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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, giving your body energy and your skin a healthy color.
As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body can't produce enough hemoglobin, a substance in red blood cells that enables them to carry oxygen. As a result, iron deficiency anemia may leave you tired, weak and pale.
You can usually correct iron deficiency anemia with iron supplementation. Sometimes, additional treatments for iron deficiency anemia are necessary, especially if you're bleeding internally.
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:
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. Take iron supplements only with a doctor's supervision. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications.
Normally, your body uses iron from the food you eat or recycled iron from old red blood cells 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.
Common reasons that iron deficiency anemia develops include:
These factors may increase the risk of iron deficiency anemia:
These groups of people may be at higher risk:
In healthy men and postmenopausal women, iron deficiency usually indicates bleeding somewhere in the gastrointestinal tract.
Donating blood — a source of blood loss — isn't a common risk factor for iron deficiency anemia unless you've given blood repeatedly over a short time. However, some people first learn their hemoglobin is low, which indicates anemia, when they offer to donate blood. Low hemoglobin may be a temporary problem remedied by eating more iron-rich foods. It may also be a warning sign of blood loss in your body. If you're told that you can't donate blood because of low hemoglobin, ask your doctor whether you should be concerned.
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:
If you think you may have iron deficiency anemia, you're likely to start by seeing your family doctor or a general practitioner. However, in some cases, you may also be referred to a doctor who specializes in treating blood disorders (hematologist). If your doctor suspects an unknown source of bleeding, you may also be referred to a doctor who specializes in digestive tract disorders (gastroenterologist), or for women, a doctor who specializes in women's reproductive health (gynecologist).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
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:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime that you don't understand something.
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 any points you want to spend more time on. Your doctor may ask:
Doctors diagnose iron deficiency anemia mainly through blood tests. You doctor will check your blood for:
Additional diagnostic tests
If your blood work indicates iron deficiency anemia, your doctor may order additional tests to identify an underlying cause. If your doctor suspects a source of bleeding within your body, you may need to have your stools tested for traces of blood. Blood in the stools is often an indicator of internal bleeding.
You may need these additional diagnostic tests:
Your doctor may order these or other tests after a trial period of treatment with iron supplementation.
Once you become deficient in iron to the point you develop anemia, increased intake of iron-rich foods is beneficial, but usually isn't enough to correct the problem. You need iron supplementation to build back your iron reserves, as well as to meet your body's daily iron requirements. In pregnant women, iron supplements help provide enough iron for both the mother and her fetus.
For children or adults with mild iron deficiency anemia, doctors may recommend a daily multivitamin containing iron. But typically, doctors recommend iron tablets — such as prescription ferrous sulfate tablets or an over-the-counter supplement. These oral iron supplements are usually best absorbed from an otherwise empty stomach. However, because iron can irritate your stomach, you may need to take the supplements with food. Your doctor may recommend that you take iron supplements with orange juice or with a vitamin C tablet. Vitamin C helps increase iron absorption. Additionally, take iron supplements two hours before or four hours after taking an antacid, as these medications can interfere with iron absorption.
Iron supplements can cause constipation, so your doctor may also recommend a stool softener. Iron almost always turns stools black, which is a harmless side effect. Iron can be given by injection, but this usually isn't necessary.
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. Pregnant women routinely take prescription iron supplements for the duration of their pregnancy, to prevent or treat iron deficiency anemia. Ask your doctor when you need to return to have your blood rechecked.
Depending on the mother's diet, breast milk may not contain enough iron for a growing infant. Most infant formulas contain adequate iron, but some babies require additional iron. Ask the doctor if your baby might need extra iron, but don't give additional iron without talking to your child's doctor first.
Treating causes other than poor diet
If iron supplements alone don't increase blood-iron levels in adults, it's likely the anemia is due to more than an iron-poor diet. It may be 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:
If iron deficiency anemia is severe, blood transfusions can help replace iron and hemoglobin quickly.
You can help prevent iron deficiency anemia by eating foods rich in iron, as part of a balanced diet. Eating plenty of iron-containing foods is particularly important for people who have higher iron requirements, such as children and menstruating or pregnant women.
Foods rich in iron include:
Meat sources of iron are more readily absorbed by your body.
You can enhance your body's absorption of iron by drinking citrus juice when you eat an iron-containing food. Vitamin C in citrus juices, like orange juice, helps your body better absorb dietary iron.
Vitamin C is also found in:
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 one year. Iron from breast milk is more easily absorbed than the iron found in formula.