Iron is an important mineral in the body that is mostly found attached to the proteins hemoglobin and myoglobin, found in red blood cells and muscle cells, respectively. At certain times in life, iron supplementation is needed to support red blood cell production, but other times it is discouraged. Iron deficiency can lead to anemia, or decreased red blood cell production. Dieting, supplementation and the diagnosis and treatment of disease should be done with the consultation of a licensed health care professional.
Types of Anemia
Anemia can be classified in different ways. One method is by the appearance of the anemia under a microscope. Microcytic anemia is a low red blood cell count with small, pale red blood cells. Normocytic anemia refers to a low count with normal sized cells. Macrocytic anemia is a low number of large red blood cells. Anemia itself is actually not a diagnosis. Rather, it is indicative of an underlying condition.
Causes of Iron Deficiency Anemia
Iron deficiency is generally caused by chronic, meaning long term, bleeding. Heavy menstruation, bleeding from the GI tract or elsewhere can cause iron deficiency. Inadequate intake in some people can also be a cause, as can problems absorbing iron from certain diseases or drugs. Inflammatory states can also suppress iron use.
Mechanism of Iron Deficiency Anemia
Iron deficiency causes a microcytic anemia. In the bone marrow, stem cells gradually divide and turn into red blood cells. These cells synthesize a large amount of the protein hemoglobin that fills up the cells. Hemoglobin contains iron atoms that bind to oxygen in the lungs, and provide it to the tissues. If iron is not available, the hemoglobin cannot be synthesized, and the red blood cells will be small and pale.
Symptoms, Diagnosis and Complications
There may be no symptoms of iron deficiency anemia. Alternatively, a person may feel more fatigued or look pale. Hair loss, brittle nails, impaired immunity, and unusual cravings, such as for dirt, called pica, can also occur. The diagnosis of iron deficiency anemia is made by studying the concentration of red blood cells, there size, variability, and hemoglobin concentration. In addition, studies can be done to measure the concentration of iron in the body or bone marrow. The diagnosis should prompt a search for the cause. Complications are usually a progression of fatigue. However, they can be even worse if somebody has other medical conditions. For example, if somebody has heart problems, anemia can strain the heart even more.
Treatment
The treatment of iron deficiency anemia entails addressing the underlying cause and repleting iron stores. For example, if there is a GI bleed, its source may be localized to a stomach ulcer, that can then be treated. Or, if heavy menstruation is the culprit, medications can be given to control the amount and frequency of bleeding. Iron repletion can be given orally or intravenously if the loss is severe.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al.; 8th Ed 2009
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci et al.; 17th Ed 2008
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