Iron deficiency anemia is caused by a lack of iron needed to produce hemoglobin. It develops in stages starting with low iron stores, then reduced red blood cell production, and finally anemia when hemoglobin levels drop below normal. Symptoms include fatigue, paleness, and shortness of breath. It is diagnosed through blood tests measuring iron, ferritin and hemoglobin levels. Treatment focuses on increasing iron intake through an iron-rich diet, vitamin C to aid absorption, and iron supplements to restore normal iron levels in the body.

1. Aneamia
Presented By Miss Sudipta Roy
Associate Professor
East Point College of Pharmacy Bangalore

2. • The word comes from the greek which means lack
of blood. An means without and emia means
blood.
• Definition :
• Anemia is defined as a decrease in the total amoun
of the red blood cells (RBCs) or hemoglobin in
blood.It is also defined as lower ability of blood to
carry oxygen.
• or
• Anemia is defined as a hemoglobin cencentration in
the blood below the lower limit of the normal

3. Normal Hemoglobin (Hb) value:
• In Male individuals : 13 gm/dl
• In female individuals : 11.5 gm/dl
• In newborn infants : 15 gm/dl
• At 3 months : 9.5 gm/dl
• The tissues of the human body need a regular
supply of oxygen to the body and lives for 120
days.

4. • Red blood cell
• Oxygen from lungs
• Hemoglobin molecules
• Oxygen bonded with hemoglobin molecules
• Oxygen released to tissue cells

5. • When they die the iron , they contain is returned to
the bone marrow and is used to create new red
blood cells. Anemia develops when heavy bleeding
causes a significant iron loss or when the
production of red blood cells slows down or they
are destroyed at fast rates.
• In anemia , the body does not enough oxygen rich
blood. As a result , the person may feel tired and
have other symptoms. With severe or long-lasting
anemia . A lack of oxygen in the blood can damage
the vital tissues of heart, brain and other organ of
the body.

6. Causes of Anemia.
• Anemia is caused by the following reasons :
• Blood loss
• Decrease in rate of RBC production
• High rate of RBC destruction
• Blood loss :
• Blood loss may be due to the following reasons
• :
• Heavy menstrual period in women
• Surgery
• Trauma
• Cancer

7. Decrease in Rate of RBC
production.
• Mainly two factors can prevent the from making
enough red blood cells. These are Acquired cause
and Inherited Cause.
• Acquired cause include :
• Poor diet (especially poor in iron and folic acid)
• Hormonal imbalance (Poor secretion of
erythropoetin from the kidneys)

8. • High rate of RBC Destruction :
• In various conditions the rate of RBC destruction
becomes high. These conditions may also be
inherited or acquired.
• When spleen gets diseased/enlarged the of RBC
destruction becomes high.
• Examples of inherited conditions that can cause the
body to destroy too many red blood cells include
sickle cell anemia , thalassemia , hemolytic anemia.
• These conditions create defects in the blood cells
that cause them to die faster than healthy red

9. Symptoms of Anemia .
• Symptoms may include :
• Fatigue
• Pale or yellowish skin
• Shortness of breath
• Light-headedness
• Dizziness
• Weakness
• Irregular heartless
• Chest Pain
• Cold hands and feet

10. • Iron deficiency anemia is a common type of anemia in which blood lacks
adequate healthy red blood cells due to deficiency of iron.
• Iron is an essential mineral that is needed to form hemoglobin (an oxygen
carrying protein) inside red blood cells.
• Definition : Iron deficiency anemia (IDA) is a condition in which the body
lack enough red blood cells to transport oxygen to the whole body as a
result iron deficiency anemia produces tiredness and shortness of breadth.
• or
• Aneamia is defined as a hemoglobin concentration below a specified cut-off
point that cut off point depends on the age , gender , physiological status ,
smokinghabits and altitude at which the population being assessed lives.
• WHO defines aneamia in children aged under 5 years and pregnant women
as a heamoglobin concentration <110 g /L at sea level and aneamia in non-
prolonged women as a heamoglobin concentration <120 g/L.

11. Distribution of IRON in Body
• Iron is distributed in active metabolic and storage
pools. Total body iron is about 3-4 gm. This amount
of iron is availble in two forms -
• Functional Form of Iron (75%)
• Hemoglobin 2 g (in men) and 1.5 g (in women)
• Myoglobin : 200 mg
• Respiratory enzymes (as cytochromes ) : 150 mg
• 2. Non-Functional Form of Iron (25%) :
• Free iron is very toxic .So iron is bound to proteins
(non-heme metaloproteins) that allows it to be
transported and stored in non-toxic forms.

