Causes Of Iron Deficiency Anaemia
In pregnancy, iron deficiency anaemia is most often caused by a lack of iron in your diet.
Heavy periods and pregnancy are very common causes of iron deficiency anaemia. Heavy periods can be treated with medicine.
For men and for women whose periods have stopped, bleeding in the stomach and intestines is the most common cause of iron deficiency anaemia. This can be caused by:
- inflammation of the bowel or food pipe
- cancers of the bowel or stomach but this is less common
Any other conditions or actions that cause blood loss could also lead to iron deficiency anaemia.
Diagnosing Iron Deficiency Anaemia
See your GP if you experience symptoms of iron deficiency anaemia, such as tiredness, shortness of breath and heart palpitations.
A simple blood test can usually confirm the diagnosis.
Your GP may also carry out a physical examination and ask you a number of questions to help determine the cause of your anaemia.
Less Common Symptoms Of Hemolytic Anemia:
- Tinnitus Buzzing, ringing, and any other unusual sounds that come from within your body rather than from your surroundings. Tinnitus usually manifests as buzzing in the ears.
- An altered sense of taste Having a metallic taste or a reduced sense of taste could indicate anemia.
- Itchy skin Itchy skin is a result of increased levels of bilirubin being deposited into the skin from red cell breakdown. The symptom is accompanied by yellowing of the skin.
- Tongue changes The tongue feels sore or oddly smooth.
- Hair loss People with anemia often notice their hair becoming dry, brittle, and thin. Hair loss is also very common with anemia.
- Pica A desire to eat non-food items.
- Difficulty swallowing Usually from dry mouth and weak muscles.
- Muscle weakness Muscles need adequate amounts of hemoglobin in order to stay strong and functional. Anemia can result in muscle wasting due to low hemoglobin levels.
- Mouth sores Open sores at the side of your mouth could also indicate anemia.
- Trouble concentrating and depression Mental confusion and low mood are a result of less oxygen and nutrients reaching the blood due to red blood cell death in hemolytic anemia.
Hemolytic CrisisHemolytic crisis occurs when a large number of red blood cells are destroyed in a short span of time.
The result of this happening is acute and severe anemia with a sudden onset and can lead to kidney damage.
Recognizing these symptoms is important in order to prevent fatal outcomes.
Side Effects Requiring Immediate Medical Attention
Along with its needed effects, apixaban may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking apixaban:
Applies to apixaban: oral tablet
What Causes Iron Deficiency Anaemia
There are many things that can lead to a lack of iron in the body. In men and post-menopausal women, the most common cause is bleeding in the stomach and intestines.
In women of reproductive age, heavy periods and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your baby during pregnancy.
Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused just by a lack of iron in your diet. However, if you do lack dietary iron, it may mean you’re more likely to develop anaemia than if you have one of the problems mentioned above.
Read more about the causes of iron deficiency anaemia
Why Does It Happen
- Blood loss is the major cause. The bleeding may be visible such as from trauma, vomiting blood, blood present in bowel movements, coughing up blood, heavy menstrual periods, or bleeding with urination. It is also possible to have hidden or occult bleeding in the gastrointestinal tract where no bleeding is visible but blood is being lost.
- Decreased absorption of iron from the GI tract. This is relatively uncommon though inflammation in the stomach, a bacterial infection , or celiac disease can cause iron deficiency and should be considered especially if the low iron levels persist despite taking an iron supplement.
- There are also several other uncommon causes such as:
- Breakdown of red blood cells inside vessels
- Losses into the lungs microscopically
- Gastric bypass. This can lead to decreased iron level because the site of iron absorption is bypassed.
Quality Of Life: The Therapeutic Goal
The ultimate therapeutic goal is improvement in quality of life but the only objective measure we have to hand is change in haemoglobin concentration. Quality of life improvements of anaemic cancer patients were detected at haemoglobin levels of up to 14 g/dl. As most IBD patients are young, they may have even higher physical and cognitive demands than cancer patients. Normalisation of haemoglobin level should be sought.
