Iron-deficiency anemia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 15, 2016
StartDiseasesIron-deficiency anemia

Iron-deficiency anemia occurs when the body is lacking iron, resulting in less red blood cell production. As red blood cells are needed to carry oxygen to vital organs and tissues, a lower red blood cell count can have devastating effects if left unchecked. Although other kinds of anemia can be caused by a lack of B12 and folate, the iron-deficiency kind of anemia is the most common.


Definition & Facts

Anemia is defined as lowered red blood cell production. This generally occurs when there is a lack of certain nutrients crucial in red blood cell production, including iron, B12, and folate. About 20% of women of child-bearing age and 2% of men suffer from iron deficiency in the US each year. This totals up to about 4.14% of the American population.

Iron-deficiency anemia has a mortality rate in the US of about 2 deaths per week (NWHIC). On a global scale, iron deficiency is the most common nutrient deficiency in the world, 30% of the world's population being anemic (WHO).

Symptoms & Complaints

The most common symptoms of iron-deficiency anemia include:

A person may not have all of these symptoms at the same time, but it is also common to experience more than one of them at once. Other symptoms that are less common might include having headaches, tinnitus (or a ringing in the ear or ears), hair loss, shifts in the sense of taste, itching sensations, a sensitive or smooth tongue, nails that develop a spoon-like shape, ulcers along the mouth, a craving for non-food items like ice, clay, or paper (known as pica), and difficulty swallowing (known as dysphagia).

Symptoms vary in intensity and types between people. In some cases, it may not be immediately obvious that anemic conditions are present in a patient. Blood tests, however, can reveal data that demonstrates these conditions.


The causes of iron-deficiency anemia are straightforward. There are two ways that iron deficiencies may occur: an increased need for iron that is not being me; or a decrease in iron consumption that does not meet standard iron needs.

Reasons a person's iron needs might increase (and subsequently not be met) include individuals who are rapidly growing, such as infants and toddlers, who may not be getting enough iron in their diets; women who are pregnant and therefore require higher amounts of nutrients; and people who have undergone a lot of blood loss, whether it is by an injury, by donation, from stomach or gastrointestinal disease including hookworm infection, or through regular menstruation.

On the flipside, people not eating enough iron for their regular needs might find themselves in this position due to restrictive or incomplete diets. A diet lacking in iron-rich foods, including certain leafy greens and meats, will result in anemia over time. Vegetarian and vegan diets are often not supplemented appropriately to ensure a balanced diet full of iron.

Sometimes, food sensitivities or allergies cause certain foods to be avoided which may make up for deficiencies in an ordinary diet. Finally, consuming certain products, like teas and coffees, can actually cause a blockage in the absorption of iron from other foods, resulting in a deficiency as well.

Diagnosis & Tests

For people who do not demonstrate strong or immediate symptoms of iron-deficiency anemia, it may be challenging to identify and subsequently diagnose them appropriately. To diagnose iron-deficiency anemia, a simple blood test can be performed. This test will take a blood sample from a vein in the arm. From that sample, a complete blood count is made which includes all of the various types of blood cells to be measured in the sample.

From this count, anemia can be diagnosed. If the sample has lower than normal levels of hemoglobin, used to transport oxygen in the body, this is one identifier. Another is a lowered red blood cell count, which also contains hemoglobin. Furthermore, red blood cells may appear paler and smaller than healthy, iron-rich cells typically found in the human body. Other tests include checking for levels of ferritin in the body. This protein stores iron, so having a lowered level of ferritin means less iron is being stored, possibly leading to iron-deficiency anemia in the body.

Treatment & Therapy

The most common method for treating iron-deficiency anemia is by taking ferrous (iron) sulphate supplements. These supplements are general in a tablet form that is taken twice a day. Sometimes these tablets can cause side-effects, such as discomfort, heartburn, and nausea. The dosage might be adjusted to address the supplement's impact on the patient, but it is also often recommended to take the supplement with food.

Ferrous glutonate is an alternative supplement for those who continue to have strong symptoms. Less side effects should occur with this supplement since it has a less concentrated amount of iron; however, it will take longer for the supplement to restore iron levels because of this reduced amount.

Additionally, in the event of chronic kidney disease in a patient, iron injections will likely be recommended by a doctor rather than tablets. Finally, working with a nutritionist to make an iron-rich diet plan is another step that can be taken to reverse iron-deficiency anemia.

Prevention & Prophylaxis

Taking preventative measures includes having a balanced diet with the appropriate levels of iron content is key to this. Iron-rich foods comprise of dark green leaves, including spinach, curly kale, and watercress, brown rice, cereals that have been fortified with iron, various pulses and beans, nuts and seeds, dried fruits, tofu, and animal products like white and red meat, fish, and eggs.

Keeping a balance of these kinds of food in one's diet will ensure preventative measures have been taken against iron-deficiency anemia.