Iron deficiency anemia – symptoms and treatment in women, signs and clinical manifestations

The main function of iron (Fe) in the human body is to provide it with oxygen. The excellent oxidizing ability of iron is well known. This ability is used by the body in order to capture and retain oxygen. The mechanism of oxygen transfer to tissues is very complex. The most important role in it is played by the iron-containing hemoglobin protein, which is part of the red blood cells – red blood cells.

Red blood cells are the main component of blood. Red blood cells circulate throughout the body and, entering the lungs through the pulmonary circulation, are enriched with oxygen in the alveoli. Then the bloodstream delivers red blood cells, and with it oxygen, to the tissues.

Iron is contained in the body quite a bit – about 4-5 g. And its largest part is used precisely in hemoglobin, for oxygen transfer. Thus, iron deficiency can lead to hemoglobin being unable to carry out its functions. And this, in turn, leads to a lack of oxygen, which negatively affects the work of all organs and tissues.

This syndrome is called iron deficiency anemia. The term “anemia” in translation means “anemia”. However, with iron deficiency anemia, the blood volume in the body may be within normal limits. Another thing is that the main function of the blood – supplying tissues with oxygen, cannot be fully performed.

Iron metabolism in the body is also very complex. The element enters the body with food, but only a very small part of it is absorbed. In total, the body should receive 2-2,5 mg of Fe per day. The largest portion is immediately sent to the bone marrow, where new red blood cells form. Partially the element is consumed by other fabrics.

The remaining share is deposited in reserve. The main stores of iron are in the liver. The accumulation of an element in the body begins in the prenatal period. However, only a small part of iron is contained in the liver, its main part circulates in the blood. However, if there is a lack of iron, then the body makes up for the element due to the liver depot.

The development of IDA occurs in several stages. At the first stage, when stocks from the depot are mobilized, the pathology can be detected only by a deficiency of ferritin. At the second stage, when transport and functional iron is mobilized, there is a decrease in the level of the element in the blood serum. At this stage, signs such as dry skin, weakness, dizziness may occur.

The development of anemia can ultimately lead to coma and death.

The distribution of iron in the body

where isiron concentration in women, mg / kgiron concentration in men mg / kg
hemoglobin2831
other functional iron in tissues67
transferrin0,20,2
ferritin48
hemosiderin24

The body of a man is more saturated with iron, and the reserves of the element in men are about 2 times higher than in women.

Iron deficiency anemia: developmental mechanism

Any anemia, including iron deficiency, is not a disease in the strict sense of the word. This is a symptom that indicates some other disease or an external factor that causes a decrease in the concentration of Fe in the blood. Therefore, without treatment of the underlying disease or elimination of the causes of the condition, unpleasant manifestations will persist.

The causes of this condition may be:

  • chronic blood loss due to diseases, menstruation, injuries, etc .;
  • lack of iron intake from food;
  • insufficient absorption of iron in the intestine;
  • increased iron consumption;
  • violation of the process of iron intake from the depot or transportation to the bone marrow.

In newborns, anemia can be inherited from the mother. If the mother’s body lacked iron, then the state of deficiency of the element passes to the newborn, and in an even more pronounced form.

What diseases and conditions can lead to chronic blood loss:

  • prolonged menstruation;
  • uterine tumors, endometriosis;
  • tuberculosis;
  • urolithiasis disease;
  • frequent nosebleeds with hypertension;
  • stomach ulcer, duodenal ulcer and gastritis;
  • hemorrhoids;
  • gastrointestinal tumors;
  • oral diseases;
  • helminthic invasions.

Even small, but chronic bleeding can eventually lead to iron deficiency anemia. If a person loses only 4 ml of blood per day, this means that 3 mg of iron is lost, which exceeds the average daily intake of an element with food.

A decrease in the intake of iron from food occurs with prolonged starvation, an unbalanced diet. The largest amount of element is found in meat products, fish and eggs. In addition, an element from such products is best absorbed.

Fe reserves in plant foods can also be absorbed. However, an important condition is necessary here – a sufficient content of vitamin C in the diet. Thus, the development of iron deficiency anemia is not uncommon with a lack of meat and vitamins in the diet. A similar situation is typical for people sitting on various fashionable diets, especially if they are based solely on plant products and are completely unbalanced in composition. A similar cause of iron deficiency anemia is an unbalanced diet, most common in children.