The mechanisms of IBD associated anaemia involve particularly ID and ACD. In cases of vitamin B12 or folic acid deficiency, appropriate substitution is needed. This leaves the major problem of directing iron therapy and improving erythropoiesis in chronic disease.
Can I Do Anything To Help My Body To Absorb The Iron In My Diet
Vitamin C helps the body to absorb non-haem iron from the gut. Vitamin C is found in high amounts in lemons, limes, tomatoes and red peppers – it is partially destroyed by cooking, so these foods will help more if you eat them raw with your meal.
Lactic acid-fermented vegetables may also aid the absorption of non-haem iron. Sauerkraut and kimchi are examples of lacto-fermented vegetables.
Calcium, which is present in milk, yoghurt and cheese, interferes with the absorption of both haem iron and non-haem iron. So drinking cow’s milk is best avoided during mealtimes. However, research has suggested that lactobacillus, such as is used in the production of live yoghurt, may aid in the absorption of non-haem iron.
Tea and coffee are best avoided at mealtimes too. This is because they contain chemicals called phenols which interfere with the absorption of non-haem iron.
What Are The Symptoms Of Anemia
The symptoms of anemia vary according to the type of , the underlying cause, the severity and any underlying health problems, such as hemorrhaging, ulcers, menstrual problems, or cancer. Specific symptoms of those problems may be noticed first.
The body also has a remarkable ability to compensate for early . If your anemia is mild or has developed over a long period of time, you may not notice any symptoms.
Symptoms common to many types of anemia include the following:
- Easy and loss of energy
- Unusually rapid beat, particularly with exercise
- Shortness of breath and , particularly with
- Difficulty concentrating
When Cancer Is Associated With Anemia
The association is infrequent, but the explanation is that Any advanced cancer can cause anemia by causing inflammation, causing bone marrow suppression and decrease in production of red cells or sometimes destruction of red cells, says Mark Levandovsky, MD, Founder and Medical Director of Preventive Medicine and Cancer Care. Dr. Levandovsky is a board certified internist and oncologist/hematologist in practice for over 17 years.
In a more advanced setting bleeding is also possible, with anemia as a result, continues Dr. Levandovsky.
Rare Types Of Hemolytic Anemia
There are rare types of hemolytic anemia and related diseases that affect a very small portion of the worlds population.
Hemolytic anemia is rare in itself, with 4 out of 100.000 people believed to have some form of hemolytic anemia.
Current suggest that there are around 200 people with this disease in Japan.
The syndrome is characterized by three symptoms, namely microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury.
The disease which can be both inherited and acquired is exceptionally rare and seems to affect all populations alike.
Another rare type of hemolytic anemia is spur cell hemolytic anemia which can be either inherited or acquired.
The disease is characterized by the formation of large and spiky red blood cells that tend to accumulate in the spleen.
The disease was previously only known to occur in alcoholics with liver dysfunction and cirrhosis, but now we know that there are cases where the disease can be inherited.
This disease has a poor prognosis as well with most people having a poor chance of survival.
Liver transplantation was found to be helpful in reversing the disease completely in some cases.
The problem with spur cell hemolytic anemia is that these patients are often too ill to undergo any surgery which limits the options to help them recover from the anemia.
A Guide To Anemia Symptoms
From fatigue to arrhythmia, anemia causes a wide range of symptoms. Understanding your symptoms can help you communicate about your condition with your doctor and loved ones.
And each type of anemia shares a basic end effect: Your body does not have enough oxygen-bearing red blood cells for its needs.
How severe or frequent your symptoms are relates to how severe your anemia is. People who have mild anemia, from a mild iron deficiency, for instance, may not have any symptoms at all, while people with severe anemia can have much more noticeable and longer lasting symptoms.
If the condition is severe enough, these symptoms are found to some degree in every type of anemia.
Some Cancers That Can Result In Anemia
Cervical Metastases to the bone marrow Myeloma Urinary tract Vaginal
Typically, for anemia to be present, cancer burden would be significant enough for other symptoms to be noted alsoso anemia alone would be atypical, says Levandovsky.
:Potential exceptions may be gastrointestinal cancers, especially colorectal ones where early stage cancers can cause iron-deficiency anemias without other symptoms.
If your doctor, during a routine physical or an exam for a benign condition, happens to mention that you look really pale and wants to order a blood test for anemia, do not panic.
Its logical to suppose that dermatologists would make this observation less frequently than would physicians of other specialties, as they would more likely associate pale skin with healthy skin , while skin with color could suggest overexposure to the sun.
The doctor who ordered a blood test for me, due to my pale facial skin was an OBGYN. My blood test was normal.
But its good when doctors are making these observations when the patient is being examined for an unrelated issue.
Dr. Levandovsky provides personalized care to health conscious individuals as well as cancer patients and survivors, focusing on an integration of genetic/molecular risk assessments, prevention, education, nutrition and psycho-oncology.
Iron Loss In Inflammatory Bowel Disease
Iron deficiency anaemia can be considered a gastroenterological condition. The leading causes of iron deficiency in the developed world are menstruation and blood loss associated with gastrointestinal disease. In the latter case, blood loss in the stomach or intestine cannot be matched by duodenal iron absorption, creating a negative iron balance. This imbalance is often seen in IBD, leading to anaemia. While our understanding of IBD has grown over the past decades, the prevalence of IBD associated anaemia has changed only little: one third of IBD patients still have haemoglobin levels below 12 g/dl.
Anaemia is a consistent clinical feature of IBD
When Should I See A Doctor
Many of the symptoms of iron deficiency are also the symptoms of the busy, and sometimes stressful, lives we live. Tiredness and struggling to focus at work, for example, are very common and not usually due to iron deficiency. They usually just get better on their own after a week or two.
If you have had one or more of the symptoms listed above, for more than a few weeks, you should arrange to see a doctor or nurse. You can then have investigations carried out, which will include looking to see if iron deficiency is causing your symptoms. If you are short of iron, it is important to get medical advice.
What Are The Causes Of Hemolytic Anemia
As weve already explained, hemolytic anemia is caused by the body breaking down red blood cells faster than normal and the body cannot make up for this loss.
Genetic disorders, certain medical conditions, and injury to the blood cells can all lead to an early breakdown of the bloods most abundant cells.
This breakdown of red blood cells is known as hemolysis and it can occur in the bloodstream or in the spleen or even live with the latter being more common.
Circulating blood is filtered continuously by the spleen. When blood contains deformed blood cells as in the case of hereditary hemolytic anemia, the blood cells dont pass the spleen effectively and they are destroyed as a result.
An article published in American Family Physician explains that immune hemolytic anemias are secondary reactions to immune disorders, blood transfusions, and certain medication.
Hereditary anemia results in disorders of blood cell membranes, cell enzymes, and hemoglobin and subsequent malfunctioning red blood cells.
Destruction of red blood cells occurring at a fast pace means that there are less healthy blood cells to carry oxygen to vital organs.
Depending on the severity, this can result in a range of uncomfortable symptoms, medical disorders, and even death.
Researchers arent sure why some people carry genes that make their body produce faulty blood cells, but there are some possible explanations brought by the large body of research on inherited hemolytic anemia.
Referral To A Specialist
In some cases, your GP may refer you to a gastroenterologist, a specialist in treating digestive conditions. They’ll carry out a more thorough examination.
For example, you may be referred to a gastroenterologist if your GP can’t identify a cause and you have a particularly low haemoglobin level, or if your GP thinks there’s a possibility your symptoms could be caused by stomach cancer or bowel cancer, although this is unlikely.
If you’re a woman with heavy periods, you may be referred to a gynaecologist if you don’t respond to treatment with iron supplements.
Young Woman With Abdominal Pain And Anemia
A 27-year-old woman with a 2-dayhistory of nausea, vomiting, andpostprandial abdominal pain is admittedto the hospital. Acute cholecystitisis suspected
A 27-year-old woman with a 2-day history of nausea, vomiting, and postprandial abdominal pain is admitted to the hospital. Acute cholecystitis is suspected.
