In human nutrition, iron is of great importance as it is a necessary mineral for body function and good health. In the body, iron is necessary for the formation of hemoglobin the pigment that carries oxygen to the tissues from the lungs. 70 to 95 percent iron of human bodies is  present in hemoglobin in circulating red blood cells. Deficiency of iron is a common problem especially in women. Actually, 5% of women between the ages of 20 and 49 have iron deficiency with anemia and 11% have iron deficiency without anemia. Iron deficiency anemia is a common type of anemia in which a person has inadequate amounts of iron to meet body demands. It is also known as sideropenic anemia.

Iron Deficiency Anemia:

For the formation of hemoglobin, the body requires iron. Hemoglobin production is limited in case of iron deficiency which in turns affects the production of red blood cells (RBCs). Anemia is a condition where the hemoglobin and RBCs content in the bloodstream is decreased. RBCs are required to carry oxygen throughout the body and anemia results in less oxygen reaching the cells and tissues. Insufficient iron intake is the major cause of iron-deficiency anemia in childhood. In the United States, it has become much less common over the past 30 years, primarily because of iron-fortified infant formulas and cereals.

Iron-deficiency anemia doesn't occur immediately but a person progresses it through periods of iron deficiency, beginning with iron depletion in which the amount of iron in the body is decreased while the iron in RBCs remains constant. If iron depletion is not corrected at proper time, it is responsible for iron deficiency that eventually leads to IDA.

Causes of Iron Deficiency Anemia:

Following are the most important causes of iron deficiency:

• Body unable to absorb adequate iron (Vitamin C aides in iron absorption)
• Inadequate daily consumption of iron rich food
• growth spurts or blood loss due to heavy period or internal bleeding
• pregnancy
• periods of rapid growth

Inadequate daily consumption of iron is the most frequent reason behind IDA in infants, toddlers, and teens. Children who don't eat enough or who consume foods that are poor sources of iron are at risk for developing this condition. Poverty is also contributing factor to IDA, as families living at or below the poverty level may not be receiving enough iron-rich foods.

After the depletion of the normal stores of iron in the body and in the bone marrow, anemia develops slowly. In general, women are more prone to this as they have smaller stores of iron than men. Also, they lose iron more frequently than men due to natural blood loss during menstruation.

Generally, anemia in men and postmenopausal women is due to gastrointestinal blood loss related with ulcers, the use of aspirin or non-steroidal anti-inflammatory medications (NSAIDS), or colon cancer. Anemia may also be caused by Gaucher disease.

Symptoms of Iron-Deficiency Anemia:

• Decreased appetite especially in children
• Headache frontal
• Lack of energy, feeling tired and weakness
• Pale skin on the lining of the eyes, the inner mouth, gums and the nails
• Disturbed sleep
• Abdominal pain
• Brittle hair
• Rapid and forceful heart beat
• Low blood pressure with position change, from sitting to standing up
• Severe menstrual pain and bleeding
• Tongue may become sore, smooth, shiny and reddened
• Finger nails become thin, brittle and white They may grow abnormally and get a spoon-shaped appearance
• Reduction in immunity and increased vulnerability to infection
• A strong desire to eat nonfoods such as ice, paint or dirt (A condition called pica)
• Shortness of breath during exercise (even during a simple exercise like walking)

The symptoms of iron-deficiency anemia may bear a resemblance to other blood conditions or medical problems, so always consult your physician for a diagnosis.

Who is at Risk for Iron Deficiency Anemia?

High-risk groups for Iron Deficiency Anemia include,

• Women having periods which lead to blood loss through menstruation
• Pregnant or lactating women who have an increased requirement for iron
• Infants, children, and adolescents in rapid growth phases
• Persons whose food habits have less or nil iron content for several years

Peptic ulcer disease, long-term aspirin use, or colon cancer are the risk factors which are associated to blood loss. Vegetarians are also at risk of getting anemia because they don’t take meat. However, vegetarians don't always develop anemia. Many vegetables such as raisins, broccoli and spinach contain sufficient iron.

Diagnosis of iron-deficiency anemia:

As iron is essential for the production of hemoglobin, the measurement of iron may be helpful in evaluating anemia. Iron-deficiency anemia may be identified from general findings on a complete medical history and physical examination, for example complaints of tiring easily, abnormal paleness or lack of color of the skin, or a fast heartbeat (tachycardia).

During a medical examination, Iron-deficiency anemia is usually discovered through a blood test including serum iron, total iron-binding capacity (TIBC), and serum ferritin. Additionally to a complete medical history and physical examination, diagnostic procedures for iron-deficiency anemia may include the following:

• Extra blood tests
• Bone marrow aspiration and biopsy - marrow may be eliminated by aspiration or a needle biopsy under local anesthesia. A fluid specimen is removed from the bone marrow in aspiration biopsy. Marrow cells (not fluid) are removed in a needle biopsy. These methods are frequently used collectively.

Treatment for iron-deficiency anemia:

For iron-deficiency anemia, physician will determine specific treatment based on:

• Extent of the anemia
• Cause of the anemia
• Your age, overall health, and medical history
• Your opinion or preference
• Expectations for the course of the anemia
• Your tolerance for specific medications, procedures, or therapies

Most cases of iron-deficiency anemia are as the result of poor dietary iron intake and in such cases diet changes replenish the depleted iron stores of the body.

Iron-rich diet:

Following are the good sources of iron:

• Leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards
• Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
• Iron-enriched white bread, pasta, rice, and cereals
• Meats - beef, pork, lamb, liver, and other organ meats
• Poultry - chicken, duck, turkey, liver (especially dark meat)
• Fish - shellfish, including clams, mussels, and oysters, sardines, anchovies
• Yeast-leavened whole-wheat bread and rolls

Iron supplements:

Sometimes, iron supplements are recommended by physician, which can be taken over several months to increase iron levels in the blood. Irritation of the stomach and discoloration of bowel movements are some side effect of iron supplements. To increase absorption, these supplements should be taken on an empty stomach, or with orange juice.

Prevention of iron-deficiency anemia:

Iron-deficiency anemia is preventable in most cases by following some basic recommendations:

• Iron-fortified products such as cereal can be a great way to get kids, especially those under the age of 2 years to get more iron.
• A variety of foods can supply your family with nutritious sources of iron: lean meats; egg yolks; broccoli, spinach, and other green leafy vegetables; dried peas and beans; blackstrap molasses; raisins; and whole-grain bread.
• Ensure children or teens on a vegetarian diet are getting enough iron. As iron from meat sources is more easily absorbed than iron from plant sources, you may require adding iron-fortified foods to their diet.
• Infants younger than 1 year should drink only breast milk or an infant formula supplemented with iron. It is essential for breastfed infants to get iron-fortified solid foods starting at about 6 months of age.
• Children under 2 years should have no more than 24 ounces of cow's milk a day. Milk can inhibit absorption of iron as noted earlier and drinking too much milk can dampen a child's appetite for other iron-rich foods. Additionally, too much cow's milk has been shown to irritate the gastrointestinal tract, which may cause intestinal bleeding, a cause of iron loss.

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Iron Deficiency Anemia: Causes and Treatment video from Youtube:

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