By nature of being busy women, most of us feel our energy levels wane once in a while. But if your fatigue is severe and totally unexplained, or if it comes with other symptoms, such as pale skin, weakness and headache, you could have a blood condition known as iron deficiency anemia (IDA).
IDA is widespread, especially in women. In fact, it's the most common nutritional disorder in the world. In the United States alone, 9 percent to 12 percent of non-Hispanic white women and nearly 20 percent of black and Mexican-American women have IDA.
IDA is the most common form of anemia, a condition where the body fails to produce enough healthy red blood cells, which are necessary for transporting oxygen throughout the body. Iron acts as an important building block for red blood cells in the body. It helps form hemoglobin, the part of red blood cells that carry oxygen from the lungs to the rest of the body and return carbon dioxide to the lungs to be exhaled.
Determining What's Sapping Those Red Cells: Causes of IDA
The main causes of IDA are blood loss, inadequate intake of iron in the diet, or problems absorbing iron. You are at an increased risk for IDA if you:
- menstruate, particularly if your menstrual periods are heavy
- are pregnant, breastfeeding or recently gave birth
- recently underwent major surgery or physical trauma
- have certain gastrointestinal disease, such as celiac sprue, or inflammatory bowel disease, such as Crohn's disease or ulcerative colitis
- have peptic ulcer disease
- eat a diet low in iron-rich foods, such as a vegan or vegetarian diet
- have had weight-loss surgery, such as a gastric bypass operation
Children who drink more than 16 to 24 ounces of cow's milk per day also have a higher risk of IDA, because cow's milk can interfere with iron absorption and irritate the lining of the intestines, leading to blood loss.
Identifying IDA: Signs and Symptoms
The symptoms of iron deficiency anemia vary depending on the severity. In mild cases, IDA may cause irritability, weakness, fatigue, headaches and trouble concentrating.
More severe cases of IDA may cause pale skin, brittle nails, shortness of breath, a blue color in the whites of the eyes, increased heart rate, sore tongue, pounding or "whooshing" sounds in the ears and light-headedness upon standing. In some cases, IDA can spark a craving for ice or clay, called pica.
If you suspect you may have IDA, see your health care professional. He or she will first conduct a medical history and ask you about symptoms. Diagnosis may also involve tests, including:
- blood tests to check for hematocrit and hemoglobin, which measure the amount of red blood cells
- tests to check for the amount of iron in your blood
- a test for blood in the stool, called a fecal occult blood test
- a urine test to look for blood or hemoglobin
- imaging tests that check for abnormalities in the gastrointestinal tract, such as upper endoscopy or colonoscopy, capsule enteroscopy, barium enema, barium swallow, or small bowel biopsy
- a gynecologic evaluation in women with excessive menstrual blood loss, including pelvic ultrasound or uterine biopsy
In addition, your health care professional may order tests to rule out other conditions that can cause IDA, like inherited blood disorders, chronic infection, kidney failure, autoimmune diseases and inflammatory disorders.
Getting the Red Back In: Treatments for IDA
Treatment for IDA depends on its cause, the severity of the anemia and the individual case. To determine the best treatment for you, your health care professional will consider all factors, including your age, health and medical history.
Most often, treatment includes taking iron supplements, either in the form of pills or intravenous (IV) iron. In a person who is actively bleeding or who has severe symptoms, treatment may require a blood transfusion.
Your health care professional may also ask you to boost intake of iron-rich foods as part of treatment for IDA. Add these iron-rich foods to your diet:
- chicken and turkey
- dark leafy greens, such as kale, collards, turnip greens and broccoli
- egg yolks
- fish, such as sardines and anchovies
- iron-enriched white bread, cereal, pasta and rice
- legumes, such as pinto beans, green peas, lima beans, and dry beans and peas
- meats—beef, pork, lamb, liver and other organ meats
- peanut butter
- raisins, prunes and apricots
- shellfish, including clams, mussels and oysters
- whole-wheat breads and rolls that contain yeast
The type of iron found in meat, fish and poultry—heme iron—is more readily absorbed for use in your body. Non-heme iron, which is found in plant foods as well as meat, isn't absorbed as completely as heme iron but is still good to eat. Non-heme iron is more completely absorbed if you eat it along with foods containing heme iron or foods high in vitamin C, like tomatoes, citrus fruits and peppers.
To prevent IDA, the best thing you can do is make sure you get sufficient iron in your diet. During periods when your body requires extra iron, such as during pregnancy or breastfeeding, boost your iron intake even more with food and talk to your health care professional about iron supplements.
This resource was developed with the financial support of AMAG Pharmaceuticals, Inc.