23 March 2012
Dolores Welborn is a 28-year-old attorney living in Portland Oregon. Dolores is in the
second trimester of pregnancy with her first child, and though her pregnancy had been
progressing normally, recently she has noticed that she tires very easily and is short of breath
from even the slightest exertion. She also has experienced periods of light-headedness, though
not to the point of fainting. Other changes she has noticed are cramping in her legs, a desire to
crunch on ice, and the fact that her tongue is sore. She doubts that all of these symptoms are
related to one another, but she is concerned, and she makes an appointment to see her physician.
Upon examining Dolores, her physician finds that she has tachycardia, pale gums and
nail beds, and her tongue is swollen. Given her history and the findings on her physical exam, the
physician suspects that Dolores is anemic and orders a sample of her blood for examination.
A diagnosis of anemia due to iron deficiency is made and oral iron supplements
prescribed. Dolores’ symptoms are eliminated within a couple of weeks and the remainder of her
pregnancy progresses without difficulty.
Iron deficiency anemia is a condition where the body has too little iron in it and it can
range from mild to severe. “Iron deficiency is the most common nutritional deficiency and the
leading cause of anemia in the world.” (Worlds) Iron deficiency can occur during rapid periods
of growth. It can also occur when the person is not taking in enough heme iron, which is the
form of iron in red meat. The majority of the symptoms of Iron deficiency anemia relate directly
to the decreased oxygen carrying capacity of the blood that results from a deficiency of
hemoglobin. A mild case of anemia can have no symptoms or problems. A severe case of anemia
can cause extreme fatigue and weakness. Severe cases can lead to serious problems for pregnant
women and young children. Severe cases can also affect the heart.
The people that are most at risk of being struck with this condition are women, children
and the elderly. “African American and
Hispanic women and their young children
are prone to iron deficiency, possibly
because of diet or perhaps different
hemoglobin needs.” (Iron Disorders)
Heart murmurs and growth and
development delay are the risk for young
children with anemia. Pregnant women
with iron deficiency anemia can produce
low birth weight babies or even premature babies. In the elderly the result can be heart failure.
This is due to the fact that the heart has to work harder to get enough oxygen throughout the
body. “Over time, this stress on the heart can lead to a fast or irregular heartbeat, chest pain, an
enlarged heart, and even heart failure.”(Worlds) “Individuals with IDA have inadequate intake,
impaired absorption or transport, physiologic losses associated with chronological or
reproductive age, or chronic blood loss secondary to disease.” (Clark) There are many other
factors to the cause of iron deficiency anemia. Some of those are diet, excessive bleeding and
Iron deficiency anemia can be diagnosed by your doctor through blood tests. These tests
are hematocrit and hemoglobin as well as RBC indices. Tests to check iron levels in your blood
include bone marrow exam, iron binding capacity in the blood, serum ferritin and serum iron
level. Tests that may be done to look for the cause of iron deficiency are colonoscopy, fecal
occult blood test and upper endoscopy.
“Taking supplements and eating iron
rich foods are important parts of treating iron
deficiency anemia.”(National) If the cause is
dietary iron deficiency, eating more iron-rich
foods such as beans and lentils or taking iron
supplements, usually with iron(II) sulfate,
ferrous gluconate, or iron amino acid chelate
ferrous bisglycinate, synthetic chelate
NaFerredetate EDTA will usually correct the
anemia. There can be a great difference between iron intake and iron absorption, also known as
bioavailability. Scientific studies indicate iron absorption problems when iron is taken in
conjunction with milk, tea, coffee and other substances. There are already a number of proven
solutions for this problem, including:
Fortification with ascorbic acid, which increases bioavailability in both presence and
absence of inhibiting substances, but which is subject to deterioration from moisture or
heat. Ascorbic acid fortification is usually limited to sealed dried foods, but individuals
can easily take ascorbic acid with basic iron supplement for the same benefits.
Microencapsulation with lecithin, which binds and protects the iron particles from the
action of inhibiting substances. The primary benefit over ascorbic acid is durability and
shelf life, particularly for products like milk which undergo heat treatment.
Using an iron amino acid chelate, such as NaFeEDTA, which similarly binds and protects
the iron particles. A study performed by the Hematology Unit of the University of Chile
indicates that chelated iron (ferrous bis-glycine chelate) can work with ascorbic acid to
achieve even higher absorption levels
Separating intake of iron and inhibiting substances by a couple of hours.
Using non-dairy milk (such as soy, rice, or almond milk) or goats' milk instead of cows'
Gluten-free diet resolves some instances of iron-deficiency anemia, especially if the
anemia is a result of celiac disease.
Consuming heme iron, found only in animal foods such as meat, fish and poultry, as it is
more easily absorbed than non-heme iron, found in plant foods and supplements.
“The goals of treating iron-deficiency anemia are to restore normal levels of red
blood cells, hemoglobin, and iron as well as to treat the condition causing the anemia.”
(Worlds) The prognosis to Iron deficiency anemia is that with treatment, the outcome is
likely to be good. However, it does depend on the cause. Usually blood counts will return
to normal in two months
You can reduce the risk of iron deficiency anemia by choosing iron-rich foods.
Foods rich in iron include beans, dark green leafy vegetables, dried fruit, eggs, iron
fortified cereals, breads and pastas. Also some other iron rich foods are peas, pork,
poultry, red meat and seafood. Your body absorbs more iron from meat than it does from
other sources. If you choose to not eat meat, you may need to increase your intake of
iron- rich, plant based foods to absorb the same amount of iron as someone who eats
meat. Also choosing foods containing vitamin C to enhance iron absorption is
recommended. You can enhance your body’s absorption of iron by drinking citrus juice
or eating other foods rich in vitamin C at the same time you eat high-iron foods. Vitamin
C in citrus juices, like orange juice, helps your body to better absorb dietary iron.
" Iron Disorders Institute:: Iron Deficiency Anemia." Iron Disorders Institute: Home. N.p., n.d.
Web. 23 Mar. 2012. <http://www.irondisorders.org/iron-deficiency-anemia>.
Clark PhD, RD, Susan F.. "Iron Deficiency Anemia." Nutrition in Clinical Practice 23.2 (2008):
"Iron deficiency anemia - PubMed Health." National Center for Biotechnology Information.
N.p., n.d. Web. 23 Mar. 2012.
"Iron-deficiency anemia." The Worlds of David Darling. N.p., n.d. Web. 23 Mar. 2012.