Iron Deficiency Anemia

Most people have heard of anemia and associate it with low iron and fatigue. Considering that everyone gets tired, the condition often goes unrecognized until it’s discovered in routine blood work or at a blood donation site. Iron deficiency is actually the most common nutrient deficiency in the world. Although global rates are higher, it is estimated that in the US, between 2%-10% of the population are affected. Fortunately, iron deficiency can usually be prevented or treated with proper diet, lifestyle and/or supplementation. By knowing who is at risk, as well as having an awareness of symptoms to look for, it becomes much easier to recognize and treat. Often just by implementing simple changes, you can elevate your level of health and wellness.

What is Anemia?

There are three stages of low iron, the most severe of which is anemia. With some knowledge and foresight, a deficiency can be corrected before it reaches the anemic stage. Anemia is a descriptive term for having a reduced number or size of red blood cells (RBC) in the body. Having a reduced RBC capacity, means less oxygen is carried to the brain, heart, muscles and tissues. Without sufficient oxygen, less energy is available the body to perform. That’s is why fatigue is considered the hallmark for the condition. There are many types of anemia, including those related to folate and B-12. However, generally speaking iron-deficiency anemia (IDA) is the most common. There are also inherited conditions that cause chronic anemia such as thalassemia, glucose-6 phosphate dehydrogenase deficiency and sickle-cell anemia. A healthcare provider can help determine whether or not any of these conditions are present.

What do RBCs Have to do With Iron?

RBCs are made in the bone marrow and iron is an integral component. The iron we eat comes in two forms, heme and non-heme. Non-heme is found in plants and fortified foods, while meats contain both forms, (vegetarians and vegans are at risk of deficiency). It’s the heme form of iron that makes up hemoglobin and myoglobin. Hemeglobin is an iron- rich protein that transports oxygen from the lungs to the tissues, and 60% of body’s iron is in this form. Myoglobin, which accounts for approximately 10%, stores oxygen within the muscle cells so it’s available for use during physical activity. The remaining 30% of the iron in the body is stored in the bone marrow and some in the liver. Non-heme iron acts as an essential cofactor in many enzymatic reactions.

What are the Symptoms?

In addition to fatigue, other signs of low iron include: cognitive impairment, gastrointestinal disturbances, hypothyroidism, dizziness, pale skin, headaches, irregular heartbeat, chest pain, irritability, reduced immunity, problems regulating body temperature, restless leg syndrome (RLS) and reduced exercise or work performance. In children, impaired growth and development, along with ADHD, may be indicative of a deficiency. Pica is a behavior that can be caused by anemia in which one has a craving to chew ice, or to ingest substances like clay or dirt. Pica is most common in pregnant women and young children. It is also worth noting that some of the symptoms mentioned may be related to the fact that iron is an essential cofactor for the conversion of thyroid hormones, T4 to T3. This point is often overlooked in cases of hypothyroidism, yet research indicates iron supplementation may be all that’s required to correct the problem.

Who is Most at Risk?

Young children, adolescents (especially girls), and women in their reproductive years, carry the greatest risk for iron deficiency. The primary causes of deficiency are related to blood loss, poor absorption, and gastrointestinal (GI) issues. One research study showed that menorrhagia (heavy periods) coupled with a gastrointestinal issue coexisted in one-third of all premenopausal women. Other conditions that increase the risk of developing anemia include:

  • Pregnancy
  • Certain prescription medications, i.e. heartburn meds.
  • Vegetarian or vegan diet
  • Excessive exercise on a regular basis
  • Autoimmune disease
  • Cancer
  • Thyroid disease
  • Inflammatory bowel disease
  • Liver or kidney disease
  • Chronic heart failure
  • Celiac

Note that a significant deficiency with no apparent cause can serve as a red flag for an underlying medical issue.

How Much Iron do I Need?

The answer is enough, but not too much, since an overload can be toxic. Iron supplements should always be kept out of reach of small children. In adults, high doses (>45mg) may cause GI discomfort, i.e. nausea, constipation. The daily-recommended intakes for males are in the range of 8-11mgs with higher needs during periods of rapid growth. Females require 8-18mgs with an increase to 25mgs during pregnancy and lactation. Therapeutic doses may be higher in order to meet the specific needs of an individual. Here is a list of good food sources:

  • Breakfast cereals, 1 serving-18mg
  • Oysters, 3oz-8mg
  • White beans, 1 cup-8mg
  • Chocolate, dark, 3oz-7mg
  • Beef liver, 3oz-5mg
  • Lentils, boiled/drained ½ c-3mg
  • Spinach, boiled/drained ½ c-3mg
  • Tofu, firm ½ c-3mg

Aside from the various conditions that can lead to deficiency, there remains the fact that the bioavailability of iron in food is low. One can potentially maximize absorbability by including vitamin C with iron and avoid absorption inhibitors i.e. calcium, tea, or phytates. However, research indicates that if anemia exists, supplementation is likely the best way to ensure that your needs are met. Choosing a high quality supplement that is readily absorbed, with minimized potential for side effects, is key for success. HoltraCeuticals’ Iron Essentials offers a superior quality option so you can get the benefits you want without the side effects you don’t. See your healthcare provider to determine if supplementation is right for you.

References
1. Beck, K. Conlon, C. Kruger, R. Coad, J. Dietary Determinants of and Possible Solutions to Iron Deficiency for Young Women Living in Industrialized Countries: A Review. Nutrients. 2014 Sep; 6(9): 3747–3776.

2. USDA National Library. DRI Tables and Application Reports. Available at: http://fnic.nal.usda.gov/dietary-guidance/dietary-reference-intakes/dri-tables-and-application-reports/ Accessed on March 19, 2016.

3. National Institutes of Health Office of Dietary Supplements. Iron: Fact Sheet. Available at: https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/#en70 Accessed on March 20, 2016.

4. USNLM: Pub Med Health. Iron Deficiency Anemia. June 11, 2014. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022011/ Accessed March 20, 2016.

5. Johnson-Wimbley, T. Diagnosis and management of iron deficiency anemia in the 21st century. Therap Adv Gastroenterol. 2011 May; 4(3): 177–184.

6. Vannella, L, Spiriti, A. Cozza, G. Benefit of concomitant gastrointestinal and gynaecological evaluation in premenopausal women with iron deficiency anaemia. Aliment Pharmacol Ther. 2008 Aug 15;28 (4):422-30.

7. Linus Pauling Institute. Iron. Available at: http://lpi.oregonstate.edu/mic/minerals/iron/ Accessed on March 20, 2016.