History. During a hospitalization for an asthma exacerbation 2 years earlier, the patient was told she had mild anemia; this had resolved by the time of a follow-up visit months later. During that hospitalization, she was also told that her potassium level was elevated, but it normalized spontaneously. Her only current medication is albuterol, which she uses as needed. Her sister and mother had “some liver problem”, about which she does not have further information.
Physical examination. The patient appears in moderate distress; she is afebrile. Blood pressure is 100/60 mm Hg; heart rate is 72 beats per minute. Pertinent physical findings include scleral icterus, right upper quadrant tenderness to palpation, and a spleen tip palpable 3 cm below the left costal margin.
What diagnosis do the clinical history and peripheral smear suggest?
E. Thrombotic thrombocytopenic purpura
A CASE IN POINT
Pernicious Anemia Occurs In The Stomach
Intrinsic factor is one such protein that your body needs, both to extract cobalamin from food and to utilize it efficiently so that it reaches your blood stream.
But with digestive disorders such as Crohns disease, or if there is any type of damage to your esophagus, stomach walls, or intestinal tract, then you run a high risk for vitamin B12 deficiency, and possibly pernicious anemia.
So while people assume that pernicious anemia is a blood disease, it really begins in the stomach, with bloating, acid reflux, and heartburn.
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 transferrin. From there, iron and transferrin are used in the production of hemoglobin, 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 doctor regarding the recommended daily iron requirements for your particular situation.
How Can I Prevent Iron Deficiency
Iron deficiency may be difficult to prevent if it is due to disease – for example, bleeding from the bowels. However, it should be possible to prevent iron deficiency that is due solely to not having enough iron in your diet. See the section below on iron-containing foods.
With increasing evidence that we need to limit our intake of meat, particularly red meat, how much iron do we need in our diet? The UK recommended daily intake for an adult man is 8.7 mg. For a woman who has not reached her menopause, this is increased to 14.8 mg. Higher amounts are needed in pregnancy and in children and young people.
Fast Facts About Epi :
- Common in alcoholics and people with chronic pancreatitis.
- The condition may be mild and diarrhea occurs only after you eat fatty foods.
- More severe disease can present with severe greasy diarrhea, abdominal pain, bloating, weight loss, and vitamin deficiency.
- Suspect if you have a history of pancreatitis.
- Treatment is usually by the replacement of deficient pancreatic enzymes.
Some Cancers Can Cause Anemia When They Cause Internal Bleeding Or Disrupt Red Blood Cell Production And Function
Anemia is the inadequate supply of healthy red blood cells.
Anemia can be caused by many factors, and one of them is cancer.
If a person suspects anemia due to having symptoms such as tiring easily, getting winded easily, pale skin, dizziness and chest pain, they may jump to the conclusion they have cancer if they know that cancer is associated with some cases of anemia.
However, anemia normally has non-malignant causes such as an intestinal ulcer, menstruation, poor diet and low iron levels. But some non-malignant causes are serious such as liver disease or lupus.
Anaemia And Unexplained Abdominal Pain: Looking For A Lead
Signs Symptoms And Complications Of Pernicious Anemia
A lack of vitamin B12 causes the signs and symptoms of pernicious anemia. Without enough vitamin B12, your body can’t make enough healthy red blood cells, which causes .
Some of the signs and symptoms of pernicious anemia apply to all types of anemia. Other signs and symptoms are specific to a lack of vitamin B12.
Decreased Or Impaired Rbcs
Bone marrow is soft, spongy tissue at the center of bones, and it plays an essential role in creating RBCs. The marrow produces stem cells, which develop into RBCs, white blood cells, and platelets.
A number of diseases can affect bone marrow, including . This is a type of cancer that triggers the production of excessive and abnormal white blood cells, disrupting the production of RBCs.
Problems with bone marrow can cause anemia. Aplastic anemia, for example, occurs when few or no stem cells are present in the marrow.
In some cases, anemia results when RBCs do not grow and mature as usual, as with thalassemia a hereditary form of anemia.
Other types of anemia that occur due to decreased or impaired RBCs include:
Sickle cell anemia
This causes RBCs to be shaped like crescents. They may break down more quickly than healthy RBCs or become lodged in small blood vessels.
