Iron Deficiency Anaemia – Symptoms, Causes and Treatment

large red blood cells floating against purple background

Today I celebrated my blood test results. After almost two years of being severely iron deficient, my iron levels are finally well within the normal range.

What is Iron Deficiency Anaemia?

Iron deficiency anaemia occurs when your body doesn’t have enough iron. Iron is a mineral responsible for the production of haemoglobin, an iron-rich protein that helps the red blood cells carry oxygen from the lungs to the rest of the body.

Iron-deficiency anaemia usually develops over time if your body doesn’t have enough iron to build healthy red blood cells. Your body starts using the iron it has stored and once that is used up your body makes fewer and smaller red blood cells which contain less haemoglobin. The result is that you cannot get enough oxygen, leaving you tired and short of breath.

What are the Symptoms of Iron Deficiency Anaemia?

About two years ago I noticed I was getting out of breath very easily. After climbing the stairs at home I would have to sit down to catch my breath and in my powerwalking classes I was huffing and puffing so badly I feared I might have a heart attack.

At the time I put it down to my asthma. The asthma nurse advised me to take two puffs of my Ventolin inhaler before exercising but the breathlessness continued.

I was also feeling extremely tired and after a morning powerwalking class I would be exhausted for the rest of the day and unable to concentrate. I thought exercise was meant to be energising but I was feeling a lot worse for it.

I only found out I had iron deficiency anaemia after I went to the doctor about a completely unrelated complaint and a full blood count revealed that my iron levels were abnormally low. Finally, all these symptoms, along with my pale skin colour, dark rings under my eyes and loss of hair under my arms started to make sense.

Some of the symptoms of iron deficiency anaemia are easily confused with other conditions. In my case I thought my thyroid was underactive again.

The symptoms of iron deficiency anaemia include:

  • Extreme fatigue
  • Pale skin
  • Weakness
  • Shortness of breath
  • Headache
  • Dizziness or lightheadedness
  • Cold hands and feet
  • Irritability
  • Inflammation or soreness of your tongue
  • Brittle nails
  • Fast heartbeat
  • Unusual cravings for non-nutritive substances, such as ice, dirt or starch
  • Poor appetite, especially in infants and children with iron deficiency anaemia
  • An uncomfortable tingling or crawling feeling in your legs (restless legs syndrome)
  • Hair loss

What are the Causes of Iron Deficiency Anaemia?

The next step was to find out what had caused my iron deficiency. Unfortunately, most doctors I have come across are not at all interested in the cause of an illness once they have a diagnosis. My GP prescribed some iron supplements and expected me to be on my way.

I persisted in wanting a reason and after a process of elimination she decided that as I was not vegetarian, ate red meat and did not have heavy periods, the most likely cause was gastro-intestinal bleeding.

Of course the alarm bells went off when I heard mention gastro-intestinal bleeding. After doing some  research on the internet I found out that the most common causes of gastro-intestinal bleeding are ulcers and inflammatory bowel disease. I asked for a Stool test to check for Helicobacter pylori, the bacteria which causes peptic ulcers, and a blood test to rule out Coeliac disease.

The results were negative, which was was good news but I was still nowhere closer to finding out the cause of my gastro-intestinal bleeding.

The most common causes of iron deficiency anaemia are:

  • Blood loss in women through long or heavy menstrual periods, bleeding fibroids in the uterus or during childbirth.
  • Internal bleeding through:
    • A bleeding ulcer, colon polyp, or colon cancer
    • Regular use of aspirin or other pain medicines, such as non-steroidal anti-inflammatory drugs (for example, ibuprofen)
    • Urinary tract bleeding
  • Blood loss from severe injuries, surgery, or frequent blood drawings
  • Poor diet
  • Pregnancy
  • Inability to absorb iron because of intestinal surgery (such as gastric bypass) or a disease of the intestine (such as Crohn’s disease or coeliac disease).

What is the Treatment for Iron Deficiency Anaemia?

I thought that perhaps my gut had become irritated during a particularly stressful time so the next step in my healing process was to try and soothe my gut and help it absorb iron from food more easily. I cut out alcohol, coffee and spicy foods for a while and stopped drinking black tea as the tannins in tea bind to minerals like iron and escort them out of the body before they can be absorbed.

Meanwhile, the iron supplements the doctor had prescribed were causing constipation so I switched to taking liquid iron in the form of Floradix which is easily absorbed.

