ANEMIA, IRON-DEFICIENCY

General Information

DEFINITION--A decreased number of circulating blood cells, or insufficient hemoglobin in the cells. Anemia is a symptom of other disorders. For proper treatment, the cause must be found.

BODY PARTS INVOLVED--Blood, which affects all body cells.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS-Initially, there may be no symptoms.

Signs of pronounced anemia include:

• Tiredness and weakness.
• Paleness, especially in the hands and lining of the lower eyelids.

Less common signs include:

• Tongue inflammation.
• Fainting.
• Breathlessness.
• Rapid heartbeat.
• Unusual quietness or withdrawal in a child.
• Appetite loss.
• Abdominal discomfort.
• Cravings for ice, paint or dirt.
• Susceptibility to infection.

CAUSES--

Decreased absorption of iron or increased need for iron. Causes in infants and children include:

• Poor nutrition. Between 6 months and 2 years of age, children may consume large quantities of milk, to the exclusion of iron-containing foods.
• Premature birth. Premature babies often have low stores of iron at birth. Causes in adolescents and adults:
• Rapid growth spurts.
• Heavy menstrual bleeding.
• Pregnancy.
• Malabsorption.
• Gastrointestinal disease with bleeding, including cancer.

RISK INCREASES WITH

• Poverty.
• Adults over 60.
• Recent illness, such as an ulcer, diverticulitis, colitis, hemorrhoids or gastrointestinal tumors.

HOW TO PREVENT--Maintain an adequate iron intake through a well-balanced diet or iron supplements. Provide iron-fortified formula for bottle-fed infants.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies of serum iron, total iron-binding capacity and ferritin levels.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Self-care.
• Blood transfusions in rare instances.

POSSIBLE COMPLICATIONS--Failure to diagnose a bleeding malignancy.

PROBABLE OUTCOME--Usually curable with iron supplements if the underlying cause can be identified and cured.

How To Treat

GENERAL MEASURES--

• The most important part of treatment for iron-deficiency anemia is to correct the underlying cause. Iron deficiency can be treated well with iron supplements.
• Avoid risk of infections.

MEDICATION--Your doctor may prescribe iron supplements:

• Take iron on an empty stomach (at least 1/2 hour before meals) for best absorption. If it upsets your stomach, you may take it with a small amount of food (except milk).
• If you take other medications, wait at least 2 hours after taking iron before taking them. Antacids and tetracyclines especially interfere with iron absorption.
• Because liquid iron supplements may discolor the teeth, a child should drink any liquid iron preparation through a straw. Iron supplements may also cause black bowel movements, diarrhea or constipation.
• Continue iron supplements until 2 to 3 months after blood tests return to normal.
• Too much iron is dangerous. A bottle of iron tablets can poison a child. Keep iron supplements out of the reach of children.

ACTIVITY--No restrictions. You may need to pace activities until symptoms of fatigue are gone.

DIET--

• Adults should limit milk to 1 pint a day. It interferes with iron absorption.
• Eat protein- and iron-containing foods, including meat, beans and leafy green vegetables.
• Increase dietary fiber to prevent constipation.

Call Your Doctor If

• You have symptoms of anemia.
• Nausea, vomiting, severe diarrhea or constipation occur during treatment.