Symptoms and Signs of Iron Deficiency Anemia
Iron deficiency anemia is characterized by pallor (reduced amount of oxyhemoglobin in skin or mucous membrane), fatigue and weakness. Because it tends to develop slowly, adaptation occurs and the disease often goes unrecognized for some time. In severe cases, dyspnea (trouble breathing) can occur. Unusual obsessive food cravings, known as pica, may develop. Pagophagia or pica for ice is a very specific symptom and may disappear with correction of iron deficiency anemia. Hair loss and lightheadedness can also be associated with iron deficiency anemia.
Other symptoms and signs of iron deficiency anemia include:
- Constipation
- Sleepiness
- Tinnitus
- Hair Loss
- Fainting or feeling faint
- Depression
- Breathlessness on exertion
- Twitching muscles
- Tingling, numbness, or burning sensations
- Missed menstrual cycle
- Heavy menstral period
- Slow social development
- Inflammation or infection of the tongue
- Inflammatory lesions at the mouth's corners
- Spoon-shaped nails or nails that are weak or brittle
- Poor Appetite
- Itchiness, particularly in the legs
- Heart Palpitations
- Always feeling cold
- Trouble thinking/concentrating
- Low immunity—prone to colds/flu, etc.
Supplemental iron is available in two forms: ferrous and ferric. Ferrous iron salts (ferrous fumarate, ferrous sulfate, and ferrous gluconate) are the best absorbed forms of iron supplements.
Who may need extra iron to prevent a deficiency?
· pregnant women
· preterm and low birth weight infants
· older infants and toddlers
· teenage girls
· women of childbearing age, especially those with heavy menstrual losses
· people with renal failure, especially those undergoing routine dialysis
· people with gastrointestinal disorders who do not absorb iron normally
Celiac Disease and Crohn's Syndrome are associated with gastrointestinal malabsorption and may impair iron absorption. Iron supplementation may be needed if these conditions result in iron deficiency anemia.
The diagnosis of iron deficiency anemia requires further investigation as to its cause. It can be a sign of other disease, such as colon cancer, which will cause the loss of blood in the stool. In adults, 60% of patients with iron deficiency anemia may have underlying gastrointestinal disorders leading to chronic blood loss. In addition to dietary insufficiency, malabsorption, chronic blood loss, diversion of iron to fetal erythropoiesis during pregnancy, intravascular hemolysis and hemoglobinuria or other forms of chronic blood loss should all be considered.
The amount of iron absorbed decreases with increasing doses. For this reason, it is recommended that most people take their prescribed daily iron supplement in two or three equally spaced doses.
Therapeutic doses of iron supplements, which are prescribed for iron deficiency anemia, may cause gastrointestinal side effects such as nausea, vomiting, constipation, diarrhea, dark colored stools, and/or abdominal distress. Starting with half the recommended dose and gradually increasing to the full dose will help minimize these side effects. Taking the supplement in divided doses and with food also may help limit these symptoms. Iron from enteric coated or delayed-release preparations may have fewer side effects, but is not as well absorbed and not usually recommended.
Animal proteins and vitamin C will improve the absorption of nonheme (plant-based) iron.
Iron and intense exercise:
Many men and women who engage in regular, intense exercise such as jogging, competitive swimming, and cycling have marginal or inadequate iron status. Possible explanations include increased gastrointestinal blood loss after running and a greater turnover of red blood cells. Also, red blood cells within the foot can rupture while running. For these reasons, the need for iron may be 30% greater in those who engage in regular intense exercise.
Tolerable Upper Intake Levels for Iron for Infants 7 to 12 months, Children, and Adults
| Age | Males
| Females
| Pregnancy
| Lactation
|
| 7 to 12 months | 40 | 40 | N/A | N/A |
| 1 to 13 years | 40 | 40 | N/A | N/A |
| 14 to 18 years | 45 | 45 | 45 | 45 |
| 19 + years | 45 | 45 | 45 | 45 |
References: ods.od.nih.gov/factsheets/iron.asp and wikipedia
Please visit the above references for more detailed information on iron deficiency anemia.
