Generally, the normal human body maintains a dynamic balance between trace excretion and compensatory intake of iron. If the excretion of iron in the body increases, or when the intake is insufficient, the lack of iron supply affects the normal production of red blood cells, and then the body develops iron deficiency anemia.
Morphologically, in iron deficiency anemia, red blood cells show small cellular hypochromic changes. This is due to the fact that iron is a necessary raw material for normal red blood cell production, as insufficient supply of iron affects hemoglobin production, while iron deficiency reduces the activity of iron-containing enzymes, thus affecting cellular metabolism. It is a common and frequent disease in hematology, affecting more than 500 million people worldwide, and can occur in all age groups, especially in children and women of childbearing age, including women during pregnancy and lactation.
Like other anemias, iron deficiency anemia is characterized by pale skin, lips, oral mucosa, conjunctiva, nails, fatigue, dizziness, tinnitus, loss of appetite, indigestion, and memory loss. In severe anemia, there may be hypothermia, rapid breathing and pulse, and enlarged heart.
The most direct and effective way to treat iron deficiency anemia is to take oral iron supplements, such as ferrous sulfate and ferrous gluconate, but do not take them with tea, milk and coffee at the same time, because such foods will reduce the absorption of iron. For gastrointestinal diseases, oral iron cannot be absorbed, or those who have serious gastrointestinal reactions to iron can choose to inject iron. After the hematocrit returns to normal, treatment should also be maintained for 3-6 months to replenish stored iron and prevent relapse. Dr. Yan also pointed out that it is also extremely important to actively treat the various primary causes of iron deficiency anemia, such as controlling chronic bleeding, treating excessive menstrual flow, and adding supplemental foods to infants and children in a timely manner.
Iron deficiency anemia is caused by the lack of iron in the body, therefore, infants, adolescents and women during pregnancy and lactation should eat iron-rich foods, and women with excessive menstruation and patients with chronic blood loss should be on a “high iron diet”. In the daily diet, foods with high iron content are animal liver, blood and other internal organs. The vegetables such as celery, rape, tomatoes, etc. have more iron; fruits such as apricots, peaches, plums, raisins, dates, prunes, oranges, grapefruit, etc. also have more iron, as well as mushrooms, fungus and seafood such as shrimp, jellyfish, kelp, nori, etc. are the preferred foods for treating iron deficiency anemia.
Vitamin C is a reducing agent that has the effect of enhancing the absorption of iron. The reason is that the iron in food is in the form of colloidal iron hydroxide of trivalent iron, trivalent iron can only be absorbed if it becomes divalent iron, and vitamin C as a reducing agent can turn trivalent iron into divalent iron. Therefore, to treat iron deficiency anemia, in addition to iron-rich foods provided by the diet, some vitamin C-rich foods must also be added. Vitamin C preparations can also be added to iron supplements to promote iron absorption.
Patients with iron deficiency anemia should be careful with their living. Patients should live in a clean environment with fresh air, go to public places as little as possible, and pay attention not to contact with people with colds and infectious diseases to avoid cross-infection and aggravation of the disease.
In addition, to strengthen physical exercise, proper physical exercise is also a good way to prevent and control iron deficiency anemia. If you are bedridden or lonely for a long time, you will suffer from depression and poor appetite, which will cause anemia or aggravate it. Therefore, except for severe anemia, easy palpitations after activity and the need for bed rest, people with mild anemia should participate in physical activity. This will not only increase the secretion and peristalsis of the gastrointestinal tract and promote appetite, but also improve the ability to resist disease, thus reducing infectious diseases.
What is iron deficiency anemia?
Iron deficiency anemia is a small-cell hypochromic anemia formed by a lack of stored iron in the body for hemoglobin synthesis, resulting in a decrease in the amount of hemoglobin synthesis. It is the most common form of anemia and can occur in all age groups, especially in women and infants.
Laboratory tests for iron deficiency anemia
Blood picture: The red blood cells are small-cell hypochromic. Usually the hemoglobin is less than 120 g/l for men and 110 g/l for women, and less than 100 g/l for pregnant women. The average volume of red blood cells is less than 80 cubic microns, the average hemoglobin of red blood cells is less than 27 micrograms, and the average hemoglobin concentration of red blood cells is less than 0.31.
