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Iron deficiency anemia

Contents of this page:

Illustrations

Reticulocytes
Reticulocytes
Blood cells
Blood cells

Alternative Names    Return to top

Anemia - iron deficiency

Definition    Return to top

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Iron deficiency anemia is a decrease in the number of red cells in the blood caused by too little iron.

See also: Iron-deficiency anemia - children

Causes    Return to top

Iron deficiency anemia is the most common form of anemia. About 20% of women, 50% of pregnant women, and 3% of men do not have enough iron in their body.

Iron is a key part of hemoglobin, the oxygen-carrying protein in the blood. Your body normally gets iron through diet and by recycling iron from old red blood cells. Without iron, the blood cannot carry oxygen effectively. Oxygen is needed for every cell in the body to function normally.

The causes of iron deficiency are:

It can also be related to lead poisoning in children.

Anemia develops slowly after the normal iron stores in the body and bone marrow have run out. In general, women have smaller stores of iron than men because they lose more through menstruation. They are at higher risk for anemia than men.

In men and postmenopausal women, anemia is usually caused by gastrointestinal blood loss from:

Iron deficiency anemia may also be caused by poor absorption of iron in the diet, due to:

High-risk groups include:

Symptoms    Return to top

Note: There may be no symptoms if the anemia is mild.

Exams and Tests    Return to top

Treatment    Return to top

The cause of the iron deficiency must be found, especially in older patients who face the greatest risk for gastrointestinal cancers.

Iron supplements (ferrous sulfate) are available. For the best iron absorption, take these supplements with an empty stomach. However, many people cannot tolerate this and may need to take the supplements with food.

Patients who cannot tolerate iron by mouth can take it through a vein (intravenous) or by an injection into the muscle.

Milk and antacids may interfere with the absorption of iron and should not be taken at the same time as iron supplements. Vitamin C can increase absorption and is essential in the production of hemoglobin.

Pregnant and breast-feeding women will need to take extra iron because their normal diet usually will not provide the required amount.

The hematocrit should return to normal after 2 months of iron therapy. However, iron should be continued for another 6 - 12 months to replenish the body's iron stores in the bone marrow.

Iron-rich foods include:

Outlook (Prognosis)    Return to top

With treatment, the outcome is likely to be good. Usually, blood counts will return to normal in 2 months.

Possible Complications    Return to top

There are usually no complications. However, iron deficiency anemia may come back. Get regular follow-ups with your health care provider.

Children with this disorder may be more likely to get infections.

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if:

Prevention    Return to top

Everyone's diet should include enough iron. Red meat, liver, and egg yolks are important sources of iron. Flour, bread, and some cereals are fortified with iron. If you aren't getting enough iron in your diet (uncommon in the U.S.), take iron supplements.

During periods when you need extra iron (such as pregnancy and breast-feeding), increase the amount of iron in your diet or take iron supplements.

References    Return to top

Brotanek JM, Gosz J, Weitzman M, Flores G. Iron deficiency in early childhood in the United States: risk factors and racial/ethnic disparities. Pediatrics. Sep 2007;120(3):568-75.

Ginder GD. Microcytic and hypochromic anemias. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 163.

Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med. 2008;121:943-948.

Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am Fam Physician. Mar 1 2007;75(5):671-8.

Update Date: 4/5/2009

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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