Natural Sources of Iron

During this period I also started paying more attention to my diet. Visits to the local butcher became more frequent as I started eating plenty of calves liver and steak. I was also thrilled to discover that dark chocolate is an excellent source of iron as is ground ginger and curry powder.

Other foods rich in iron include:

  • lentils
  • fortified breakfast cereals
  • pumpkin seeds
  • dried apricots
  • haricot beans
  • eggs.

close up of orange slice

Vitamin C

If you are taking iron supplements or eating spinach and other iron rich foods, it’s important to take them with foods containing Vitamin C, like orange juice and strawberries, kale and peppers, to help with absorption of the iron.

Complications of Iron Deficiency Anaemia

If left untreated, iron deficiency anaemia can lead to health complications such as:

  • Rapid or irregular heartbeat. Because your heart has to pump more blood to compensate for the lack of oxygen carried in your blood it can lead to an enlarged heart or heart failure.
  • Problems during pregnancy. Severe iron deficiency anaemia has been linked to premature births and low birth weight babies.
  • Growth problems. In infants and children severe iron deficiency can delay growth and development. It also increases susceptibility to infections.
A Happy Ending

After many months, and several blood tests later, my story finally has a happy ending. I can exercise now without getting completely out of breath and climbing the stairs is a breeze, I continue to eat iron rich foods and take iron supplements and, I have to admit, tiredness is still a problem.

If you’ve been feeling tired lately and are out of breath I recommend having a blood test to test your iron levels. It’s a really common problem in women that is easily treated but so often goes undiagnosed.

Photo: Thanks to kingdesmond1337 on Flickr.com

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5 Responses to Iron Deficiency Anaemia – Symptoms, Causes and Treatment

  1. Thedoc Toriscrazy May 25, 2012 at 5:17 pm #

    Congratulations on joining the euferric! Yes, I just made up that word but it is a good one don’t you think? eu = good/happy/balanced + ferric = iron

    But unlike the doctors you describe, I *am* concerned about the cause of your anemia.

    I assume your periods are not especially heavy as that is the first thing your doctor would have checked. You mention GI bleeding as a potential cause, but you don’t mention if you ever got a stool test for faecal occult blood. Has this been done & what did it show?

    If bleeding is ruled out, do you think it could be years of poor diet? That you have responded to dietary supplements argues against it being a problem with absorption, or at least implies that your absorption is normal now.

    You should not have to spend the rest of your life taking iron supplements, so it *is* important to figure out the cause, even though the condition itself has been treated.

    And I have to put in a word on one of my pet peeves: taking dietary supplements *wrong*. Unless specifically instructed otherwise, dietary supplements should be taken with a meal. This means eat one-third of your food, then take your supplements, then finish the meal. This will ensure that your digestive juices are working at their max so more of the supplement will be absorbed, and the absorption will be *slowed* by mixing with the food so your body has more time to process the incoming nutrients. It will also help prevent the upset stomach some supplements can cause.

    I assume you will continue having your iron checked from time to time. Can I suggest that once it reaches the mid-normal range you start tapering the iron supplement and eventually replace it with a good quality multi-vitamin with minerals? Unless there is some underlying problem, that should be enough insurance against the occasional dietary inadequacy.

    Congratulations again!

    • Angie Macdonald May 25, 2012 at 5:35 pm #

      Thanks for this, doc, and yes, euferric is a brilliant word!

      Good point about how to take supplements – with the liquid iron it said to take it on an empty stomach 30 minutes before a meal. I normally take my multi-vitamin after a meal but will take them mid-meal from now on.

      I can’t remember if they tested for faecal occult blood when they tested for h-pylori. And I think my diet is pretty good – the only thing I could think of that was detrimental was the black tea.

      So, yes, you’re right, I do still need to figure out the cause. Thanks!

  2. Angela May 25, 2012 at 10:02 am #

    Glad you are feeling better, Angie. I too have sometimes deficiency in my iron levels when I feel tired or overall sluggish. Actually, given my lifestyle in perpetual movement I realised I wasn’t paying enough attention to the quality of my diet. Now that I changed my food habits and I’m careful about all the necessary nutrition properties, I feel I have more energy and my immune system is much more prepared for my trips 🙂

    • Angie Macdonald May 25, 2012 at 10:31 am #

      That’s great that you realised you needed to pay more attention to your diet, Angela, and I’m glad that you have more energy. I think it must be quite difficult to maintain a healthy diet if you’re travelling a lot and you’re not careful and conscious about what you eat. Happy travelling and good health to you!

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