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Iron deficiency anemia

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Iron deficiency anemia is the most common nutritional deficiency worldwide involving individuals of all ages.

Although the cause is multifaceted, iron deficiency anemia generally results when the body’s iron demands are not adequately met by iron absorption from the diet, either due to inadequate intake, impaired absorption or transport, physiologic losses associated with reproductive age or chronic blood loss secondary to diseases.1

Iron deficiency anemia is characterized by a defect in hemoglobin synthesis, resulting in RBCs that are small (microcytic) and contain reduced amount of hemoglobin (hypochromic). Therefore, the oxygen delivery capacity of the blood to cells and tissues is significantly reduced.


Complications of Iron deficiency anemia

In adults, iron deficiency anemia can result in a wide variety of unfavorable outcomes including reduced work or exercise capacity, impaired cognitive functioning and memory, immune dysfunction, increased rates of infection, gastrointestinal disturbances and increased risk of pregnancy complications such as prematurity and fetal growth retardation.

Iron deficiency anemia affects roughly 10–30% of all pregnancies and among others morbidities, may contribute to the development of postpartum depression.2 In addition, iron deficiency anemia concomitant with chronic kidney disease or congestive heart failure can worsen the outcome of both conditions.

Iron deficiency anemia may affect visual and auditory functioning and is associated with poor cognitive development in children.3.4


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Screening of iron deficiency anemia

The Centers for Disease Control and Prevention (CDC) recommends routine anemia screening for all adolescent females at least once every five years in absence of risk factors for anemia.5,6 In presence of risk factors, the screening need to be done once in a year.

Adolescent males only required to be screened for anemia in the presence of risk factors.


Diagnosis of iron deficiency anemia

The diagnosis of iron deficiency anemia requires that a patient be anemic and show laboratory evidence of iron deficiency. The most accurate initial diagnostic test for iron deficiency anemia is the serum ferritin measurement. The serum transferrin receptor assay is a newer approach to measuring iron status at the cellular level. The levels are increased in patients with iron deficiency anemia and normal in patients with ACD.


Treatment of iron deficiency anemia

Iron therapy, in combination with proper dietary approaches to increase iron and vitamin C intakes, effectively treats iron deficiency anemia by increasing the hemoglobin level and replacing iron stores.

The most economical and effective medication in the treatment of iron deficiency anemia is the oral administration of ferrous iron salts. Among the various iron salts, ferrous sulfate is most commonly used. Ferrous sulfate in a dose of 300 mg provides 60 mg of elemental iron whereas, 325 mg of ferrous gluconate provides only 36 mg of elemental iron.

Although oral iron has the advantage of being simple and economical, it is limited by side-effects, poor compliance, poor absorption and low efficacy. Intravenous iron is the best means of ensuring delivery of readily available iron to the bone marrow.

Indications for the use of intravenous iron include chronic uncorrectable bleeding, intestinal malabsorption, intolerance to oral iron or a hemoglobin level less than 6 g/dL with signs of poor perfusion in patients who would otherwise receive transfusion.

In countries where the feasibility of general dietary improvement is limited, iron supplementation and food fortification are the most cost-effective means of addressing iron deficiency anemia .Supplementing dietary iron with iron tablets, syrups or drops and fortifying processed foods and condiments with iron are helpful in the prevention and treatment of anemia.

Supplementing dietary iron can meet the needs of pregnant women and young children, whose high iron requirements cannot be met only with fortified foods and vulnerable groups who do not consume fortified food.

Related articles:

Vitamin deficiency anemia

Anemia of chronic disease

Anemia in pregnancy

Written by: Healthplus24 team
Date last updated: July 03, 2011