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Anemia

What Is Iron Deficiency Anemia?

Iron Deficiency Anemia (IDA) is a condition where a person has inadequate amounts of iron to meet body demands. If uncorrected, IDA leads to reduced work capacity, diminished learning ability and increased susceptibility to infection and possibly increasing the risk of death.

Is Iron Important?

Iron is an essential component of hemoglobin, the oxygen carrying pigment in the blood. Iron-deficient people tire easily because their bodies are starved for oxygen. Iron is also part of myoglobin which helps muscle cells use oxygen. Without enough iron, the body fuel cannot be properly utilized.

Which cases are most affected and why?

Iron Deficiency anemia occurs frequently in the following cases:

  1. Pregnancy
  2. Infancy (at birth, infant has enough stored iron for 3-6 months, making it important to feed iron-fortified cereals after 6 months of age)
  3. Growing children and teens (due to an increased utilization)
  4. Women of child-bearing ages (due to monthly menstrual losses, repeated pregnancies)
  5. The elderly (due to poor dietary intake, Long term aspirin use, colon cancer or Peptic ulcer disease)
  6. Vegetarians because they don't eat meat, (especially red meat) which is high in iron

People with IDA may suffer from:

There are many symptoms of anemia. Each individual could not necessarily experience all the symptoms, and if the anemia is mild, the symptoms may not be noticeable. Some of the symptoms are: Pale skin color, fatigue, irritability, dizziness, weakness, shortness of breath, sore tongue, brittle nails, headache, and decreased appetite (especially in children).

How to Diagnose

There are several complex lab tests done to diagnose Iron Deficiency Anemia, the most important is serum ferritin for early diagnosis and the simplest is hemoglobin, since lower than normal hemoglobin levels indicate anemia.

Hemoglobin Ranges are:

  • In Adults:
    • For Men: 13.5 to 17.5 g/dL.
    • For Menstruating women: 12.0 to 15.5 g/dL .
  • In Infancy and Childhood:
    • 6 months to 5 years, the hemoglobin levels should not be less than 11 g/dL.
    • 5 years to 12 years, the hemoglobin levels should not be less than 11.5 g/dL.
  • In Pregnancy:
    • First and third trimesters, the hemoglobin levels should not be less than 11 g/dL.
    • Second trimester, the hempglobin levels should not be less than 10.5 g/dL.

Treatment

  1. Eat a lot of meat, fish, and liver
  2. Eat a lot of vitamin C rich food and drinks e.g. orange, strawberry, guava, kiwi along with the iron-rich food, to increase the absorption of iron and maximize the benefits.
  3. Avoid phosphates (cheese, soft drinks, fast food, sausages), phytates (cereals), tannins (coffee, tea), oxalates (chocolate), alginates (pudding, instant soups, ice cream), polyphenoles (vegetables, cereals, spices) since they inhibit iron absorption.
  4. Ideal iron preparation for oral therapy should be:
    • Given with vitamin C to increase iron absorption.
    • A recommended daily dose of 100 mg iron is required, so that the desired 20 mg should be absorbed.
    • A common error is to discontinue iron therapy after the hemoglobin rises toward normal, this is because replenishment of iron stores occurs slowly and therapy must be continued for 3-4 months for stores to be repleted.
  5. Parenteral administration should be reserved for those subjects who are unable to tolerate or absorb orally administrated iron, because of its systemic reactions which may be severe (e.g. headache, fever, arthralgia, back pain, and fatal anaphylactic shock).

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