Disorders of iron absorption in the intestine can occur with various diseases of the stomach and intestines, with alcoholism, removal of a part of the stomach or duodenum, pancreatitis. All these reasons lead to a lack of iron due to the fact that the mechanism of its binding to the transferrin protein is disrupted.

Pregnancy and lactation, increased physical exertion, prolonged fever, and increased sweating can be causes of increased iron withdrawal from the body that is not associated with bleeding.

Violation of the process of iron intake from the depot occurs in liver diseases (hepatitis, cirrhosis). Since elimination of iron deficiency due to body reserves is a process that occurs infrequently, in patients with hepatic insufficiency anemia occurs only in 20% of cases.

Long-term infectious diseases (tuberculosis, brucellosis) lead to the fact that iron molecules are captured by immune cells. As a result, red blood cells also suffer from a deficiency of an element important to them.

Iron deficiency anemia is a common condition in women during pregnancy. This is due to the fact that the female body is forced to share iron with the body of the baby. If the child does not receive a sufficient amount of a chemical element, then this will lead to improper development of its organs and to anemia in the first months of life.

Any anemia, including iron deficiency, is not a disease in the strict sense of the word. This is a symptom that indicates some other disease or an external factor that causes a decrease in the concentration of Fe in the blood. Therefore, without treatment of the underlying disease or elimination of the causes of the condition, unpleasant manifestations will persist.

In newborns, anemia can be inherited from the mother. If the mother’s body lacked iron, then the state of deficiency of the element passes to the newborn, and in an even more pronounced form.

Even small, but chronic bleeding can eventually lead to iron deficiency anemia. If a person loses only 4 ml of blood per day, this means that 3 mg of iron is lost, which exceeds the average daily intake of an element with food.

A decrease in the intake of iron from food occurs with prolonged starvation, an unbalanced diet. The largest amount of element is found in meat products, fish and eggs. In addition, an element from such products is best absorbed.

Fe reserves in plant foods can also be absorbed. However, an important condition is necessary here – a sufficient content of vitamin C in the diet. Thus, the development of iron deficiency anemia is not uncommon with a lack of meat and vitamins in the diet. A similar situation is typical for people sitting on various fashionable diets, especially if they are based solely on plant products and are completely unbalanced in composition. A similar cause of iron deficiency anemia is an unbalanced diet, most common in children.

Disorders of iron absorption in the intestine can occur with various diseases of the stomach and intestines, with alcoholism, removal of a part of the stomach or duodenum, pancreatitis. All these reasons lead to a lack of iron due to the fact that the mechanism of its binding to the transferrin protein is disrupted.

Pregnancy and lactation, increased physical exertion, prolonged fever, and increased sweating can be causes of increased iron withdrawal from the body that is not associated with bleeding.

Violation of the process of iron intake from the depot occurs in liver diseases (hepatitis, cirrhosis). Since elimination of iron deficiency due to body reserves is a process that occurs infrequently, in patients with hepatic insufficiency anemia occurs only in 20% of cases.

Long-term infectious diseases (tuberculosis, brucellosis) lead to the fact that iron molecules are captured by immune cells. As a result, red blood cells also suffer from a deficiency of an element important to them.

Adult Treatment

The basic principles of the treatment of iron deficiency anemia include the elimination of etiological factors, diet correction, and replenishment of iron deficiency in the body. Etiotropic treatment is prescribed and carried out by specialists gastroenterologists, gynecologists, proctologists, etc .; pathogenetic – by hematologists. In iron deficiency conditions, a complete nutrition is shown with the mandatory inclusion in the diet of products containing heme iron (veal, beef, lamb, rabbit meat, liver, tongue). It should be remembered that ascorbic, citric, succinic acid contribute to increased ferrosorption in the digestive tract. Oxalates and polyphenols (coffee, tea, soy protein, milk, chocolate), calcium, dietary fiber and other substances inhibit iron absorption.

However, even a balanced diet is not able to eliminate the already developed iron deficiency, therefore, patients with hypochromic anemia are shown replacement therapy with ferrodrugs. Iron preparations are prescribed for a course of at least 1,5-2 months, and after normalizing the level of Hb, maintenance therapy is carried out for 4-6 weeks with a half dose of the drug. For the pharmacological correction of anemia, ferrous and ferric iron preparations are used. In the presence of vital indications resort to blood transfusion therapy.

The main component of treatment is the administration of iron-containing drugs in tablets and capsules. Treatment only with a diet with a pronounced deficiency of a chemical element in the body is ineffective, even in the early stages. Although the correct diet must also be followed. Only in severe cases, with a severe hemoglobin deficiency that threatens the patient’s life, donated blood is transfused.

