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Iron-Deficiency Anemia

(Reduced Iron in Blood)

Definition

Anemia is a low level of red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. Lower RBC counts mean the body is not getting enough oxygen.

Red Blood Cells
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Iron makes a critical component of red blood cells.

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Causes

Iron is needed to build healthy RBCs. This type of anemia is caused by low levels of iron in the body. Low iron levels may be caused by one or more of the following:

  • Problems passing iron from the stomach or intestines into the blood—may be due to diseases of the intestine or surgery
  • Chronic bleeding
  • Not enough iron in the diet—common cause in infants, children, and pregnant women

Risk Factors

Things that may increase the chance of this anemia are:

  • Rapid growth cycles—may happen in infant or children and teens
  • Heavy menstrual bleeding
  • Health issues that cause bleeding in GI tract
  • Pregnancy
  • Breastfed infants who have not started on solid food after 6 months of age
  • Babies who are given cow’s milk before 12 months
  • Alcohol use disorder
  • Diets that don't have enough iron—rare in the US

Symptoms

Mild anemia may not cause problems. Those that do have problems may have:

  • Fatigue
  • Pale skin
  • Fingernail changes
  • Weakness
  • Headache
  • Decreased work capacity
  • Heart palpitations
  • Infection
  • Craving to eat things that are not food such as ice or clay
  • Hair loss
  • Shortness of breath during or after physical activity
  • Restless legs at night

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Blood tests will be used to confirm anemia. It will also show problems with the level of iron. Other tests may be done to look for a cause.

Treatment

Iron levels will need to be brought back to normal. The body will then be able to increase RBC levels and cure the anemia. Treatment choices may include:

  • Treat related problems. Steps may include:
    • Slowing or stopping blood loss. This will stop the loss of iron and allow iron levels to recover.
    • Treating health issues of the intestines. It may improve absorption of iron.
  • Iron supplement may be needed. They can increase the volume of iron that gets into the blood. May be given as a pill or through injections.
  • Iron fortified foods may help. A fortified cereal may be recommended for babies.

Prevention

If you are at risk for anemia:

  • Eat a diet rich in iron. Include iron-rich foods such as oysters, meat, poultry, or fish.
  • Avoid foods that can block or slow iron absorption. Black tea is one common iron blocker.
  • Follow treatment plan for related health problems.

Talk to your doctor about your baby’s diet. General guidelines include:

  • Breastfed infants need an iron supplement starting at 4 months of age. Once they are older they can get iron from other sources, like cereal or fortified formula.
  • Bottle-fed infants should get a formula that is fortified with iron.
  • Premature infants may need extra iron by 1 month of age.
RESOURCES:

Healthy Children—American Academy of Pediatrics
https://healthychildren.org

The American Congress of Obstetricians and Gynecologists
https://www.acog.org

CANADIAN RESOURCES

Dietitians of Canada
http://www.dietitians.ca

Health Canada
https://www.canada.ca

REFERENCES:

Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015 May 7;372(19):1832-43.

Iron deficiency anemia in adults. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/iron-deficiency-anemia-in-adults/. Updated March 14, 2019. Accessed February 12, 2020.

Iron deficiency in children (infancy through adolescence). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/iron-deficiency-anemia-in-children. Updated January 29, 2020. Accessed February 12, 2020.

Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016 Feb 27;387(10021):907-16.

10/12/2010 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T435307/Iron-deficiency-in-children-infancy-through-adolescence: Baker R, Greer F, Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-1050.

Last reviewed September 2019 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 2/12/2020