12. • Transferrin : 250-300 mg (For transport of iron in Blood) .
• Ferritin : 1 g (in men ) and 0.6 g (in women ) - For storage of iron in
tissues.
• Hemosiderin : 300 mg (For storage)
• Functions of Iron :
• Iron performs several functions in human body .
• These are --
• It is carrier of oxygen from lung to tissues
• It transports electrons within cells.
• It acts as a co-factor for essential enzymatic reactions such as :
• Neurotransmission
• Synthesis of steroidal hormones
• Synthesis of bile salts
• Detoxification process in the liver

13. Etiology .
• Iron deficiency anemia is usually due to :
• 1. Blood loss : Blood loss may be due to following
reasons :
• Menorrhagia (abnormally heavy or prolonged
bleeding)
• Chronic internal bleeding
• Surgery
• Trauma
• Cancer
• Decrease iron intake

14. • Decrease Iron Absorption :
• Absorption of iron can be decreased due to :
• Intestinal disorders such as Crohn's disease, celia
disease
• Reular use of stomach acid blockers
• Certain food like milk , tea , coffee etc.

15. • Increased Iron Requirements:
• It may be due to -
• Juvenile Age
• Pregnancy
• Lactation

16. • Pathophyiology :
• Iron deficincy occurs when the body's iron stores
are deplted and a restricted supply of iron to
various tissues becomes apparent.If not corrected ,
iron deficiency can lead to iron deficiency anemia
,which is a condition defined by a low hemoglobin
concentration in the blood. Iron deficiency
commonly occurs in three stages.

17. • Stage 1 : Diminished Tota Body Iron Content :
• This stage is identified by reduction in bone
marrow iron stores . Level of iron in hemoglobin
and serum remain normal but serum ferritin falls to
<20 ng/ml.
• Serum ferritin concentration typically correlates
well with total body iron stores. However , within
this stage transferrin level rises to increase the
absorption of iron.

18. • Stage 2 : Reduced Red Blood Cell Formation :
• This stage occurs when the iron supply is
insufficient to support the formation of red blood
cells . So, in this stage erythropoesis is impaired.
Erythropoiesis is impaired when serum iron falls to
below 50 mcg/dl and transferrin saturation to less
than 16 % . High levels of a blood marker called zinc
protoporphyrin (ZPP) can indicate this stage. When
iron is not readily available , zinc is used in its place,
producing ZPP.

19. • Iron deficieny Anemia :
• In this final stage , hemoglobin concentration is
affected and drops below the normal range , which
is typically 12 to 15 grams per deciliter for women
and 14 to 16.5 grams per decilter for men. The
normal range , however will be slightly higher for
atheletes living at higher altitudes .

20. Clinical Manifestations.
• The symptoms of moderate to severe iron deficiency anemia can conclude :
• Brittle nails
• Cracks in the sides of mouth
• Extreme Fatigue (tiredness)
• Weakness
• Chest Pain
• Pale skin
• Shortness of breath
• Dizziness or light headedness
• Fast or irregular heartbeat
• Headaches
• Strange cravings to eat items with no nutritional value
• A tingling or crawling feeling in the legs
• Tongue swelling or soreness
• Cold hands and feet

21. • Diagnosis :
• Iron deficiency anemia can be diagnosed with blood tests.
• These include :
• 1. Complete Blood Count (CBC) Test :
• A CBC test measures the amount of cellular or cell related
components in the blood , including
• :
• Red blood cells (RBCs)
• White blood cells (WBCs)
• Hemoglobin
• Hematocrit
• Platelets

22. • Microscopic Examination of Blood :
• These blood tests provide information , including :
• The iron level in blood
• RBC size and color (RBCs are pale if they are
deficient in iron )
• Ferritin level
• Total iron-binding capacity (TIBC)

23. • Treatment :
• Non Pharmacological Treatment :
• Diets that include the following foods can help treat
or prevent iron deficiency :
• Red meat
• Green , leafy vegetables
• Dried fruits
• Nuts
• Iron fortified cereals , breads and pastas
• peas

24. • Additionally , vitamin C may help to absorb iron,
source of vitamin C are a glass of orange juice or
citrus fruit , tomatoes , broccoli, grapefruit , kiwi ,
melons etc.
• Pharmacological Treatment :
• Iron Supplements :
• Iron tablets can help to restore iron levels in your
body . Take iron tablets on an empty stomach , that
helps the body absorb them better. If they upset
your stomach , you can take them with meals .