What Is Iron Deficiency Anemia?

Iron deficiency anemia occurs when the body doesn’t have enough iron to make a normal supply of red blood cells.

What Causes Iron Deficiency Anemia?

The cause is usually loss of blood resulting in increased iron requirements to make more blood cells to replace the ones that are lost or having too little iron in the diet. Normally, the body saves iron. As old red blood cells break down, iron inside is reused to make new red blood cells.

Iron-rich foods are animal products such as meat, milk, and eggs. Vegetables such as spinach and broccoli are iron rich, but the intestine can’t absorb them as well. In developing countries, poor nutrition is the main cause of anemia. In Europe and the United States, chronic blood loss is more often the cause of iron deficiency.

People who are vegetarians (don’t eat animal products), have a poor diet, or need large amounts of iron (such as pregnant or nursing women) have greater chances of getting the disorder. Also at risk are people with celiac disease, gastric ulcers, or intestinal tumors.

What Are the Symptoms of Iron Deficiency Anemia?

Symptoms are feeling tired and dizzy and having trouble doing normal daily activities. Severe disease may cause shortness of breath and pale skin. Long-lasting disease causes sore mouth, trouble swallowing, and soft, curling fingernails.

Another symptom is craving crunchy foods or ice cubes or eating odd things such as dirt or clay (called pica).

How Is Iron Deficiency Anemia Diagnosed?

The health care provider makes a diagnosis by doing blood tests to measure the iron and hemoglobin content. Finding the reason for iron loss is important, especially for babies, teens, and pregnant women. Blood loss from the intestinal tract due to cancer or bleeding ulcers must be ruled out.

If the diagnosis remains unclear, the doctor may do a bone marrow test. A blood specialist will get a small sample of bone marrow from a spot near the hip and will study it with a microscope to determine the iron content and rule out other blood disorders that can cause anemia.

How Is Iron Deficiency Anemia Treated?

Treatment depends on how severe the anemia is. Usually, people need to take extra iron as pills or liquids. Iron is taken at least once daily for 3 to 6 months. Severe anemia may mean a blood transfusion. Recovery is slow. An iron supplement may be needed for several months or years; most people start feeling better in a few weeks after starting iron replacement.

DOs and DON’Ts in Managing Iron Deficiency Anemia:
  • DO take your iron supplement as directed by your health care provider.
  • DO take prenatal vitamins if you’re pregnant. Keep taking them if you breast-feed.
  • DO eat a well-balanced diet with foods high in iron, such as meat, beans, and leafy green vegetables.
  • DO watch for and report symptoms of worsening anemia. Call your health care provider if you have severe tiredness, dizziness, chest pain, or shortness of breath.
  • DO call your health care provider if you have bleeding or chronic bleeding increases.
  • DO call your health care provider if you have abdominal pain from the iron supplement. A lower dose or changing the supplement may help.
  • DON’T overexert yourself.

Contact the following sources:

  • The American Society of Hematology
    Tel: (202) 776-0544
  • Centers for Disease Control and Prevention
    Tel : (800) 311-3435
  • National Heart, Lung, and Blood Institute Health
    Information Center
    Tel: (301)592 8573

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor

Anemia is a common problem in children. About 20% of children in the U.S. will be diagnosed with anemia at some point. A child who has anemia does not have enough red blood cells or hemoglobin. Hemoglobin is a type of protein that allows red blood cells to carry oxygen to other cells in the body.

There are many types of anemia. Your child may have one of the following:

  • Iron deficiency anemia. Too little iron in the blood. Iron is needed to form hemoglobin. This is the most common cause of anemia. 
  • Megaloblastic anemia. Red blood cells are too large. One type of megaloblastic anemia is pernicious anemia. In this type, there is a problem absorbing vitamin B12, important to making red blood cells.
  • Hemolytic anemia. Red blood cells are destroyed. There are many different causes, such as serious infections or certain medications.
  • Sickle cell anemia. An inherited type of anemia with abnormally shaped red blood cells. It is a type of hemolytic anemia.
  • Cooley's anemia (thalassemia). Another inherited type of anemia with abnormal red blood cells.
  • Aplastic anemia. Failure of the bone marrow to make blood cells.

Because anemia is common in children, doctors do routine screening for it. Plus, it often has no symptoms. Most anemia in children is diagnosed with these blood tests:

  • Hemoglobin and hematocrit. This is often the first screening test for anemia in children. It measures the amount of hemoglobin and red blood cells in the blood.
  • Complete blood count, or CBC. A complete blood count checks the red and white blood cells, blood clotting cells (platelets), and sometimes, young red blood cells (reticulocytes). It includes hemoglobin and hematocrit and more details about the red blood cells.
  • Peripheral smear. A small sample of blood is examined under a microscope to see if they look normal.

To get a blood sample, a healthcare provider will insert a needle into a vein, usually in the child's arm or hand. A tourniquet may be wrapped around the child's arm to help the healthcare provider find a vein. Blood is drawn up into a syringe or a test tube. In some cases, blood can be taken using a needle prick.

Blood tests may cause a little discomfort while the needle is inserted. It may cause some bruising or swelling. After the blood is removed, the healthcare provider will remove the tourniquet, put pressure on the area, and put on a bandage.

Depending on the results of the blood tests, your child may also have a:

  • Bone marrow aspiration, biopsy, or both. This involves taking a small amount of bone marrow fluid (aspiration) or solid bone marrow tissue (called a core biopsy). The fluid or tissue is examined for the number, size, and maturity of blood cells and/or abnormal cells. 

Anemia has 3 main causes:

  • Loss of red blood cells
  • Inability to make enough red blood cells
  • Destruction of red blood cells

Decreased red blood cells or hemoglobin levels may be due to:

  • Inherited red blood cell defects
  • Infections
  • Some diseases
  • Certain medicines
  • Lack of some vitamins or minerals in the diet
Call your child's healthcare provider if you notice that your child has any of the symptoms of anemia. And, if your child has not been checked for anemia, talk with the provider about your child's risk of getting it.