Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Iron-Deficiency Anemia

(Reduced Iron in Blood)
by Editorial Staff And Contributors
Definition

This condition results from reduced iron stores in the blood. This happens when you do not eat enough iron to replace the iron that your body uses. Your body uses iron to produce hemoglobin. This is part of red blood cells that carries oxygen to tissues and muscles. Bleeding a lot can also cause anemia .

Causes

Factors that play a role include:

  • Chronic bleeding (eg, heavy menstrual bleeding, bleeding in the gastrointestinal [GI] tract)
  • Iron that is poorly absorbed in the digestive tract (may occur due to intestinal diseases or surgery)
  • Not enough iron in the diet (common cause in infants, children, and pregnant women)
Risk Factors

These factors increase your chance of developing this condition. Tell your doctor if you have any of these risk factors:

  • Alcoholism
  • Babies who are given cow’s milk prior to age 12 months
  • Breastfed infants who have not started on solid food after six months of age
  • Diets that contain insufficient iron (rare in the United States)
  • Heavy menstrual bleeding or chronic blood loss from the GI tract
  • Pregnancy
  • Rapid growth cycles (infancy, adolescence)
Symptoms

While most people with mild anemia have no symptoms, when present, symptoms may include:

  • Craving to eat things that are not food (called a pica), such as ice or clay
  • Decreased work capacity
  • Fatigue
  • Fingernail changes
  • Hair loss
  • Headache
  • Heart palpitations
  • Infection
  • Pale skin
  • Shortness of breath during or after physical activity
  • Weakness
Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

  • Fecal occult blood test —to look for hidden blood in the stool
  • Microscope examination of a blood smear
  • Serum ferritin level
  • Serum iron
  • Transferrin iron binding capacity
Treatment

Treatments may include:

Iron Supplements

Iron can be taken as a supplement or as part of a multivitamin. Iron comes in many "salt" forms. Ferrous salts are better absorbed than ferric salts. Ferrous sulfate is the cheapest and most commonly used iron salt. Slow-release or coated products may cause less stomach problems. But, they may not be absorbed as well. Some products contain vitamin C to improve absorption. Talk to your doctor, though, because your iron level could get too high.

Iron-Fortified Cereal

Your doctor may recommend that you feed your baby iron-fortified cereal.

Prevention

To help reduce you or your child's chances of getting this condition, take the following steps:

  • Ask your doctor if your infant is getting enough iron—The general guidelines are:
    • Many premature infants need extra iron starting at one month of age.
    • Bottle-fed infants should get a formula that is fortified with iron.
    • Starting at four months, breastfed infants need an iron supplement until they get enough iron from other sources, like infant cereal or iron-fortified formula.
  • Eat a diet rich in iron (eg, oysters, meat, poultry, fish)
  • Avoid foods that interfere with iron absorption, like black tea

Last reviewed: September 2011 by Igor Puzanov, MD.

RESOURCES:
CANADIAN RESOURCES
References:
  • American Academy of Pediatrics. Committee on Nutrition. Iron fortification of infant formulas. Pediatrics . 1999;104:119-123. Pediatrics website. Available at: http://pediatrics.aappublications.org/cgi/content/full/104/1/119 . Accessed July 15, 2007.
  • Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy . 17th ed. Hoboken, NJ: John Wiley & Sons; 1999.
  • Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy . 18th ed. Hoboken, NJ: John Wiley & Sons; 2006.
  • Iron. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 2007. Accessed July 15, 2008.
  • Schroeder K. Good food sources of iron. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated December 2006. Accessed July 15, 2008.
  • US Preventive Services Task Force. The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force . 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2002.
  • US Preventive Services Task Force. The Guide to Clinical Preventive Services: Report of the United States Preventive Services Task Force . AHRQ Publication No. 06-0588; Rockville, MD: 2006.
  • 10/12/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Baker R, Greer F, the Committee on Nutrition. Clinical report—diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). American Academy of Pediatrics website. Available at: http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2576v1 . Published October 5, 2010. Accessed October 12, 2010.