Iron Deficiency Anaemia: Symptoms and Treatment

Iron deficiency anaemia is a condition where the body lacks sufficient iron to produce an adequate amount of haemoglobin, the protein in red blood cells that carries oxygen throughout the body. This deficiency results in fewer and smaller red blood cells, which can cause a variety of symptoms and health issues.

What are the symptoms of iron deficiency anaemia?

Many individuals with iron deficiency anaemia do not show any symptoms at all. However, some common symptoms include:

• Headache 
• Weakness
• Fatigue
• Irritability
• Brittle nails
• Difficulty exercising due to shortness of breath or tiredness
• Sore tongue
• Restless legs syndrome
• Pica (an atypical craving for non-food items such as clay or dirt, paper products, or cornstarch)
• Pagophagia (a form of pica in which there is an atypical craving to eat ice)

What causes this condition? 

Your body requires iron to produce healthy red blood cells. Several factors can increase your risk of developing iron-deficiency anaemia, including:

• Diets low in iron: A diet lacking in iron-rich foods can lead to insufficient iron levels. This is common in vegetarians or vegans if they do not consume enough plant-based iron sources or supplements.

• Poor iron absorption: Certain conditions affect the body’s ability to absorb iron efficiently, such as celiac disease that damages the intestine and reduces iron absorption; Crohn’s disease, which is an inflammation in the digestive tract that can interfere with nutrient absorption; and gastric bypass surgery, a weight loss surgery that can reduce the stomach’s capacity to absorb nutrients.

• Increased iron demand: Certain life stages require more iron, such as during pregnancy, childhood growth spurts, and adolescence. Pregnant women are particularly at risk of anaemia during pregnancy due to the increased need for iron to support the growing foetus and placenta.

• Blood loss: Heavy menstrual periods, gastrointestinal tract bleeding due to peptic ulcers, colorectal cancer, and major injuries or surgeries that result in blood loss can deplete iron levels.

How is iron deficiency anaemia diagnosed? 

This condition is diagnosed through a combination of medical history, physical examination, and investigations.

1. Complete blood count (CBC)
   • Haemoglobin (Hb): Low haemoglobin levels indicate anaemia.
   • Haematocrit (Hct): The proportion of red blood cells in the blood; low levels suggest anaemia.
   • Red Blood Cell Count (RBC): The number of red blood cells; low count may indicate anaemia.
   • Mean Corpuscular Volume (MCV): Measures the average size of red blood cells. In iron deficiency anaemia, the red blood cells are often smaller than normal (microcytic).
   • Mean Corpuscular Haemoglobin (MCH): The average amount of haemoglobin per red blood cell. It may be low in iron deficiency anaemia.
2. Serum ferritin 
   • Measures the stored iron in the body. Low ferritin levels are a strong indicator of iron deficiency.
3. Serum iron 
   • The amount of circulating iron in the blood. Low levels suggest iron deficiency.
4. Total iron-binding capacity (TIBC) 
   • Measures the blood’s capacity to bind iron with transferrin. TIBC is usually higher in iron deficiency.
5. Transferrin saturation
   • The percentage of transferrin (iron transport protein) that is saturated with iron. Low saturation indicates iron deficiency.
6. If the cause of iron deficiency anaemia is unclear, further tests may be required, such as:
   • Stool occult blood test: To check for hidden blood loss in the gastrointestinal tract.
   • Endoscopy or colonoscopy: To identify sources of bleeding or gastrointestinal conditions.
   • Celiac disease screening: If poor absorption is suspected, testing for celiac disease may be necessary.
   • Bone marrow biopsy: In rare cases where the diagnosis is uncertain, a bone marrow biopsy may be performed to evaluate iron stores in the bone marrow.

How is this condition treated and prevented?

The treatment of iron deficiency anaemia involves addressing both the underlying cause and the iron deficiency itself.

1. Dietary changes 
   • Increase the intake of iron-rich foods like red meat, poultry, fish, lentils, beans, tofu, spinach, and fortified cereals.
   • Consume vitamin C-rich foods (citrus fruits, tomatoes, and bell peppers) alongside iron-rich foods to enhance iron absorption.
   • Limit consumption of substances that can inhibit iron absorption, such as calcium supplements, tea, coffee, and high-fibre foods, around the time of iron-rich meals.
2. Iron administration 
   • Oral iron supplements

     In most cases of iron deficiency anaemia and iron deficiency without anaemia, oral iron supplementation is the preferred treatment. Some people may experience side effects when taking iron tablets, such as constipation or diarrhoea, tummy ache, heartburn, nausea/vomiting, and passing darker than usual stools.

     Taking iron supplements every other day or on specific days of the week can be particularly beneficial for those who may forget to take daily supplements. Iron supplements should be taken on an empty stomach and alongside vitamin C to enhance iron absorption.

   • Intravenous (IV) iron
     

     If oral iron is ineffective, not tolerated well, or if there is a need for rapid replenishment (e.g., severe anaemia, malabsorption conditions, chronic kidney disease), intravenous iron may be administered.

3. Treating underlying causes 
   • Treatment may include managing heavy menstrual bleeding, treating gastrointestinal bleeding, addressing other sources of chronic blood loss, and managing chronic conditions like celiac disease, Crohn’s disease, or chronic kidney disease that may affect iron absorption.
4. Blood transfusions
   • In cases of severe anaemia with symptoms of significant fatigue, chest pain, or shortness of breath, blood transfusions may be necessary for rapid correction. Your doctor would conduct follow-up blood tests to monitor haemoglobin, haematocrit, and ferritin levels to ensure the treatment is effective.

Make an appointment at Pantai Hospitals

Consult our doctors if you are experiencing symptoms of iron deficiency anaemia. A dedicated and expert team of haematologists at Pantai Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding iron deficiency anaemia. We assure you the best possible care tailored to your specific needs.

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