Recently, I had a patient present in the hospital who was found to have anemia. She was surprised with the results, as she did not know anything was amiss. Except for mild symptoms and feeling stressed, she could go on with her many daily activities. Further testing revealed the patient to have iron deficiency. She thought she was eating a balanced diet. What happened?
Iron makes up our blood. Specifically, the red blood cells use iron to hold on and carry oxygen to our organs and tissues. Iron is mainly consumed in the diet, and the better-absorbed heme-version can be found in meat, poultry and seafood. Non-heme iron can be found in fruits, vegetables, legumes and juices. Our red blood cells usually circulate for 180 days. Our body recycles and reuses the iron to create more blood at the end of their lifespan.
However, if we bleed, we lose valuable stores of iron. Bleeding in women can occur with vaginal versus intestinal bleeding. Women and men can both lose iron through colonic bleeding. Iron loss can cause iron deficiency, leading to hair loss, fatigue, lightheadedness, shortness of breath, nail abnormalities and weakness. Iron deficiency has also been linked to anxiety and depression.
There is also evidence to show that low iron during pregnancy can lead to fetal cognitive deficits later on. The World Health Organization determined that the prevalence of anemia in women globally is 29.9% for those between the ages of 15-49. The rates for children are even more dire, with a 39.8% global rate of children between the ages of 6-59 months suffering from anemia.
Independent reporting for Pine Bluff & Jefferson County since 1879.
So, how do we check for iron deficiency?
The doctor will check your cells by ordering a complete blood count (CBC). A CBC provides the numbers of white blood cells, red blood cells and platelets. A reduction in the red blood cells is generally called an anemia. Iron deficiency can cause anemia, but it is only one of many causes. To check if you have iron deficiency, the doctor must order an iron panel, which includes several tests to determine the iron level.
The United States Preventative Services Task Force recently recommended against screening pregnant females without symptoms for iron deficiency as they were unable to determine if doing so led to any difference in outcomes. However, if you have any of the symptoms listed above, seek a further evaluation with your physician to see if you are anemic.
Symptoms such as fatigue, weakness and overall lethargy can be seen in various diseases. A complete blood count is a simple and basic test that can start evaluating what is going on with you. Iron deficiency is easy to treat and requires daily iron medication. Pregnant or not, don’t delay asking your doctor if you may be low in iron.
Sources: Weyand AC, Chaitoff A, Freed GL, Sholzberg M, Choi SW, McGann PT. Prevalence of Iron Deficiency and Iron-Deficiency Anemia in US Females Aged 12-21 Years, 2003-2020. JAMA. 2023;329(24):2191-2193. doi:10.1001/jama.2023.8020; https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children; and https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/iron-deficiency-anemia-in-pregnant-women-screening-and-supplementation.
Dr. Naznin Jamal is a Jefferson Regional Medical Center hospitalist.