Anemia is commonly referred to as a disease caused by a decrease in the volume of red blood cells in the body’s peripheral blood below the lower limit of the normal range, resulting in corresponding clinical symptoms. Because of the complexity of red blood cell volume measurement, the presence of anemia is often judged clinically by the measurement of hemoglobin (Hb) concentration. The synthesis of hemoglobin requires the participation of iron, and iron deficiency has a serious impact on the synthesis of Hb. Insufficient intake, impaired absorption or excessive consumption of iron for any reason will result in a lack of stored iron in the body and eventually cause a decrease in the production of hemoglobin. This kind of anemia caused by iron deficiency is called iron deficiency anemia in medical science.
I. What are the common causes of iron deficiency anemia?
Generally speaking, the incidence of iron deficiency anemia is higher in women than in men. The main cause of iron deficiency anemia in men is closely related to their poor living habits, such as addiction to tobacco and alcohol, drinking strong tea, etc.. Tea contains a lot of tannic acid, and after drinking a lot of strong tea, tannic acid combines with iron to form an insoluble substance, which hinders the absorption of iron. Coffee and antacid drugs can also lead to impaired absorption of iron. In contrast, vitamin C, amino acids and fructose are beneficial for iron absorption. For female patients, the main influencing factors are excessive menstrual flow and prolonged periods. And as chronic blood loss due to hookworm disease, gastrointestinal inflammation, tumor, chronic liver disease, recurrent hemorrhoid bleeding and other chronic blood loss is also the cause for some patients, they should be vigilant for timely screening of related diseases.
Second, what are the characteristic manifestations of iron deficiency anemia for us to identify?
The common manifestations of anemia include weakness, easy tiredness, dizziness, headache, tinnitus, palpitations, shortness of breath, loss of appetite, etc. It may also be accompanied by pallor and rapid heart rate. These symptoms are mainly related to insufficient oxygen supply to several organs and tissues of the body. Due to iron deficiency, there may also be abnormal mental behavior, such as irritability, irritability, inattention, xenophagia, decreased physical strength and endurance, susceptibility to infection, stomatitis, tongue inflammation, tongue papillae atrophy, stomatitis, iron deficiency dysphagia, dry hair, loss of hair, lack of luster of finger (toe) nails, brittle and easy to crack, and in severe cases, flattened finger and toe nails, or even depressed in a spoon shape (spoon nail), which is often referred to as Anti-nail. However, with the improvement of medical treatment and people’s health awareness, many typical symptoms of iron deficiency anemia are not common. Patients with anemia symptoms should actively go to the hospital for relevant examinations to help early detection and early treatment.
What necessary tests should be done for iron deficiency anemia?
Generally, according to the patient’s symptoms and signs (pale face, pale lips and nails, dizziness and weakness, etc.), those who are considered to be anemic should undergo targeted examinations, including blood routine, serum iron content, transferrin saturation, protoporphyrin, etc. Among them, routine blood tests often show microcytic hypochromic anemia, and red blood cell morphology may have obvious hypochromic manifestations. Among the other indicators, serum ferritin is the more sensitive one. In addition, iron staining can be performed on the patient’s bone marrow to understand the storage of iron in the body, which also helps to diagnose and detect the effect of treatment.
How to prevent the occurrence of iron deficiency anemia in middle-aged and elderly people?
Some middle-aged and elderly patients with chronic diseases may suffer from iron deficiency anemia due to lack of stomach acid, atrophic gastritis, chronic enteritis and long-term use of antacid drugs and some zinc, magnesium and copper preparations, which affect the absorption and utilization of iron by the body. Therefore, for patients with the above-mentioned diseases, the first step is to treat gastric diseases and adjust the habits of medication. Food should be diversified, cereals should be the mainstay to ensure adequate nutrition, intake of rich good protein food and more iron-rich food. Don’t overly abstain from eating, correct partial eating in time and have a balanced diet. Patients with iron deficiency anemia should avoid drinking strong tea while taking iron, and it is advisable to take iron after meals, and actively participate in physical exercise to enhance appetite.
Fifth, will the middle-aged and elderly people often eat vegetarian food cause iron deficiency anemia?
