Iron deficiency anemia is a disease characterized by a decrease in the level of hemoglobin in the blood. According to the results of studies in the world, about 2 billion people suffer from this form of anemia of varying severity.
Children and lactating women are most susceptible to this disease: every third child in the world suffers from anemia, almost all lactating women have anemia of varying degrees.
This anemia was first described in 1554, and the drugs for its treatment were first applied in 1600. It is a serious problem that threatens the health of society, as it has no small impact on performance, behavior, mental and physiological development.
This significantly reduces social activity, but, unfortunately, anemia is often underestimated, because gradually a person becomes accustomed to a decrease in iron stores in his body.
Causes of iron deficiency anemia
What it is? Among the causes of iron deficiency anemia, there are several. Often there is a combination of reasons.
Iron deficiency is often experienced by people whose body requires an elevated dose of this trace element. This phenomenon is observed with increased growth of the body (in children and adolescents), as well as during pregnancy and lactation.
The presence of a sufficient level of iron in the body depends largely on what we eat. If the diet is unbalanced, food intake is irregular, the wrong foods are consumed, then in aggregate all this will cause a lack of iron in the body with food. By the way, the main food sources of iron are meat: meat, liver, fish. Relatively much iron in eggs, beans, beans, soybeans, peas, nuts, raisins, spinach, prunes, pomegranate, buckwheat, black bread.
Why does iron deficiency anemia appear, and what is it? The main reasons for this disease are as follows:
- Insufficient intake of iron in the diet, especially in newborns.
- Disruption of suction.
- Chronic blood loss.
- Increased need for iron with intensive growth in adolescents, during pregnancy and lactation.
- Intravascular hemolysis with hemoglobinuria.
- Violation of iron transport.
Even minimal bleeding of 5-10 ml / day will result in a loss of 200-250 ml of blood per month, which corresponds to approximately 100 mg of iron. And if the source of latent bleeding is not established, which is quite difficult due to the absence of clinical symptoms, then after 1-2 years the patient may develop iron deficiency anemia.
This process occurs faster in the presence of other predisposing factors (impaired absorption of iron, insufficient consumption of iron, etc.).
How does IDA develop?
- The body mobilizes reserve iron. There is no anemia, no complaints, ferritin deficiency can be detected during the study.
- Mobilized tissue and transport iron, hemoglobin synthesis saved. There is no anemia, dry skin, muscle weakness, dizziness, signs of gastritis. The examination revealed a deficiency of serum iron and a decrease in transferrin saturation.
- All funds are affected. Anemia appears, the amount of hemoglobin decreases, and then the red blood cells decrease.
The degree of anemia of iron deficiency in hemoglobin content:
- easy - hemoglobin does not lower below 90 g / l;
- average - 70-90 g / l;
- severe - hemoglobin below 70 g / l.
Normal levels of hemoglobin in the blood:
- for women - 120-140 g / l;
- for men - 130-160 g / l;
- in newborns - 145-225 g / l;
- children 1 month. - 100-180 g / l;
- children 2 months. - 2 years. - 90-140 g / l;
- in children 2-12 years old - 110-150 g / l;
- children 13-16 years old - 115-155 g / l.
However, the clinical signs of severity of anemia do not always correspond to the severity of anemia according to laboratory criteria. Therefore, the proposed classification of anemia according to the severity of clinical symptoms.
- Grade 1 - no clinical symptoms;
- 2 degree - moderately expressed weakness, dizziness;
- Grade 3 - there are all the clinical symptoms of anemia, disability;
- Grade 4 - represents the grave state of precoma;
- 5 degree - is called "anemic coma", lasts several hours and is fatal.
Signs of latent stage
Latent (hidden) iron deficiency in the body can lead to symptoms of sideropenic (iron deficiency) syndrome. They have the following character:
- muscle weakness, fatigue;
- decreased attention, headaches after mental exertion;
- to salt and spicy, spicy food;
- sore throat;
- dry pale skin, paleness of mucous membranes;
- brittle and pale nail plates;
- hair dullness.
