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Case study 2012


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Case study 2012

  1. 1. Baker 1 Rusti Baker Dr. Whittaker Biology 2402-001 23 March 2012 Case Study 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
  2. 2. Baker 2 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
  3. 3. Baker 3 factors to the cause of iron deficiency anemia. Some of those are diet, excessive bleeding and cancer. 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
  4. 4. Baker 4 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' milk.  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
  5. 5. Baker 5 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.
  6. 6. Baker 6 Works Cited " Iron Disorders Institute:: Iron Deficiency Anemia." Iron Disorders Institute: Home. N.p., n.d. Web. 23 Mar. 2012. <>. Clark PhD, RD, Susan F.. "Iron Deficiency Anemia." Nutrition in Clinical Practice 23.2 (2008): 128-144. Print. "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. <>.