Iron-deficiency anaemia occurs when the body lacks the iron needed to manufacture haemoglobin, which is the protein in red blood cells that transports oxygen around the circulatory system.

What is iron-deficiency anaemia?

In order to make all the haemoglobin it needs, the body usually has sufficient iron reserves from food and from the iron that is reabsorbed when red blood cells die.

It is usually lost through shedding of skin cells or menstruation, but the body is normally able to adequately replenish its stores of iron from the diet in order to maintain good health.

What causes anaemia?

There are four main causes of iron-deficiency anaemia:

• Bleeding depletes the number of red blood cells in the body and so uses up its iron stores. Women with heavy periods are particularly vulnerable to anaemia. Diseases that commonly lead to anaemia due to chronic bleeding include peptic ulcers, gastritis, and ulcerative colitis. Cancer of the stomach and bowel may cause iron-deficiency anaemia, although bleeding is the most common cause of the condition.
• Inability to absorb iron contained in food usually occurs because part of the stomach or small intestine has been surgically removed.
• Pregnancy causes iron depletion since the baby uses up iron from the mother’s stores while in the womb. Some women are prescribed iron supplements during pregnancy to prevent or treat this type of anaemia.
• Lack of iron in the diet occurs most frequently in children under two years old, or in people on a very poor diet. It is a common cause of iron-deficiency anaemia even though iron is present in much of the food in our normal diet. A diet containing iron-rich foods such as fish, beans, vegetables and wholemeal bread will help guard against iron-deficiency anaemia.

Symptoms

1.    Weakness and general fatigue.

2.    Palpitations.

3.    Shortness of breath.

4.    Pallor (especially around gums, nail-beds and in the rims of the eyes).

5.     Headache.

6.    Sore mouth or tongue.

7.    Brittle nails.

8.    Pica, which is a craving for dirt, clay, paint, or other non-food substances.

How is this deficiency diagnosed and treated?

Anaemia can be diagnosed with a simple blood test. It may be easily cured by improving the quality of the diet. If this proves insufficient, iron supplements may then be recommended. However, your doctor will first want to establish that the anaemia is not caused by abnormal and possibly dangerous bleeding somewhere inside the body.

What can I do myself ?

Look at your diet to see if you are getting a sufficient intake of iron. Liver, red meat, fish, eggs, green vegetables, nuts, beans, cereals, dried fruit, black treacle, parsley, figs, and cocoa are all good sources of iron.

Natural remedies

Drinking nettle tea or eating lightly cooked nettles in salads may help iron deficiency. When cooking nettles, do not put your face over the pan, since the vapour given off by the nettles contains formic acid which can sting and cause discomfort. You may wish to consult a qualified herbalist who might also prescribe natural remedies such as Yellow Dock and St. John’s Wort, while a homoeopath may recommend tissue salt supplements as a cure.

Do not attempt to treat symptoms that you think might be due to anaemia with iron supplements without first obtaining a definite diagnosis from your doctor. Such self-treatment could disguise the presence of a dangerous but treatable condition such as a bleeding ulcer. An excessive iron intake may also cause cirrhosis of the liver.

Less serious problems caused by taking iron pills include constipation, indigestion and abdominal bloating. These can usually be avoided by taking the pills with food. However, there is no point in taking supplements that are not needed, so check with your doctor first.

When should I see my doctor?

You should see your doctor if you have any of the symptoms described. These could be caused by a variety of medical disorders, or even by stress and emotional worry, rather than by iron-deficiency anaemia. Your doctor can then carry out tests to see if you are suffering from iron-deficiency.

What will the doctor do?

If the cause of the deficiency is not immediately apparent, your doctor may want a stool sample to check for intestinal bleeding. X-ray studies of your gastrointestinal tract or other tests may be taken to ensure there is no internal bleeding. Occasionally, bone-marrow samples may be needed to check that the anaemia is not caused by such uncommon disorders as aplastic anaemia, which requires different treatment. If you are markedly anaemic, your doctor may recommend iron injections. However iron pills are usually sufficient.

What can I do to avoid iron deficiency?

Follow a balanced diet that includes good sources of iron. Include citrus fruits or other sources of vitamin C in meals that contain iron-rich foods. This increases iron absorption. Avoid drinking too much tea, as this hinders iron absorption.

Is iron-deficiency anaemia dangerous?

Anaemia can be a symptom of a dangerous condition, such as internal bleeding, and should never be ignored. It can also weaken the body’s resistance to illness. Iron-deficiency anaemia is an indication of an underlying problem, not a disease itself, so it is necessary to determine and treat the cause. However, the cause is usually fairly simple, and iron reserves can be built up with diet and or iron supplements.

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