Anemia is defined as a reduced absolute number of circulating RBCs or a condition in which the number of RBCs (and subsequently their oxygen-carrying capacity) is insufficient to meet physiological needs.
The World Health Organization (WHO) definition of anemia (hemoglobin concentration <12 g/dL in women and <13 g/dL in men) is most often used in epidemiologic studies of older adults.
Iron deficiency anemia is caused by deficiency of iron in the body which is required for the RBC growth & maturation. Normal levels of iron are as follows:
Diagnosing anemia based on Hb levels
Dietary iron
Di etary iron is found in two forms, heme and nonheme iron. Heme iron, which is present mainly in meat, poultry and fish, is well absorbed. Non-heme iron, which accounts for the majority of the iron in plants, is less well absorbed ( potential cause of IDA )
Causes of Iron deficiency anemia include decreased iron intake in strict vegetarian diet or not eating enough foods that contain iron, Conditions with increased iron loss from the body like heavy, long, or frequent menstrual periods, cancer in the esophagus, stomach, small bowel, or colon, esophageal varices, often from cirrhosis, use of aspirin, ibuprofen, or arthritis medicines for a long time, which can cause gastrointestinal bleeding & peptic ulcer disease. It is also common in conditions with Increased iron requirement like pregnancy & lactation
Symptoms of Anemia
- Fatigue or weakness
- Pale or yellow skin
- Shortness of breath
- Dizziness or lightheadedness
- Headaches
- Fast or irregular heartbeat
- Chest pain
- Cold feet and hands
- Brittle, cracked nails, spoon-shaped nails
- Hair loss
- Cracks near the side of your mouth
- Pica (cravings for inedible things, like dirt, starch, clay, or ice)
- Sore and swollen tongue
- Restless legs syndrome (an urge to move your legs while you’re in bed)
Management of Iron deficiency anemia:
- Beef, pork, liver, chicken, turkey, duck, and shellfish
- Leafy greens such as broccoli, kale, turnip greens, and collard greens
- Peas & black-eyed peas
- Iron-enriched cereals and other grains
- Dried fruits, such as dates and raisins
- Vit C (red bell peppers, kiwis, oranges) enhances iron absorption
Bioavailability of iron is as important as the total iron in the diet. The heme form is mainly present in flesh food, such as meat, poultry, and fish, and has more bioavailability than the non-heme form, obtained, in different amounts, mainly from plants and animal foods. The absorption of nonheme forms by the organism needs to be improved by other ingredients, such as ascorbic acid and flesh food, which can enhance the absorption of this metal, achieved by adopting a balanced diet. Cereals and fruits hold high amounts of phytic acid, iron-binding phenolic compounds, and calcium, which also potentially obstruct the iron absorption by animals. Thus, Emphasis should be on including both heme & non heme sources in the diet.
References:
- Iron deficiency anemia: MedlinePlus Medical Encyclopedia (no date). Available at: https://medlineplus.gov/ency/article/000584.htm (Accessed: 24 November 2021).
- Iron-Deficiency Anemia | NHLBI, NIH (no date). Available at: https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia (Accessed: 24 November 2021).
- Schrier, S.L., Mentzer, W.C. and Landaw, S.A., 2016. Approach to the adult patient with anemia. UpToDate, 2016 , pp.1-33.
- Young, I. et al. (2018) ‘Association between Haem and Non-Haem Iron Intake and Serum Ferritin in Healthy Young Women’, Nutrients, 10(1). doi: 10.3390/NU10010081.
