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Iron Deficiency Anaemia | World's No. 1 Nutrient Deficiency

Red Blood Cells

Summary
  • Some Quick Facts
  • What is Iron Deficiency Anaemia?
  • Signs and symptoms of iron deficiency anaemia
  • Causes of iron deficiency anaemia
  • People at risk for iron deficiency anaemia

Some Quick Facts

  • Iron deficiency is the most common nutrient deficiency worldwide, affecting 2 billion people worldwide.
  • Those at the highest risk of iron deficiency are women and children in developing countries
  • It’s estimated that every second pregnant woman and about 40% of pre-school children in developing countries are anaemic
  • Iron deficiency is the only nutrient deficiency that’s is also significantly prevalent in developed nations
  • Anaemia is responsible for 20% of all maternal deaths
 Source: WHO
  • According to the most recent micronutrient survey, prevalence of anaemia in Kenya among pregnant women stands at 55.1% and 46.4% among non-pregnant women
 Source: KNBS

What is Iron Deficiency Anaemia?

Iron deficiency anaemia, sometimes referred to as IDA, is a common condition that occurs when the body lacks sufficient iron leading to reduction of the red blood cells. This is because iron is a vital component in the production of the red blood cells. The low iron could be as result of low intake of dietary iron, poor absorption of iron from food or due to blood loss.

Red blood cells, whose function is to transport oxygen throughout the body and to carry carbon dioxide back from the tissues to be removed, are mature blood cells that contain haemoglobin. Haemoglobin is a iron rich protein that gives red blood cells their characteristic bright red colour and it’s responsible for this transport.

Without sufficient iron, the body is unable to make enough of this haemoglobin in the red blood cells, leading to iron deficiency anaemia. As a result, the red blood cells become small and pale affecting oxygen transport to body organs and tissues..

IDA is just one of the several forms of anaemia out there. Other common types of anaemia include:
  • Sickle cell anaemia
  • Pernicious anaemia
  • Megaloblastic anaemia
  • Haemolytic anaemia
These occur as result of other causes including nutrient deficiencies other than iron.

Note:
Iron deficiency is not one and the same thing as iron deficiency anaemia (IDA). Iron deficiency only refers to the depletion of iron in the body and some people, while iron deficient, may not be aneamic.

Signs and symptoms of Iron Deficiency Anaemia

Most people with iron deficiency anaemia show few symptoms. The symptoms may be noticed immediately or may develop slowly if they’re caused by a long term underlying problem. Some common symptoms include:
  • Fatigue (tiredness)
  • Shortness of breath
  • Dizziness
  • Rapid Heartbeat
  • Pale skin, eyes and palm
  • Feeling cold in the feet and hands
  • Lethargy (lack of energy)
  • Headache
  • Dysphagia (difficulty in swallowing)
  • Feeling itchy
  • Spoon shaped nails / Brittle nails
  • Pica (having a desire to eat non-food substances e.g. soil, dirt, chalk, ice)
You should always see your doctor if you experience such symptoms or suspect to be aneamic. A quick simple blood test can be carried out to confirm whether you’re anaemic or not.

Causes of Iron Deficiency Anaemia

Blood Loss

Blood loss is the major cause of iron deficiency anaemia.
Some significant ways through which blood loss can cause IDA include:
  • Heavy periods in women
  • Bleeding in your digestive system, (stomach and intestines) e.g. due to stomach ulcers, some cancers
  • Significant blood loss due to injury/trauma e.g. car accidents
  • Donating too much blood
  • Too much nose bleeding

Pregnancy

It common for pregnant women not receiving adequate iron to develop anaemia. This is because of the increased demand for iron from the pregnancy to ensure the baby gets enough oxygen and nutrients for growth and development.
It’s for this reason that pregnant women receive iron supplements during pregnancy. For instance in Kenya the Ministry of Health runs the IFAS (Iron Folic Acid Supplementation) programme as part of Antenatal Care (ANC). Please consult a health facility near you for more information.

Low Dietary Iron Intake

Though rare with the exception of pregnant women, insufficient dietary iron intake can cause iron deficiency anaemia. According to some studies, vegetarian or vegans are at more risk of developing anaemia due to the lack of meat, a rich iron source, in their diets.

Medical Reasons

Some diseases e.g. cancer and kidney diseases, can make it difficult for the body hard to make red blood cells. Also treatment of some of cancers can damage red blood cells or the organs responsible for producing them (bone marrow).

HIV/ADS patients can be affected by anaemia due to destruction of the red blood cells through infection or treatment used.

Worm Infections

Infection by parasitic worms (e.g hookworm) is a major cause of iron deficiency anaemia among children in Africa. This worms cause inflammation and intestinal blood loss and when this is coupled by a poor diet, lead to iron deficiency anaemia.

Always maintain good hygiene and deworm regularly to avoid worm infestation.

Poor Absorption of Iron

Some intestinal conditions (e.g. coeliac disease) may reduce the ability of the body to absorb iron leading to iron deficiency anaemia. Poor absorption may be also caused by poor dietary practices. This will be looked in the next article on prevention and treatment of IDA.

People at risk of iron deficiency anaemia

  • Women of childbearing age - most women in this age lost their blood through monthly period which put them in risk of getting anaemia.
  • Pregnant women - the requirement for iron in pregnant women is twice that of non-pregnant women
      • Infants born with low birth weight or preterm babies, can develop iron deficiency anaemia since their iron stores are lower compared to those of full term infants. 
      • Infants and toddlers who consume a lot of cow milk rather than breastfeeding are at high risk of developing anaemia. This is because cow milk is poor source of iron.
      • Infants who are fed with formula that is not fortified with iron.
      • Infants over 6 months that are complementary fed (breast milk and food) with foods that don’t contain or are poor in iron.
      • Children with worm infections.
      • Older people
      • People with internal bleeding - people who are suffering from cancer or ulcers in their digestive system are likely to develop iron deficiency anaemia due to loss of blood.
      • People with chronic diseases e.g. people with kidney failure are at risk of developing iron deficiency anaemia.
      • Dialysis patients - kidney failure patients undergoing dialysis can develop iron deficiency anaemia as the kidney fails to produce sufficient amounts of a hormone required for production of red blood cells.

      Next : Prevention and Treatment of Iron Deficiency Anemia


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