Iron deficiency anaemia (IDA) is the most common nutritional deficiency worldwide and is especially prevalent in women and children.
Iron deficiency (ID) is the leading cause of anaemia in the world, yet it often goes unrecognised.
In a recent study of iron status in a healthy South African adult population, the prevalence of ID was 39,8% in all participants, and as high as 56,6% in females.
What is iron deficiency anaemia?
ID occurs when the iron stores in the body become depleted, which can lead to anaemia. To manage anaemia, it helps to understand it.
“It occurs when the level of red blood cells in blood is too low,” explains Dr Jon Patricios, a specialist in sports medicine.
“The most common cause is inadequate amounts of the mineral iron and this is called iron-deficiency anaemia. Iron is required to make a protein called haemoglobin.” Haemoglobin is responsible for oxygen transport around the body.
What causes it and who is at risk?
Iron-deficiency anaemia can be caused by poor absorption or internal bleeding.
A deficiency can have serious repercussions, from delayed physical, mental and social development in children, to ill health and lethargy in adults, and reduced capacity to study and work.
“Children at greater risk for iron deficiency include premature babies, those drinking unfortified baby formula and those who drink cow’s or goat’s milk before age one,” says Dr Patricios.
Cow’s milk has little iron and includes calcium, which can inhibit iron absorption.
For adolescent girls and adult women, the cause of deficiency is primarily heavy menstrual bleeding, says Dr Patricios.
“Pregnant and breastfeeding women also have greater demands for iron as iron is lost in breast milk.” Their iron stores must serve their increased blood volume and provide haemoglobin for the growing foetus (3).
What are the symptoms?
“It’s vital to recognise the signs of anaemia,” says Dr Patricios.
- Extreme fatigue and weakness
- Pale skin
- Chest pain
- Fast or irregular heartbeat
- Shortness of breath
- Dizziness or lightheadedness
- Cold hands and feet and tingling legs
- Inflammation or soreness of your tongue
- Brittle nails
- Poor appetite
- Unusual cravings for non-nutritive substances such as ice or earth
If you or your children have these symptoms, see a healthcare provider who will take a medical history and do tests to confirm anaemia, Dr Patricios advises.
Prevention and treatment
For babies, feeding should start with breast milk for at least six months, followed by iron-fortified formula in the first year, and after one year, limiting them to 590 ml of cow’s milk a day.
Key to managing anaemia for children and adults is a well-balanced diet, Dr Patricios says. This includes eating foods higher in iron.
“These are red meat (especially beef and liver), and to a lesser extent, chicken, pork and shellfish. Non-meat sources of iron include iron-fortified breads and cereals, spinach and other dark, leafy vegetables, peas, lentils and beans, tofu and prunes.”
However, with today’s busy lifestyles, meals can be rushed or skipped, and you may benefit from an iron supplement.
The usual recommended dose of oral iron for the treatment of IDA in adults is 100 to 200 mg of elemental iron daily. Many supplements contain only small amounts of this. Pleasant tasting Ferrimed® contains 100% elemental iron and is available in a wide range of formulations. Ferrimed® also contains Fe3+ which allows the body to absorb the iron in a controlled way. It has fewer and milder side effects, such as constipation and nausea, and it can be taken conveniently with food.
- World Health Organisation: www.who.int/nutrition/topics/ida/en
- Phatlhana, D.V., Zemlin, A.E., Matsha, T.E., Hoffman, M., Naidoo, N., Hoffman, M., et al . ‘The iron status of a healthy South African population’. Clinica Chimica Acta 460 (2016) 240-245.
- Mayo Clinic: www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/dxc20266514
- Ziegler, E.E. ‘Consumption of cow’s milk as a cause of iron deficiency in infants and toddlers’. Nutr Rev. 2011Nov;69 Suppl 1:S37-42.
- Wang, W., Bourgeois, T., Klima, J. ‘Iron deficiency and fatigue in adolescent females with heavy menstrual bleeding’. Haemophilia. 2013; 19(2):225-230.
- Toblli, J.E., Brignoli, R. (2007). ‘Iron (III)-hydroxide polymaltose complex in iron deficiency anaemia/review and metanalysis’. Cold Spring Harb Perspect Med 2013;3:a011866. 7
- Geisser, p. ‘Safety and efficacy of iron (III)-hydroxide polymaltose complex/ar review of over 25 years experience’. Arzneimittelforschung 2007;57:439-452
- