurrent diseases of the oral cavity.
• Fainting conditions.

All these symptoms may be absent with anemia if it has a latent course.

As for pregnant women, iron deficiency threatens not only the health of the expectant mother, but also the fetus. Moreover, the child's central nervous system will suffer, experiencing acute hypoxia. Iron deficiency anemia in pregnant women is associated with the risk of premature birth, as well as with infectious complications in the period after the baby is born.

Factors and causes of development

To understand the reasons for the development of iron deficiency anemia, it is necessary to outline the role of iron both in the process of hemoglobin formation and in the body as a whole.

Iron deficiency is at the root of iron deficiency anemia. If its level in the body is below the prescribed values, then this element will not be enough to complete the last stage of heme production. He will start taking it from the depot, taking it away from ferritin. However, to be shared with heme, ferritin must also contain sufficient iron. If the ferritin of this microelement is less than 25%, then, due to some circumstances, he received less of it.

Low heme production leads to the fact that hemoglobin is not able to be produced in sufficient quantities. There are too few hemes to form a hemoglobin molecule (normally it consists of 4 hemes and globin).

Erythrocytes leave the red bone marrow without acquiring hemoglobin. Such defective blood plates are unable to transport oxygen from the lungs to the tissues of the internal organs. As a result, they begin to suffer from hypoxia, a person develops circulatory-hypoxic syndrome.

Moreover, iron deficiency leads to the fact that the tissues cease to produce enzymes in the normal degree. This is reflected in their internal metabolism. The skin and mucous membranes undergo atrophic changes, which cause the first signs of the disease.

So, the main reason that entails iron deficiency anemia is a lack of iron and depletion of its depot (ferritin) with further disruption of the production of heme, and then hemoglobin.

Iron deficiency develops on condition that it does not reach the level at which it participates in heme synthesis. Iron losses are also possible along with erythrocytes, which is observed with the development of bleeding.

After massive blood loss in the body, acute post-hemorrhagic anemia develops, it does not belong to iron deficiency anemia. Such blood loss is typical for difficult childbirth, serious injuries, criminal abortions, etc. If assistance is provided to the victim on time and blood loss can be stopped, then the volume of circulating blood will fully recover after a while. At the same time, the level of erythrocytes and hemoglobin will return to normal.

The following reasons lead to the development of iron deficiency anemia:

• Chronic bleeding, in which red blood cells leave the blood along with hemoglobin and ferrous iron. Such bleeding is not characterized by massive loss of life-supporting fluid. These include: prolonged menstruation due to malfunctioning of the ovaries, uterine fibroids or endometriosis, as well as gastrointestinal bleeding, nasal and gingival blood loss.
• Insufficient intake of iron from food. In this case, vegetarianism or eating foods that contain extremely low levels of iron can lead to anemia.
• Excessive needs for iron in humans. A similar situation is observed in adolescence, in pregnant women (this problem is especially relevant for the third trimester of pregnancy), and in nursing mothers.
• A person who has cancer can develop iron deficiency anemia, especially if the tumors are growing very quickly. Also, foci of chronic infection in the body can provoke a violation.
• Iron deficiency anemia develops when this trace element is not able to be absorbed normally into the bloodstream in the intestines. The reason for this is various diseases of the digestive system: gastroduodenitis, enteritis, enterocolitis, removal of a part of the stomach or duodenum 12.
• Failure in the iron transportation processes will also lead to the development of this problem.
• If a woman suffered from anemia during pregnancy, then a lack of iron will be observed in the child's body.

Iron deficiency anemia, which develops in children, deserves special attention. At the age of less than 2-3 years, it is the lack of iron that is observed in babies more often than other deficiency conditions. Errors in the child's nutrition, which parents make, lead to such a pathology. This is a serious problem, since in addition to iron, children often lack proteins and vitamins.

Iron deficiency anemia is considered to be more of a female disease, since it often develops with profuse blood loss during uterine bleeding, or during labor. In addition, adolescents deplete iron stores faster than adults, which is associated with periods of active growth of their body. Of course, young children are at risk.

Degree of iron deficiency anemia

Depending on what exactly is the iron deficiency in the body, there are three degrees of anemia: mild, moderate and severe.

Mild anemia

Mild anemia is characterized by the level of hemoglobin in the blood in the range of 90-110 g / l. At this time, iron deficiency anemia is in a latent stage. It can last for a long time. There is no abrupt transition to moderate anemia. Sometimes it is possible to identify a lack of iron only by a blood test, but it will be necessary to study the concentration of serum iron, since hemoglobin will remain within the normal range.

Read more: Mild Anemia 1

Average

The average degree of iron deficiency anemia is characterized by a hemoglobin level in the range of 70-90 g / l. At this time, the patient develops sideropenic syndrome and begins to present certain complaints to the doctor. It can take several years (8-10 years) from the moment of manifestation of mild anemia to the development of moderate anemia.

Tissue sideropenic syndrome is characterized by symptoms such as: disturbances in the functioning of the digestive system, changes in the skin, deterioration of the condition of hair and nails.

Read more: Moderate Anemia 2

Heavy

Severe iron deficiency anemia is characterized by a decrease in hemoglobin levels to 70 g / l. In this case, the patient develops the whole complex of syndromes: circular-hypoxic, sideropenic, hematological. It is already impossible not to notice or ignore their manifestations, a person seeks medical help.

Read more: Severe Anemia 3

Diagnostics

Complaints from a patient who comes to an appointment may prompt the doctor to think that he is developing iron deficiency anemia.

To confirm this assumption, it is necessary to assign a number of laboratory tests, which include:

• General blood analysis. The following signs will indicate iron deficiency anemia: a decrease in the level of hemoglobin in the blood, the growth of small erythrocytes (microcytosis), hypochromia, an increase in the level of reticulocytes. Although sometimes the number of reticulocytes remains within the normal range.
• Decreased serum iron levels. Normal values for men are 13-30 μmol / l, and for women - 11-30 μmol / l.
• The level of transferrin in the blood rises, the normal values of which should be in the range of 27-40 μmol / l.
• In the gland, the transferrin content will not exceed 25%, which is also a characteristic sign of anemia.
• Serum ferritin in the blood decreases with IDA. Its normal values for a healthy man are 30 ng / ml, and for a healthy woman - 10 ng / ml.

However, it is not enough just to establish the fact that a person has iron deficiency anemia. It is imperative to identify the cause that led to its development. It cannot be ruled out that a serious illness or other life-threatening condition became the impetus. To determine the cause of IDA, the following studies may be required:

• It is imperative to check with the patient if he is an adherent of a vegetarian diet. It is possible that the cause of anemia lies precisely in the characteristics of the patient's diet.
• The development of anemia for latent internal bleeding is characteristic, therefore, most patients are recommended to undergo EGD, colonoscopy, sigmoidoscopy. This will make it possible to detect hidden bleeding in the organs of the digestive system.
• Women must be sent to see a gynecologist without fail.

The search for the cause of IDA must be completed before the time when treatment is prescribed. Therapy for anemia based on assumptions is not possible.

Treatment for iron deficiency anemia

There are several basic principles for treating iron deficiency anemia, including:

• It is impossible to get rid of the disease by simply adjusting the menu. The patient should take iron supplements.
• IDA treatment consists of 2 stages. First, you need to eliminate anemia, which takes 30-45 days (an increase in hemoglobin levels will occur after 21 days of treatment). The next step is to replenish iron in the body's reserves. The duration of this stage is 60 days.
• After the hemoglobin level returns to normal, therapy should not be stopped. A full course cannot be less than 3-4 months.

A reticulocytic crisis that develops on the 5-8th day of therapy indicates that it was selected correctly. In this case, the level of young erythrocytes, called reticulocytes, increases 20-50 times.

If the patient is prescribed oral iron intake, then no more than 20-30% of the total dose will be absorbed. The rest is simply excreted by the intestines. Therefore, the doctor should be engaged in the selection of the dosage of the iron preparation.

