Anemia is characterized by a decrease in the number of red blood cells in the blood or in their hemoglobin content. The main symptoms, if any, are fatigue, a pale complexion, and more pronounced shortness of breath on exertion.
Iron deficiency anemia occurs because of iron deficiency . Iron binds to the “heme” pigment of hemoglobin that brings oxygen to the body’s cells. Oxygen is essential for cells to produce energy and perform their functions.
Iron deficiency anemia is most often caused by acute or chronic blood loss or a lack of iron in the diet . In fact, the body cannot synthesize iron and must therefore draw it from food. More rarely, it may be due to iron utilization problems in the manufacture of hemoglobin.
Symptoms of iron deficiency anemia
Most people with mild iron deficiency anemia do not notice this. The symptoms depend to a large extent on the rate at which anemia has set in. When anemia gradually appears, the symptoms are less obvious.
- Abnormal tiredness
- Pale skin
- A fast pulse
- Shortness of breath more pronounced with the effort
- Cold hands and feet
- A decrease in intellectual performance
- People at risk
Women of childbearing age who have very heavy menstrual periods, because there is a loss of iron in the menstrual blood.
The pregnant women and those with multiple and frequent pregnancies.
The children, especially from 6 months to 4 years.
People with a disease that causes iron malabsorption: Crohn’s disease or celiac disease, for example.
People with a health problem that cause chronic blood loss in the stool (not visible to the eye): peptic ulcer, benign polyps in the colon or correctional cancer, for example.
The vegetarians , especially if they do not consume any animal source product (vegan).
The babies who are not breastfed.
People who regularly consume certain drugs , such as antacids proton pump inhibitors type to relieve heartburn. The acidity of the stomach transforms dietary iron into an assimilable form through the intestine. Aspirin and nonsteroidal anti-inflammatory drugs can also, in the long term, cause bleeding in the stomach.
People with kidney failure , especially those on dialysis.
Iron deficiency anemia is the most common form of anemia . According to the World Health Organization , more than 30% of the world’s population suffers from anemia 1 . Half of these cases are attributed to iron deficiency, particularly in developing countries.
In North America and Europe, it is estimated that between 4% and 8% of women of childbearing age have iron deficiency 3 . Estimates may vary because the criteria used to define iron deficiency are not the same everywhere. In men and postmenopausal women, iron deficiency is rather rare.
In the United States and Canada, some refined foods, such as wheat flour, breakfast cereals, pre-cooked rice and pasta, are fortified with iron to prevent deficiencies.
Because the symptoms of iron deficiency anemia may be due to another health problem, laboratory analysis of a blood sample must be done in order to make a diagnosis. A blood count (complete blood count) is usually prescribed by the doctor.
These 3 measurements make it possible to detect anemia. In case of iron deficiency anemia, the following results are below normal values.
Hemoglobin level : The concentration of hemoglobin in the blood, expressed in grams of hemoglobin per liter of blood (g / l) or per 100 ml of blood (g / 100 ml or g / dl).
Hematocrit : The ratio, expressed as a percentage, of the volume of red blood cells in a blood sample (centrifuged) over the volume of whole blood in that sample.
The count of red blood cells : the number of red blood cells contained in a given volume of blood, normally expressed in millions of red blood cells per microliter of blood.
A mild anemia has no major health consequences. If there are no other health problems, the physical symptoms at rest are felt only for a hemoglobin value of less than 80 g / l (if the anemia has gradually established).
However, if left untreated, its aggravation can lead to serious problems:
For pregnant women : an increased risk of premature birth and low birth weight babies.
Measures to prevent recurrence
People who have had anemia are more likely to have anemia again (depending on the cause). The following measures can reduce this risk.
For some people, taking an iron supplement or an iron multivitamin is helpful in maintaining reserves. They should be taken only on the advice of a health professional, given the risks associated with the overdose.
It is important to be very vigilant. For example, in addition to regularly consuming animal source foods with a source of vitamin C, it is recommended that people who drink tea or coffee do not do so at meal times. It is better to take these drinks one hour before the meal or two hours later. Tea and coffee contain tannins that interfere with the absorption of iron in food.
See more tips from nutritionist Hélène Baribeau in the bespoke Diet: Anemia .
If heavy menstruation causes anemia, taking oral contraceptives may be helpful as they reduce menstrual flow.
The consumption of iron- rich foods is a useful adjunct to treatment. However, it is rarely enough to correct the problem, meet the daily iron needs and rebuild the reserves.
The recommended daily dosage for adults with a deficiency is 150 mg to 200 mg iron per day. Either of the following iron forms may be employed.
Ferrous fumarate: 106 mg of iron per tablet (Euro-fer, Palafer, Ferrate)
Ferrous sulphate: 65 mg of iron per tablet or 44 mg per teaspoon (Apo-Ferrous Sulfate, Fer-In-Sol, PMS-Ferrous Sulfate, etc.)
Ferrous Gluconate: 28 mg to 36 mg iron per tablet (Apo-Ferrous Gluconate, Novo-Ferrogluc)
It is not recommended to take enteric-coated tablets that are to say, that resist the acidity of the stomach and dissolve in the intestine. The film that surrounds this type of tablets delays their dissolution and impairs the absorption of iron.
How to take supplements
- Iron is better absorbed when the stomach is empty: an hour before a meal or two hours later. Indeed, some foods can reduce the absorption of iron. This same interval should be respected for coffee and tea (especially black tea – green tea contains less tannin).
- To maximize iron absorption, take the supplement with orange juice or a 250 mg vitamin C supplement.
- Iron supplements interact with many medications as well as with calcium supplements. Tell your doctor about the medicines you are taking. It will suggest a time interval to prevent interaction.
- Possible side effects. Iron supplementation can cause constipation, abdominal pain or nausea. People who have digestive discomfort can try various solutions:
- Take the supplement with meals;
- Reduce the dose;
- Opt for ferrous sulphate in liquid form, which is generally better tolerated.
- In case of constipation, eating more fiber and increasing water intake is sometimes enough. Moreover, iron supplementation makes the stools black.
Precaution. Keep iron supplements out of the reach of children. Every year, in Canada and the United States, children get intoxicated, sometimes deadly.
If iron cannot be absorbed through the digestive tract, as is the case for some people with intestinal disease, it is injected intravenously . Blood transfusions may be necessary in case of severe anemia.
- See tips in the Prevention section.
- Complementary approaches
- Treatment of iron deficiency anemia requires iron supplementation. No complementary approach is particularly indicated.