Iron Deficiency Anaemia (IDA) is a common problem estimated to affect two billion people worldwide 1. It is the most prevalent micronutrient deficiency and main cause of Anaemia, which the World Health Organization (WHO) estimates is responsible for 50 percent of the cases of Anaemia in women 2. In Sri Lanka, it is estimated that one in three children and one in four adults suffer from IDA making it a significant health issue that needs to be tackled 3. In this article we will explore what it is, the signs and symptoms, diagnosis, causes and treatment options available.
What is IDA?
Haemoglobin is the substance in your red blood cells that is responsible for transporting oxygen around your body. When your Haemoglobin is low, this is called Anaemia. Iron is responsible for the production of Haemoglobin. However, if there are not enough stores of iron, your body is unable to produce the required amount of Haemoglobin, thus contributing to Anaemia. There are other causes of Anaemia such as chronic disease and B12 deficiency, however these are less common.
Signs and symptoms
There are many signs and symptoms ranging from mild to more severe. Common symptoms include fatigue, shortness of breath on exertion and heart palpitations. More subtle-symptoms include poor concentration and mood, hair loss, brittle nails, sensitivity to cold and restless legs.
Physical signs can include spoon-shaped nails (koilonychia), swollen patches around the mouth (angular cheilitis), pale skin and a big, beefy tongue (atrophic glossitis). As everybody is different, signs and symptoms will vary from person to person, however it is commonly accepted the more Anaemic a person, the more signs and symptoms are noticeable.
Causes
Like many diseases in medicine, the cause is often multifactorial. Diet can play a big factor. Good sources of iron include red meat, liver (to be avoided in pregnancy), beans, lentils, nuts, dried fruit (i.e. apricots) and seafood including salmon, tuna, oysters and mussels. Other causes of IDA include blood loss (i.e. menstruation, post-surgery, pregnancy), malabsorption (i.e. gut conditions such as Inflammatory Bowel Disease, Gastritis) and the many conditions where there is inflammation in the body (i.e. rheumatoid arthritis, congestive heart failure, chronic kidney disease and cancer to name a few).
Diagnosis
If the above symptoms are experienced, a simple blood test can confirm the diagnosis. In some cases, this might lead to other investigations that may uncover an underlying cause for your IDA and that is why it is important to screen for this.
Treatment
Supportive lifestyle changes including modifying your diet are the first line options. Milk, tea and coffee can make iron absorption in the gut more difficult. Therefore, reducing tea/coffee consumption at the same time as consuming iron rich foods or taking over-the-counter iron supplements can help. Medical professionals may prescribe iron tablets to boost levels in the blood - These are effective, however do have side effects which include constipation and diarrhoea, nausea, heartburn and dark stool. If you are concerned that you may have IDA, the first step is to speak to your doctor who can help investigate this and arrange treatment if required.
Authors
Dr. Jonathan Andrews MBBS, BMed Sc
Dr. Bhanuka Senasinghe MBChB, MA
References
1) Russell, S., 2021. The Global Iron-Deficiency Crisis. [online] Scientific American. Available at: <https://www.scientificamerican.com/article/the-global-iron-deficiency-cr... [Accessed 6 October 2021].
2) Miller, J., 2013. Iron Deficiency Anemia: A Common and Curable Disease. Cold Spring Harbor Perspectives in Medicine, 3(7), pp.a011866-a011866.
3) ReliefWeb. 2021. ‘Iron Deficiency a Leading Cause of Anemia’ say’s Ministry of Health & UNICEF - Sri Lanka. [online] Available at: <https://reliefweb.int/report/sri-lanka/iron-deficiency-leading-cause-ane... [Accessed 6 October 2021].