Iron Deficiency Anemia
What is Iron and Why Do We Need It?
Iron is a vital mineral that plays many important roles in our body. It helps red blood cells carry oxygen, supports hormone production, and is essential for energy production and muscle function. Without enough iron, many people experience symptoms like fatigue, shortness of breath, and even feelings of depression.
What is Iron Deficiency Anemia?
Iron deficiency anemia occurs when your body doesn't have enough iron to make healthy red blood cells. This leads to less oxygen being delivered to your body’s tissues, which can cause you to feel tired and weak. It's a common condition, affecting millions worldwide, particularly in low-income countries and increasingly in the U.S.
Who is at Risk?
Both women and men can experience iron deficiency, but women of childbearing age are particularly at risk due to menstrual blood loss. Pregnant women need even more iron. Unfortunately, many women do not get the recommended amount of iron, while many men tend to get enough or more than needed.
Chronic health conditions like ulcers, inflammatory bowel diseases, and autoimmune diseases can also lead to anemia. Additionally, low stomach acid, which is common with age, can affect iron absorption.
Symptoms of Iron Deficiency
Common symptoms include:
Extreme fatigue
Shortness of breath
Pale skin
Rapid heartbeat
Dizziness
Cold hands and feet
Difficulty concentrating
Some unusual symptoms can include cravings for non-food items like dirt or ice and changes in the appearance of nails.
How is it Diagnosed?
Doctors usually check for anemia during routine blood tests. A Complete Blood Count (CBC) can indicate whether your blood has enough red blood cells to carry oxygen effectively. However, changes in iron levels may not show up immediately in these tests. More specific tests for iron status, such as measuring ferritin (which shows how much iron is stored in your body), can provide clearer insights.
Treating Iron Deficiency
Treatment depends on the cause. If you have heavy periods, your doctor might suggest birth control. If dietary iron is insufficient, they may recommend iron supplements and iron-rich foods. In severe cases, intravenous iron may be necessary.
Choosing the Right Iron Supplement
Iron pills that are often prescribed come in the form of iron salts, such as iron oxide, iron sulfate, iron gluconate or iron fumarate. These are also called ferrous oxide, ferrous sulfate, ferrous gluconate or ferrous fumarate. Unfortunately taking iron in the form of iron salts has two major problems. The first is that these forms of iron are poorly absorbed. In some cases, the rate of absorption has been reported to be as low as 20%. If it’s not being absorbed, your body can’t use it to do its job.
Iron that’s not absorbed can create the second problem: nausea, abdominal cramping, bloating and constipation. A summary of 43 studies found that ferrous sulfate was more than twice as likely to cause gastrointestinal distress than placebo and more than three times as likely to cause these side effects than intravenous iron. The better the absorption of the iron supplement, the lower the risk for side effects. The most absorbable form of iron is the amino acid chelated form. Chelated iron is bound to amino acids. This increases its absorption and decreases side effects. Iron absorption from iron bisglycinate chelate has been shown to be four times better than absorption from ferrous sulfate. One additional advantage of ferrous bisgycinate is that the “glycinate” part is the amino acid glycine. Glycine is an important amino acid the body needs two molecules are attached to each atom of iron, providing a highly absorbable carrier for iron.
How much do I need?
The goal of taking iron when someone has iron deficiency is to replenish iron stores and, in the case of iron deficiency anemia, correct the anemia. Guidelines suggest that the appropriate amount of iron to take is based on a person’s weight. A person should consider taking 2-3 mg/kg per day, and some guidelines recommend even higher doses. If you measure your body weight in pounds, your body weight approximately equal the recommended amount of iron. For example, if you weigh 135 pounds, your recommendation would be for approximately 135 mg iron per day. Dr. Neustadt typically recommends 45 mg of iron (as ferrous bisglycinate) twice or three times daily for a total of 90-135 mg per day. And follow up blood testing every three months.
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