This blockage can reduce oxygen levels and cause pain further down in the bloodstream.
This involves the body producing too few RBCs due to a lack of iron in the body.
Iron-deficiency anemia may develop as a result of:
- a diet low in iron
- certain digestive conditions, such as Crohns disease
- medications that irritate the gut lining, such as ibuprofen
Vitamin B-12 and are both essential for the production of RBCs. If a person does not consume enough of either vitamin, their RBC count may be low.
How Do Doctors Treat An Iron Deficiency
Your doctor first will determine what is causing your anemia. Treatment will then focus on both the iron deficiency and the underlying cause. If your diet is the culprit, Dr. Brill offers several tips for improving your iron intake.
An especially good source is quinoa one serving has 5 mg or about 1/3 of your daily needs, he says.
Other good sources include:
- Spinach .
- Red meat.
If Iron Deficiency Anaemia Is Not Treated
Untreated iron deficiency anaemia:
- can make you more at risk of illness and infection a lack of iron affects the immune system
- may increase your risk of developing complications that affect the heart or lungs such as an abnormally fast heartbeat or heart failure
- in pregnancy, can cause a greater risk of complications before and after birth
Page last reviewed: 29 January 2021 Next review due: 29 January 2024
Treating The Underlying Cause
Your GP will also need to ensure the underlying cause of your anaemia is treated so it doesn’t happen again.
For example, if non-steroidal anti-inflammatory drugs are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding.
Heavy periods can be treated with medication or in particularly severe cases surgery.
Most Iron Supplements Cause Gi Side Effects
Most forms of iron just sit in your stomach and wreak havoc but they are commonly used because they are inexpensive and readily available. Most manufacturers dont really understand the Science of Iron or what we as women go through on a daily and monthly basis.
As the founder of Get Your Iron Up, I have heard from many thousands of women whose primary complaint about oral iron is the gastrointestinal distress such as nausea, constipation, abdominal pain, diarrhea, gas, bloating, acid reflux and indigestion that many brands can cause. Those formulations are not easy to tolerate, they are hard on the system and practically make you feel worse than your Iron Deficiency Anemia does. The GI side effects and stomach discomfort can be unbearable.
What Are The Symptoms Of Iron
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
A desire to eat peculiar substances such as dirt or ice
The symptoms of iron-deficiency anemia may resemble other blood conditions or medical problems. Always consult your doctor for a diagnosis.
When To See Your Doctor
- If you have heavy and prolonged menstrual periods and show symptoms of iron deficiency anaemia.
- If you develop strange food cravings, along with symptoms of tiredness and weakness.
- If your stool becomes black and foul-smelling.
- If you notice growth faltering or a fall-off in growth on the road to health card of your child.
Previously reviewed by Dr Betsie Lombard, MBChB , Mmed
Reviewed by Dr Yasmin Goga MBBCH , DCH , FCPaeds , Cert Clin Haem Paeds , June 2011
R75 per month
Anaemia Of Chronic Disease
ACD is the most frequent anaemia in hospitalised patients and develops in subjects suffering from diseases that are associated with chronic activation of cell mediated immunity, such as chronic infections, immune mediated inflammatory disorders, or malignancy. Thus ACD is primarily an immune driven disorder with cytokines such as TNF- or IFN- and acute phase proteins being the major players. Several factors contribute to the development of ACD.
Diversion of iron traffic
A hallmark of ACD is hypoferraemia, and accordingly iron limitations at the erythron, while iron is taken up by macrophages and dendritic cells of the reticuloendothelial system . Thus ACD can be easily diagnosed by the presence of hypoferraemia and increased serum levels of ferritin .
Iron and erythropoiesis in chronic disease. When erythropoiesis is suppressed, iron which is released at the end of the red cell lifespan and which would normally have been recycled into new haemoglobin is diverted into iron stores. As a result, serum ferritin levels are increased. Iron absorption is driven mainly by erythropoiesis. When this is suppressed, iron absorption is likewise decreased.
Inhibition of erythroid progenitor proliferation and differentiation
Blunted Epo response
Erythrocyte life cycle