Common medical conditions explained: Iron deficiency anaemia

    9 December 2019

    What is it?

    Broadly speaking, anaemia means a lack of red blood cells. There are various things that can cause this, but the most common is due to a lack of iron (other types can be caused by lack of vitamin B12 or folate). Iron is needed to make an important part of red blood cells called haemoglobin, which is what helps the red blood cells to transport oxygen around the body. Without enough iron, then the body can’t make enough red blood cells. This means that the organs wont get as much oxygen as they normally would. This can lead to a number of symptoms such as feeling weak, short of breath, tired or looking pale. It can also sometimes cause palpitations, itchiness or hair loss. It is diagnosed by a simple blood test that looks at the number of red blood cells and the amount of haemoglobin.

    What causes it?

    Iron deficiency anaemia can be caused by several things and it’s often an important sign of something else that’s happening in the body. Unless you’re pregnant or eat a very restricted diet, it’s uncommon for it to be caused simply by not having enough iron in your diet. The main cause is the body losing blood faster than it can make it and the most common cause is bleeding in the stomach or intestines. Therefore the doctor will often arrange investigations to see if this is happening. This kind of bleeding can be caused by stomach ulcers or certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) – a group of anti-inflammatory painkillers that include ibuprofen. It can also be caused by stomach or bowel cancer, which is why it’s important the cause of the iron deficiency is investigated. In women of reproductive age, it’s often caused by heavy periods. This should be investigated and it may be possible to treat this.

    How is it treated?

    Once the cause of the iron deficiency has been established, then doctors will often prescribe a course of iron supplements. These are stronger than the ones that can be bought in health good shops or over the counter and are very effective. The GP will then likely continue to monitor to ensure the levels of iron in the blood increase to normal levels. It’s important that the iron supplements are kept out of the reach of young children as they can be fatal if taken in overdose. In a few cases – for example, in kidney disease – iron injections may be needed instead of tablets. It’s important to get iron deficiency anaemia treated as in the long term it can impact on the immune system and increase the risk of developing problems with the heart and lungs.

    What can the patient do?

    If you have developed iron defiency anaemia then the priority should be ensuring a cause is found and then taking supplements to ensure that it is treated. It’s important to go for the regular blood tests while the iron levels improve. Tea, coffee, milk and dairy products, walnuts and almonds all reduce the body’s ability to absorb iron so avoid these. Some medications such as antacids and proton pump inhibitors (PPIs) which reduce the acid in the stomach also reduce the absorption of iron. Dark green leafy vegetables, cereals and bread fortified with iron, meat and pulses are all good sources of iron, so you should eat plenty of these. If you take an iron supplement, vitamin C can help it be absorbed better, so it’s best to take it with a glass of fresh orange juice.