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Diet treatment

Although the main emphasis in IDA is on taking iron-containing drugs, however, without a proper diet and eating iron-rich foods, the treatment process can take a long time.

Most easily digestible iron is found in meat and fish products. This is especially true for mammalian meat (beef, veal, lamb). The champion in the content of the element is beef liver. Animal fats interfere with the absorption of Fe, so preference should be given to lean meats. A lot of the element is also found in egg yolks.

Among fruits, pomegranates, plums, apples, blueberries, and strawberries are most rich in iron. These fruits and berries have a lot of vitamin C, so Fe from them will also be easy to digest. And among cereals primacy belongs to sin. There are almost no vitamins in buckwheat groats, therefore it is best to drink buckwheat porridge with juices. A lot of iron is also found in nuts (walnuts and hazelnuts), mushrooms, beans, cocoa.

The digestibility of iron from various products:

  • meat – 25%;
  • fish, eggs – 10-15%;
  • plant products – 1-5%.

There are also products – antagonists of Fe. These include those that contain tannin (tea) or calcium (dairy products). Therefore, during the treatment period, they should be consumed as little as possible or eliminated altogether from the diet.

Iron preparations are usually taken orally. Fe from them is digested several times better than from food. Therefore, iron-containing drugs are much more effective in combating hemoglobin deficiency than iron-rich foods. Many iron-containing drugs are available in capsule form, which helps to reduce their negative effect on the gastric mucosa.

Divalent preparations available in pharmacies are presented in the form of organic and inorganic salts. The first group includes gluconates and fumarates. To the second – chlorides and sulfates. Trivalent preparations are represented by succinylates and hydroxides in combination with polymaltose. The bioavailability of divalent drugs can reach 40%, while in trivalent drugs it is only 10%.

Preparationchemical formvalence
TotemGluconate2
FerretabFumarate2
Sorbifer, Tardiferon, Fenyuls, Actiferrin, Ferro-Folgamma, Ferroplex, FerrogradumetSulfate2
HemoferChloride2
FerlatumSuccinylate3
Ferrum Lek, Maltofer, BioferHydroxide in complex with polymaltose3

There are also forms of iron-containing preparations for parenteral administration:

The process of treatment with iron-containing drugs must be carried out under the supervision of a doctor, since an overdose of these drugs can adversely affect health.

Stages of treatment for IDA

Treatment of iron deficiency anemia consists of three main stages. The first stage of treatment is to eliminate hemoglobin deficiency and restore its normal values. During the second stage, the restoration of iron stores in the body. And, finally, the third stage is supportive therapy, aimed at maintaining the level of an element in the body at the required level and preventing the development of relapses.

Stages of treatmentrecommended dose of iron preparations, mg per dayduration
elimination of acute anemia150 – 3002 months and more
restoration of iron stores in the body100 – 2002-6 months
maintenance therapy50-100 (7-10 days per month)constantly with ongoing blood loss

The main component of treatment is the administration of iron-containing drugs in tablets and capsules. Treatment only with a diet with a pronounced deficiency of a chemical element in the body is ineffective, even in the early stages. Although the correct diet must also be followed. Only in severe cases, with a severe hemoglobin deficiency that threatens the patient’s life, donated blood is transfused.

Diet treatment

Although the main emphasis in IDA is on taking iron-containing drugs, however, without a proper diet and eating iron-rich foods, the treatment process can take a long time.

Most easily digestible iron is found in meat and fish products. This is especially true for mammalian meat (beef, veal, lamb). The champion in the content of the element is beef liver. Animal fats interfere with the absorption of Fe, so preference should be given to lean meats. A lot of the element is also found in egg yolks.

Among fruits, pomegranates, plums, apples, blueberries, and strawberries are most rich in iron. These fruits and berries have a lot of vitamin C, so Fe from them will also be easy to digest. And among cereals primacy belongs to sin. There are almost no vitamins in buckwheat groats, therefore it is best to drink buckwheat porridge with juices. A lot of iron is also found in nuts (walnuts and hazelnuts), mushrooms, beans, cocoa.

There are also products – antagonists of Fe. These include those that contain tannin (tea) or calcium (dairy products). Therefore, during the treatment period, they should be consumed as little as possible or eliminated altogether from the diet.

The treatment of anemia directly depends on its type and on what causes it caused. So, the treatment of anemia, which is associated with profuse blood loss, is to stop bleeding, restore hemodynamics.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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