Many elderly people usually prefer vegetables and vegetarian food, which contain a lot of oxalic acid and other substances that can easily combine with iron and affect the absorption of iron. If this is the case for a long time, it is likely to cause vitamin B12 and iron deficiency in the body. Non-vegetarian foods, such as animal blood, offal and lean meat contain high levels of heme iron, are easily absorbed and can be used directly by the body, and are the main source for people to obtain iron from the outside world. The iron content of some foods is as follows: beef liver (42%), beef kidney (22%), beef (11%), ham (10%), egg yolk (6%), milled cereals, pure sugar and fruits have a very low iron content. Therefore, it is recommended that the elderly should not eat vegetarian food for a long time, but if they cannot change their diet, they can consider vegetarian food with relatively high iron content, such as: black fungus, red dates, black dates, black beans, rye, purple rice, etc. All in all, the main means to prevent iron deficiency anemia in middle-aged and elderly people is to harmonize the diet and match the meat and vegetables.
Is it effective to take blood supplements for a long time?
There are many kinds of blood supplements on the market, but generally speaking, taking iron-based supplements is beneficial to the treatment of iron deficiency anemia. Patients should not take them indiscriminately, but sometimes delay the disease and lose more than they gain. It is recommended to regulate under the guidance of physicians. If the condition is serious, timely examination should be conducted to find out the cause of iron deficiency anemia and to deal with the original disease.
7. Can I stop the medication immediately after the hemoglobin rises to normal level after treatment?
For the treatment of iron deficiency anemia, doctors often give iron supplementation treatment while controlling the primary disease, such as gastritis and hemorrhoids. Generally, if the diagnosis is correct, the reticulocytes in the patient’s blood routine will rise within 5-10 days, followed by a significant improvement in hemoglobin and a corresponding degree of improvement in clinical anemia symptoms. However, after the hemoglobin is normalized, it is still not possible to stop the medication immediately, but should be continued for about 3-6 months under the guidance of a doctor. Because the normalization of hemoglobin is a manifestation of sufficient available iron in the body, but the recovery of stored iron takes a longer time, during which the blood routine should be reviewed frequently to pay attention to changes in the condition.
VIII. What kind of discomfort will I experience when taking oral iron supplements? What should I pay attention to when taking them?
Some patients may have gastrointestinal reactions to oral iron supplements, so it is recommended that iron supplements should be taken after meals. At the same time, eating cereals, dairy and strong tea during medication may affect the absorption of iron, while fish, meat and vitamin C may promote its absorption, so it is especially important to adjust the diet appropriately. If the discomfort caused by oral iron is not tolerated, or if the absorption of iron in the intestine is impaired due to digestive tract dysfunction, patients may be advised to use intramuscular injections of iron dextran. However, this method also has its limitations and may result in causing myositis at the injection site, pain is evident as the main reason why some patients cannot receive intramuscular injections, and violent and sometimes fatal allergic reactions may occur.
IX. What should I do if I overdose on iron? What are the adverse consequences?
Generally, intramuscular and intravenous iron injections are prone to overdose, while oral administration is generally not. Iron overdose without timely correction can cause many symptoms, including abnormalities in liver, kidney and heart functions. In mild cases, it can cause heart rate disorders, and in severe cases, it can be complicated by hemochromatosis and liver cirrhosis, and renal failure can occur, directly threatening the patient’s life. Therefore, patients should not take iron supplements indiscriminately and without scruples because of their original iron deficiency, but should take them strictly in accordance with medical advice, and frequently recheck serum iron. Once the presence of iron overload is detected, it should be immediately discontinued and active de-ironing treatment should be carried out by a regular hematologist.
X. Does Chinese herbal medicine have good efficacy in treating iron deficiency anemia?
For the treatment of iron deficiency anemia, Chinese herbal medicine is mainly based on dialectical treatment in Chinese medicine or on the basis of iron supplementation. In general, it is mainly to benefit qi and nourish blood, and to nourish spleen and kidney, which can achieve twice the effect with half the effort. After comprehensive analysis, most of the current iron supplementation treatment has not obtained the expected effect, and the main reason is that the gastrointestinal adverse reactions caused by iron supplementation make patients unable to tolerate or refuse to take further medication. Chinese medicine, on the other hand, can be added and subtracted according to the symptoms, and has the effect of strengthening the spleen and stomach, reducing the appearance of gastrointestinal discomfort and other reactions during patient treatment, and improving the symptoms of loss of appetite in some patients, thus increasing the intake of edible iron and further improving anemia. However, it must be emphasized that the etiological treatment of iron deficiency anemia is the key to successful treatment.