Although it is impossible to get rid of iron deficiency with diet alone, this does not mean that the patient should give it up. Compliance with a diet enriched with this microelement is a prerequisite for recovery. First of all, a person should get meat products that do not contain a lot of fat. These are beef, hot lamb and veal. The menu is complemented with buckwheat, fish, citrus fruits, apples.

In addition, the patient is prescribed vitamin and mineral complexes with the charming inclusion of ascorbic acid, vitamin A, B and E.

Preparations - sources of iron must be taken according to the following rules:

• Short-acting drugs are taken a quarter of an hour after a meal, or in between approaches to the table. Long-acting medications can be taken before meals and at night. These include drugs such as: Sorbifer durules, Tardiferon-retard, Ferrograd, Ferrogradumet. It is enough to take them once every 24 hours in the dosage prescribed by the doctor.
• Do not drink iron preparations with dairy products or whole milk. They contain calcium, which interferes with the normal absorption of iron.
• Chewing medicinal products, unless they are chewable tablets, is prohibited. They are taken whole and washed down with water. Also, as a drink can be used a decoction of wild rose, or any light juice that does not contain fruit pulp.

For children who have not reached the age of three years, iron preparations are prescribed in drops. Syrups can be offered to children 3-6 years old. At an older age, chewable tablets are suitable for the treatment of anemia, which young patients do not refuse.

Modern pharmacology offers a wide range of medications designed to compensate for iron deficiency. They can be found in different forms of release, so choosing the best option is not difficult.

The most common iron-containing medicines include:

• Ferrum Lect.
• Maltofer.
• Ferroplex.
• Aktiferrin.
• Hemofer.
• Ferrocerone.
• Tardiferon.
• Ferrogradumet.
• Heferol.
• Ferrograd.
• Sorbifer Durules.

Medicines on the list should not be taken on your own initiative. They must be prescribed by a doctor. To begin with, the doctor selects a therapeutic dose, and then reduces it to a preventive one.

Intramuscularly iron is injected only if a violation of its absorption at the gastrointestinal tract level is established. This is caused by surgical interventions on the intestines and stomach, as well as various pathologies of the digestive system.

It should be taken into account that intramuscular and intravenous administration of iron preparations can provoke an allergic reaction, up to anaphylactic shock.

In addition, the treatment of some other types of anemia with iron supplements is strictly contraindicated. Therefore, before starting therapy, you should make sure that the diagnosis is correct.

In some cases, a blood transfusion is required; the indications for this procedure are:

• Prenatal or preoperative preparation of a patient with a hemoglobin level below 50 g / l.
• The inability to take iron preparations in the form of tablets and an allergy to their parenteral administration.
• Transfused during IDA only erythrocyte mass, which has been washed at least 3 times.

Prevention of iron deficiency anemia is an important measure to prevent serious disorders in the body. Particular attention should be paid to children and women in position. In order to prevent the development of anemia in children under the age of one year, it is necessary not to give up breastfeeding. If the child is on artificial formula, then they must contain a sufficient amount of iron. It is imperative to introduce complementary foods with meat and fish dishes in a timely manner.

All pregnant women who are in the third trimester of pregnancy should take iron supplements. Women who have not entered menopause are obliged to remember the need for prophylactic iron supplementation in early spring. The prophylactic course should last 4 weeks. A separate risk group includes adolescent girls, athletes and blood donors.

If a person discovers the first signs of anemia, then treatment should not be delayed. You need to see a doctor and get adequate therapy.

Useful articles on the restoration of hemoglobin in the blood:

• List of iron supplements in the treatment of anemia
• Diet and nutrition for anemia
• Home treatment for anemia (effective and proven recipes)
• TOP 5 products to increase hemoglobin in the blood
• Which doctor should I contact for anemia?

Video: iron deficiency anemia, RIA Novosti story:

The author of the article: Shutov Maxim Evgenievich | Hematologist

Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.