Blood Diseases

Anemias

Iron-Deficiency Anemia

What is iron-deficiency anemia?

The most common cause of anemia is iron deficiency. Iron is needed to form hemoglobin. Iron is mostly stored in the body in the hemoglobin. About 30 percent of iron is also stored as ferritin and hemosiderin in the bone marrow, spleen, and liver.

What causes iron-deficiency anemia?

Iron-deficiency anemia may be caused by the following:

diets low in iron
Iron is obtained from foods in our diet, however, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested. A person unable to have a balanced iron-rich diet may suffer from some degree of iron-deficiency anemia.
body changes
An increased iron requirement and increased red blood cell production is required when the body is going through changes such as growth spurts in children and adolescents, or during pregnancy and lactation.
gastrointestinal tract abnormalities
Malabsorption of iron is common after some forms of gastrointestinal surgeries. Most of the iron taken in by foods is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and result in iron-deficiency anemia.
blood loss
Loss of blood can cause a decrease of iron and result in iron-deficiency anemia. Sources of blood loss may include GI bleeding, menstrual bleeding, or injury.

What are the symptoms of iron-deficiency anemia?

The following are the most common symptoms of iron-deficiency anemia. However, each individual may experience symptoms differently. Symptoms may include:

abnormal paleness or lack of color of the skin
irritability
lack of energy or tiring easily (fatigue)
increased heart rate (tachycardia)
sore or swollen tongue
enlarged spleen
a desire to eat peculiar substances such as dirt or ice (a condition called pica)

The symptoms of iron-deficiency anemia may resemble other blood conditions or medical problems. Always consult your physician for a diagnosis.

How is iron-deficiency anemia diagnosed?

Iron-deficiency anemia may be suspected from general findings on a complete medical history and physical examination, such as complaints of tiring easily, abnormal paleness or lack of color of the skin, or a fast heartbeat (tachycardia). Iron-deficiency anemia is usually discovered during a medical examination through a blood test that measures the amount of hemoglobin (number of red blood cells) present, and the amount of iron in the blood. In addition to a complete medical history and physical examination, diagnostic procedures for iron-deficiency anemia may include the following:

additional blood tests
bone marrow aspiration and biopsy - marrow may be removed by aspiration or a needle biopsy under local anesthesia. In aspiration biopsy, a fluid specimen is removed from the bone marrow. In a needle biopsy, marrow cells (not fluid) are removed. These methods are often used together.

Treatment for iron-deficiency anemia:

Specific treatment for iron-deficiency anemia will be determined by your physician based on:

your age, overall health, and medical history
extent of the anemia
cause of the anemia
your tolerance for specific medications, procedures, or therapies
expectations for the course of the anemia
your opinion or preference

Treatment may include:

iron-rich diet
Eating a diet with iron-rich foods can help treat iron-deficiency anemia. Good sources of iron include the following:
- meats - beef, pork, lamb, liver, and other organ meats
- poultry - chicken, duck, turkey, liver (especially dark meat)
- fish - shellfish, including clams, mussels, and oysters, sardines, anchovies
- leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards
- legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
- yeast-leavened whole-wheat bread and rolls
- iron-enriched white bread, pasta, rice, and cereals
iron supplements
Iron supplements can be taken over several months to increase iron levels in the blood. Iron supplements can cause irritation of the stomach and discoloration of bowel movements. They should be taken on an empty stomach, or with orange juice, to increase absorption.

How does the body process iron?

Iron is present in many foods and absorbed into the body through the stomach. During this process of absorption, oxygen combines with iron and is transported into the plasma portion of blood by binding to transferri. From there, iron and transferri are used in the production of hemoglobin (the molecule that transports oxygen in the blood), stored in the liver, spleen, and bone marrow, and utilized as needed by all body cells.

The following is a list of foods that are good sources of iron. Always consult your physician regarding the recommended daily iron requirements for your particular situation.

Iron-Rich Foods	Quantity	Approximate Iron Content (mg)
Oysters	3 ounces	13.2
Beef liver	3 ounces	7.5
Prune juice	1/2 cup	5.2
Clams	2 ounces	4.2
Walnuts	1/2 cup	3.75
Ground beef	3 ounces	3.0
Chickpeas	1/2 cup	3.0
Bran flakes	1/2 cup	2.8
Pork roast	3 ounces	2.7
Cashew nuts	1/2 cup	2.65
Shrimp	3 ounces	2.6
Raisins	1/2 cup	2.55
Sardines	3 ounces	2.5
Spinach	1/2 cup	2.4
Lima beans	1/2 cup	2.3
Kidney beans	1/2 cup	2.2
Turkey, dark meat	3 ounces	2.0
Prunes	1/2 cup	1.9
Roast beef	3 ounces	1.8
Green peas	1/2 cup	1.5
Peanuts	1/2 cup	1.5
Potato	1	1.1
Sweet potato	1/2 cup	1.0
Green beans	1/2 cup	1.0
Egg	1	1.0

This page was last updated on: January 30, 2008.

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