Iron deficiency

Specialty of Haematology

What is iron deficiency?

Iron is an important mineral needed by the body, particularly for processes involving oxygen. The principal biological use of iron in humans is as a constituent of haemoglobin – the protein found in red blood cells that binds to oxygen. Haemoglobin enables the red blood cells to transport oxygen around the body and deliver it to the cells that need it. In short, iron is essential to keeping us alive.

Iron deficiency is when the body does not have enough iron, either because the need for iron has increased, or because the intake or absorption of iron has fallen. This shortage of iron means that the body can’t make as many red blood cells (anaemia), and, as a result, less oxygen can be carried by the blood. The ultimate consequence is that the rest of the cells in the body are running on a reduced amount of oxygen.

Iron deficiency anaemia is one of the most common forms of anaemia, and iron deficiency is also one of the most common nutritional deficiencies.

What are the symptoms of iron deficiency?

Most of the symptoms of iron deficiency are related to the associated anaemia. The shortage of iron means a shortage of oxygen reaching respiring cells, and this means the body can’t function at full capacity. Typical symptoms include:

  • Fatigue
  • Light-headedness/dizziness/headaches
  • Weakness
  • Pallor
  • Irritability
  • Shortness of breath
  • Heart palpitations
  • Brittle nails
  • Hair loss
  • Cold extremities

Iron deficiency can also affect memory and mental function, particularly in teens, while appetite may be affected in some patients (usually young children with iron deficiency anaemia).

Another strange symptom that has been reported in a number of cases is ‘pica’. This refers to unexplained cravings for strange foods or non-food items.

What causes iron deficiency?

There are several causes of iron deficiency. Most involve blood loss of some description. It is possible to develop iron deficiency simply through a lack of iron in the diet, but this is very unlikely unless the patient is pregnant. However, this will increase the risk of iron deficiency when coupled with one of the following other causes:

  • Malabsorption – if your body struggles to absorb iron from food (for example caused by coeliac disease), this will lead to iron deficiency.
  • Monthly periods – the most common cause of iron deficiency in women of reproductive age. Usually, only heavy periods will lead to iron deficiency/anaemia.
  • Pregnancy – extra iron is needed to supply the growing baby with blood and oxygen, meaning that pregnant women often have to up their iron intake.
  • Bleeding in the G-I tract – the most common cause of iron deficiency in men and post-menopausal women, this can be caused by:

Any other condition or incident that causes blood loss could lead to iron deficiency, even if only temporarily, for example, after giving blood, or losing blood due to trauma.

What is the treatment for iron deficiency?

Treatment usually involves taking iron supplements and/or eating more iron-rich foods, such as red meat, fish, dark green leafy vegetables, beans, pulses, brown rice and eggs. However, in some cases this will not be enough, and the underlying cause will have to also be addressed. It is important for the doctor to monitor the patient, taking more blood tests after a few weeks to see if haemoglobin levels are returning to normal levels.

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