Iron Deficiency Anemia

Iron deficiency anemia is a worldwide public health problem of epidemic proportions, and it causes much illness.

Iron deficiency anemia is a decrease in the number of red blood cells due to inadequate supply or storage of the mineral iron. It is the most common nutritional deficiency, and even in industrialized countries, where other nutritional deficiencies may not happen, its occurrence is significant. This condition is the leading cause of anemia in the United States, and two billion people worldwide have anemia, many of which are cases of iron deficiency.

Iron and hemoglobin

Iron is part of the hemoglobin molecule of red blood cells, and hemoglobin, a protein, serves to transport oxygen to all parts of the human body. Nearly two-thirds of the body’s iron is in hemoglobin. There is also some iron in myoglobin which supplies oxygen to muscle. This mineral is part of enzymes of the cell and therefore plays an important role in its function.

Causes of iron deficiency

Deficiency of iron may occur when there is inadequate intake of the mineral in the diet or from difficulty in iron absorption through the gastrointestinal tract. There are certain instances when the body’s requirement for iron are especially high, and these scenarios will predispose to deficiency if one does not take proper preventive measures.

Blood loss is a well-known cause of iron deficiency, and it takes place in adolescent girls and women of childbearing age who, of course, menstruate. A person who regularly donates blood may become iron deficient, and patients who bleed from their gastrointestinal tract or anywhere else in the body are at risk for the condition.

The regular use of ASA and other nonsteroidal anti-inflammatory drugs may contribute to loss of blood from the gastrointestinal tract. Other causes of blood loss which can lead to iron deficiency include injuries, surgery, the presence of an intrauterine device, and frequent blood drawings.

Patients with malabsorption problems may develop iron deficiency because the gastrointestinal tract will not accept all of the iron the patient consumes. This occurs in Crohn’s disease, celiac disease, and after intestinal surgery.

In some developing countries, iron deficiency may become worse when certain infectious conditions such as tuberculosis, human immunodeficiency virus infection, malaria, and intestinal worms are present.

Chronic conditions such as arthritis and cancer may lead to anemia, but these cases do not respond to iron therapy as does iron deficiency anemia.

Pregnant women require twice the iron supply that a nonpregnant adolescent or woman of childbearing age does, and they must take a supplement. This is because she has to provide iron for the fetus, and her own increase in volume necessitates additional amounts of the mineral. Nutritionists estimate that half of all pregnant women worldwide are deficient in iron, and iron deficiency during pregnancy can predispose to premature or low birth weight infants.

Infants and small children are at risk for iron deficiency anemia. At birth, healthy full-term infants have enough iron storage in their bodies to last four to six months. However, they need a continuous supply of iron through infancy and the toddler years because of their rapid growth. The American Academy of Pediatrics recommends six months of exclusive breastfeeding from birth. Should the mother change the baby to formula, she should purchase the iron fortified preparation.

The baby’s gastrointestinal system will absorb iron from breast milk much better than it will from iron-fortified formula. Cereals which are iron fortified are beneficial for babies after discontinuation of breastfeeding at six months of age. Premature or low birth weight infants will be at risk for iron deficiency too because their body iron stores are lower than those of healthy full-term babies.

Infants should not receive cow’s milk prior to their first birthday because it contains very little iron and does not absorb well in the baby’s digestive system. Furthermore, cow’s milk can cause blood loss from the baby’s gastrointestinal tract. The greatest risk for iron deficiency in pediatric patients is between six months and three years of age.

It is also a concern for children between the ages of one and five who receive more than 24 ounces of cow, goat, or soy milk every day. Not only is milk low in iron, but it also may, in large amounts, serve to replace other foods which are rich in iron. Children with chronic infections and dietary restriction are at risk for iron deficiency as well, and their nutritional status requires careful attention.

Iron deficiency is a preventable medical condition, and when it does occur, physicians can usually treat it with success.


National Institutes of Health. Office of Dietary Supplements. Dietary supplement fact sheet: Iron.

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