Bone marrow picture: erythrocytes were actively proliferating, young erythrocytes were small in size, and cytoplasm was blue. Bone marrow iron staining suggested the disappearance of extracellular iron and iron granulocytes less than 0.15.
Why iron deficiency anemia is not effective
①The cause of iron deficiency has not been removed, e.g. bleeding has not stopped, and iron supplementation is not sufficient to replace the amount of iron lost.
②Insufficient dose of iron supplementation, the patient failed to take enough dose because of side effects of iron or other reasons.
③The patient has other causes of nutritional anemia present at the same time, such as megaloblastic anemia and iron deficiency at the same time.
④There is an error in diagnosis and the patient is not iron deficiency anemia.
There are three stages of iron deficiency anemia
Iron deficiency phase: It is the latent phase of iron deficiency, where only the iron stores are reduced to depletion.
Iron deficiency erythropoietic phase: there is a lack of stored iron, a decrease in serum iron and transferrin saturation, and iron deficiency in the red blood cells, but anemia has not yet occurred.
Development of iron deficiency anemia: decreased or deficient stored iron, with decreased serum iron and transferrin saturation, decreased hemoglobin levels, and decreased erythrocyte pressure volume.
Clinical manifestations of iron deficiency anemia
The clinical manifestations of iron deficiency anemia are not specific, and the symptoms are the same as those of anemia, i.e., pallor of the face, lips and nails, dizziness, headache, weakness, easy fatigue, palpitations, shortness of breath after activity, blurred eyes and ringing in the ears. Severe iron deficiency patients may develop spatulate nails (rebound nails), persistent low fever, retinal hemorrhage, stomatitis, tongue inflammation, chapped corners of the mouth, dry and cracked skin, etc. A few patients also have xenophagia, preferring to eat wall dirt, mud, etc.
In addition, anemia can cause systemic tissue and organ symptoms due to hypoxia and ischemia. ①When the cardiovascular system is deprived of oxygen, it can lead to rapid heartbeat, panic and shortness of breath. In severe anemia, myocardial hypoxia is obvious, leading to heart enlargement and heart failure. ②When the gastrointestinal tract is hypoxic, gastrointestinal dysfunction, loss of appetite, nausea and vomiting, diarrhea and other manifestations may occur. ③Brain tissue hypoxia will result in dizziness, drowsiness, weakness and memory loss. ④If the reproductive system is affected, menstrual disorders and changes in libido may occur.
Four factors cause iron deficiency anemia in children
The first one is congenital insufficiency of iron stores, i.e., the child does not get enough iron from the mother when the woman is pregnant, plus rapid growth after birth. Premature birth, pediatric blood loss, and the mother’s own iron deficiency anemia can all lead to inadequate congenital iron stores in children.
The second is inadequate intake, which mainly refers to the fact that the food eaten does not contain enough iron.
The third is poor absorption, although the child eats food containing iron, but due to the food mix is not reasonable, but also affect the absorption of iron in the child’s body.
The fourth is that the child’s diarrhea also leads to iron loss, parents should also pay more attention to this, and find diarrhea should be treated in a timely manner.
Common causes of iron deficiency anemia
Iron deficiency anemia is easily caused by the lack of iron in the diet of infants, adolescents and women of childbearing age, especially women with multiple pregnancies and breastfeeding, who need more iron. Moreover, adolescent girls are prone to iron-deficiency anemia because of the onset of menstruation and their faster body growth and development, and their need for iron is also high.
Poor absorption of iron
Patients suffering from atrophic gastritis, gastric acid deficiency, and post-gastrectomy can suffer from iron deficiency anemia due to the lack of gastric acid affecting the freeing of high-valent iron in food, as well as the rapid entry of food into the jejunum without passing through the duodenum after major gastrectomy, or small intestine mucosal lesions, chronic diarrhea, and large amounts of tea after meals, which can cause iron absorption disorders and iron deficiency anemia due to the precipitation of iron by manic acid in tea.
Chronic blood loss
In adult men, it is gastrointestinal bleeding, and in adult women, it is excessive menstrual flow. Ulcer disease, gastritis, gastric cancer, intestinal cancer, hemorrhoids, hookworm disease, chronic hemoptysis and uterine fibroids can all lead to iron deficiency. In addition, iron excreted from the urine with hemoglobin or iron-containing heme due to chronic intravascular hemolysis can also cause iron deficiency anemia, mostly seen in paroxysmal sleep hemoglobinuria.