Somewhat later, an anemic syndrome develops, the severity of which is caused by the level of hemoglobin and red blood cells in the body, as well as the speed of anemia (the faster it develops, the more severe the clinical manifestations will be), the compensatory capabilities of the body (in children and the elderly, they are less developed) and the presence of concomitant diseases.
Symptoms of iron deficiency anemia
Iron deficiency anemia develops slowly, so its symptoms are not always pronounced. Anemia often exfoliates, deforms and breaks nails, splits hair, skin becomes dry and pale, there are stickings in the corners of the mouth, weakness, indisposition, dizziness, headache, flickering flies before eyes, fainting appears.
Very often in patients with anemia, a change in taste is noted, an irresistible craving for non-food products, such as chalk, clay, and raw meat, appears. Many begin to attract sharp odors, such as gasoline, enamel paint, acetone. The full picture of the disease opens only after a general blood test for basic biochemical parameters.
Diagnosis of IDA
In typical cases, the diagnosis of iron deficiency anemia is not difficult. Often the disease is detected in the analyzes, passed on a completely different reason.
In general, a manual blood test reveals a decrease in hemoglobin, a color index of blood, and hematocrit. When performing a KLA on the analyzer, changes are detected in erythrocyte indices characterizing the hemoglobin content in erythrocytes and the size of erythrocytes.
Identification of such changes is the reason for the study of iron metabolism. More details of the assessment of iron metabolism are disclosed in the article on iron deficiency.
Treatment of iron deficiency anemia
In all cases of iron deficiency anemia, before starting treatment, it is necessary to establish the immediate cause of this condition and, if possible, eliminate it (most often, eliminate the source of blood loss or treat the underlying disease, complicated by sideropenia).
Treatment of iron deficiency anemia in children and adults should be pathogenetically substantiated, comprehensive and aimed not only at eliminating anemia as a symptom, but also at eliminating iron deficiency and replenishing its reserves in the body.
The classic treatment of anemia:
- elimination of the etiological factor;
- organization of proper nutrition;
- taking iron supplements;
- prevention of complications and recurrence of the disease.
With proper organization of the above procedures, you can count on getting rid of the pathology within a few months.
In most cases, iron deficiency is eliminated with the help of iron salts. The most affordable drug that is used to treat iron deficiency anemia today is iron sulfate tablets, it contains 60 mg of iron, and take it 2-3 times a day.
Other iron salts, such as gluconate, fumarate, lactate, also have good absorption properties. Considering the fact that the absorption of inorganic iron with food decreases by 20-60% with food, it is better to take such drugs before meals.
Possible side effects from iron supplements:
- metallic taste in the mouth;
- abdominal discomfort;
- nausea and / or vomiting.
The duration of treatment depends on the ability of the patient to absorb iron and continues until the laboratory blood counts (red blood cell count, hemoglobin, color index, serum iron level and iron binding capacity) are normalized.
After eliminating signs of iron deficiency anemia, the use of the same drug is recommended, but in a reduced prophylactic dose, since the main focus of treatment is not so much the elimination of signs of anemia, as the replenishment of iron deficiency in the body.
Diet for iron deficiency anemia is the consumption of foods rich in iron.
It is shown good nutrition with the mandatory inclusion in the diet of foods containing heme iron (veal, beef, lamb, rabbit meat, liver, tongue). It should be remembered that ascorbic, citric, succinic acid contribute to the enhancement of ferrosorption in the gastrointestinal tract. Oxalates and polyphenols (coffee, tea, soy protein, milk, chocolate), calcium, dietary fibers and other substances inhibit the absorption of iron.
However, no matter how much we eat meat, only 2.5 mg of iron will get into the blood from it per day - this is how much the body is able to absorb. And from iron-containing complexes absorbed 15-20 times more - which is why with the help of a diet alone, the problem of anemia is not always possible to solve.
Iron deficiency anemia is a dangerous condition that requires an adequate approach to treatment. Only long-term administration of iron supplements and elimination of the cause of bleeding will lead to getting rid of the pathology.
To avoid serious complications of treatment, laboratory blood tests should be constantly monitored throughout the course of disease therapy.