Deficiency Iron Anemia (Mayo

Clinic)
Definition
By Mayo Clinic Staff
Iron deficiency anemia is a common type of anemia a condition in which blood lacks
adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues.
As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron,
your body can't produce enough of a substance in red blood cells that enables them to carry
oxygen (hemoglobin). As a result, iron deficiency anemia may leave you tired and short of
breath.
You can usually correct iron deficiency anemia with iron supplementation. Sometimes additional
tests or treatments for iron deficiency anemia are necessary, especially if your doctor suspects
that you're bleeding internally.
Symptoms
By Mayo Clinic Staf

Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes
more deficient in iron and anemia worsens, the signs and symptoms intensify.
Iron deficiency anemia symptoms may include:

Extreme fatigue

Pale skin

Weakness

Shortness of breath

Chest pain

Frequent infections

Headache

Dizziness or lightheadedness

Cold hands and feet

Inflammation or soreness of your tongue

Brittle nails

Fast heartbeat

Unusual cravings for non-nutritive substances, such as ice, dirt or starch

Poor appetite, especially in infants and children with iron deficiency anemia

An uncomfortable tingling or crawling feeling in your legs (restless legs

syndrome)

When to see a doctor

If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your
doctor. Iron deficiency anemia isn't something to self-diagnose or treat. So see your doctor for a
diagnosis rather than taking iron supplements on your own. Overloading the body with iron can
be dangerous because excess iron accumulation can damage your liver and cause other
complications.

Causes
By Mayo Clinic Staff
Iron deficiency anemia occurs when your body doesn't have enough iron to produce hemoglobin.
Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood
cells to carry oxygenated blood throughout your body. If you aren't consuming enough iron, or if
you're losing too much iron, your body can't produce enough hemoglobin, and iron deficiency
anemia will eventually develop.
Causes of iron deficiency anemia include:

Blood loss. Blood contains iron within red blood cells. So if you lose blood, you lose
some iron. Women with heavy periods are at risk of iron deficiency anemia because they
lose blood during menstruation. Slow, chronic blood loss within the body such as from
a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer can cause iron
deficiency anemia. Gastrointestinal bleeding can result from regular use of some overthe-counter pain relievers, especially aspirin.

A lack of iron in your diet. Your body regularly gets iron from the foods you eat. If you
consume too little iron, over time your body can become iron deficient. Examples of ironrich foods include meat, eggs, leafy green vegetables and iron-fortified foods. For proper
growth and development, infants and children need iron from their diet, too.

An inability to absorb iron. Iron from food is absorbed into your bloodstream in your
small intestine. An intestinal disorder, such as celiac disease, which affects your
intestine's ability to absorb nutrients from digested food, can lead to iron deficiency
anemia. If part of your small intestine has been bypassed or removed surgically, that may
affect your ability to absorb iron and other nutrients.

Pregnancy. Without iron supplementation, iron deficiency anemia occurs in many

pregnant women because their iron stores need to serve their own increased blood
volume as well as be a source of hemoglobin for the growing fetus.

Risk factors
By Mayo Clinic Staff
These groups of people may have an increased risk of iron deficiency anemia:

Women. Because women lose blood during menstruation, women in general are at
greater risk of iron deficiency anemia.

Infants and children. Infants, especially those who were low birth weight or born
prematurely, who don't get enough iron from breast milk or formula may be at risk of iron
deficiency. Children need extra iron during growth spurts. If your child isn't eating a
healthy, varied diet, he or she may be at risk of anemia.

Vegetarians. People who don't eat meat may have a greater risk of iron deficiency
anemia if they don't eat other iron-rich foods.

Frequent blood donors. People who routinely donate blood may have an increased risk
of iron deficiency anemia since blood donation can deplete iron stores. Low hemoglobin
related to blood donation may be a temporary problem remedied by eating more iron-rich
foods. If you're told that you can't donate blood because of low hemoglobin, ask your
doctor whether you should be concerned.

Complications
By Mayo Clinic Staff
Mild iron deficiency anemia usually doesn't cause complications. However, left untreated, iron
deficiency anemia can become severe and lead to health problems, including the following:

Heart problems. Iron deficiency anemia may lead to a rapid or irregular heartbeat. Your
heart must pump more blood to compensate for the lack of oxygen carried in your blood
when you're anemic. This can lead to an enlarged heart or heart failure.

Problems during pregnancy. In pregnant women, severe iron deficiency anemia has
been linked to premature births and low birth weight babies. But the condition is
preventable in pregnant women who receive iron supplements as part of their prenatal
care.

Growth problems. In infants and children, severe iron deficiency can lead to anemia as
well as delayed growth and development. Additionally, iron deficiency anemia is
associated with an increased susceptibility to infections.

Preparing for your appointment

By Mayo Clinic Staf

Make an appointment with your doctor if you have any signs and symptoms that worry you. If
you're diagnosed with iron deficiency anemia, you may need tests to look for a source of blood
loss, including tests to examine your gastrointestinal tract.
Here's some information to help you get ready for your appointment, and what to expect from
your doctor.
What you can do

Write down any symptoms you're experiencing, including any that may
seem unrelated to the reason for which you scheduled the appointment.

Write down key personal information, including any major stresses or

recent life changes.

Make a list of all medications, vitamins or supplements you're taking.

Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the
most of your time together. For iron deficiency anemia, some basic questions to ask your doctor
include:

What's the most likely cause of my symptoms?

Are there other possible causes for my symptoms?

Is my condition likely temporary or long lasting?

What treatment do you recommend?

Are there any alternatives to the primary approach that you're suggesting?

I have another health condition. How can I best manage these conditions
together?

Are there any dietary restrictions that I need to follow?

Are there any brochures or other printed material that I can take with me?
What websites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask
questions during your appointment.
What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve
time to go over points you want to spend more time on. Your doctor may ask:

When did you begin experiencing symptoms?

How severe are your symptoms?

Does anything seem to improve your symptoms?

What, if anything, appears to worsen your symptoms?

Have you noticed unusual bleeding, such as heavy periods, bleeding from
hemorrhoids or nosebleeds?

Are you a vegetarian?

Have you recently donated blood more than once?

Tests and diagnosis

By Mayo Clinic Staf

To diagnose iron deficiency anemia, your doctor may run tests to look for:

Red blood cell size and color. With iron deficiency anemia, red blood cells
are smaller and paler in color than normal.

Hematocrit. This is the percentage of your blood volume made up by red

blood cells. Normal levels are generally between 34.9 and 44.5 percent for
adult women and 38.8 to 50 percent for adult men. These values may change
depending on your age.

Hemoglobin. Lower than normal hemoglobin levels indicate anemia. The

normal hemoglobin range is generally defined as 13.5 to 17.5 grams (g) of
hemoglobin per deciliter (dL) of blood for men and 12.0 to 15.5 g/dL for

women. The normal ranges for children vary depending on the child's age
and sex.

Ferritin. This protein helps store iron in your body, and a low level of ferritin
usually indicates a low level of stored iron.

Additional diagnostic tests

If your blood work indicates iron deficiency anemia, your doctor may order additional tests to
identify an underlying cause, such as:

Endoscopy. Doctors often check for bleeding from a hiatal hernia, an ulcer or
the stomach with the aid of endoscopy. In this procedure, a thin, lighted tube
equipped with a video camera is passed down your throat to your stomach.
This allows your doctor to view your esophagus the tube that runs from
your mouth to your stomach and your stomach to look for sources of
bleeding.

Colonoscopy. To rule out lower intestinal sources of bleeding, your doctor

may recommend a procedure called colonoscopy. A thin, flexible tube
equipped with a video camera is inserted into the rectum and guided to your
colon. You're usually sedated during this test. A colonoscopy allows your
doctor to view inside some or all of your colon and rectum to look for internal
bleeding.

Ultrasound. Women may also have a pelvic ultrasound to look for the cause
of excess menstrual bleeding, such as uterine fibroids.

Your doctor may order these or other tests after a trial period of treatment with iron
supplementation.
Treatments and drugs
By Mayo Clinic Staf

To treat iron deficiency anemia, your doctor may recommend you take iron supplements. Your
doctor will also treat the underlying cause of your iron deficiency, if necessary.
Iron supplements

Your doctor may recommend over-the-counter iron tablets to replenish the iron stores in your
body. Your doctor will let you know the correct dose for you. Iron is also available in liquid form
for infants and children. To improve the chances that your body will absorb the iron in the
tablets, you may be instructed to:

Take iron tablets on an empty stomach. If possible, take your iron tablets
when your stomach is empty. However, because iron tablets can upset your
stomach, you may need to take your iron tablets with meals.

Don't take iron with antacids. Medications that immediately relieve

heartburn symptoms can interfere with the absorption of iron. Take iron two
hours before or four hours after you take antacids.

Take iron tablets with vitamin C. Vitamin C improves the absorption of

iron. Your doctor might recommend taking your iron tablets with a glass of
orange juice or with a vitamin C supplement.

Iron supplements can cause constipation, so your doctor may also recommend a stool softener.
Iron may turn your stools black, which is a harmless side effect.
Iron deficiency can't be corrected overnight. You may need to take iron supplements for several
months or longer to replenish your iron reserves. Generally, you'll start to feel better after a week
or so of treatment. Ask your doctor when you need to return to have your blood rechecked to
measure your iron levels. To be sure that your iron reserves are replenished, you'll probably need
to take iron supplements for a year or more.
Treating underlying causes of iron deficiency

If iron supplements don't increase your blood-iron levels, it's likely the anemia is due to a source
of bleeding or an iron-absorption problem that your doctor will need to investigate and treat.
Depending on the cause, iron deficiency anemia treatment may involve:

Medications, such as oral contraceptives to lighten heavy menstrual flow

Antibiotics and other medications to treat peptic ulcers

Surgery to remove a bleeding polyp, a tumor or a fibroid

If iron deficiency anemia is severe, you may need iron given intravenously or you may need
blood transfusions to help replace iron and hemoglobin quickly.
Prevention
By Mayo Clinic Staf

You can reduce your risk of iron deficiency anemia by choosing iron-rich foods.
Choose iron-rich foods

Foods rich in iron include:

Red meat

Pork

Poultry

Seafood

Beans

Dark green leafy vegetables, such as spinach

Dried fruit, such as raisins and apricots

Iron-fortified cereals, breads and pastas

Peas

Your body absorbs more iron from meat than it does from other sources. If you choose to not eat
meat, you may need to increase your intake of iron-rich, plant-based foods to absorb the same
amount of iron as someone who eats meat.
Choose foods containing vitamin C to enhance iron absorption

You can enhance your body's absorption of iron by drinking citrus juice or eating other foods
rich in vitamin C at the same time that you eat high-iron foods. Vitamin C in citrus juices, like
orange juice, helps your body to better absorb dietary iron.
Vitamin C is also found in:

Broccoli

Grapefruit

Kiwi

Leafy greens

Melons

Oranges

Peppers

Strawberries

Tangerines

Tomatoes

Preventing iron deficiency anemia in infants

To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula
for the first year. Cow's milk isn't a good source of iron for babies and isn't recommended for

infants under 1 year. Between the ages of 4 and 6 months, start feeding your baby iron-fortified
cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children
don't drink more than 24 ounces of milk a day. Too much milk often takes the place of other
foods, including ones that are rich in iron.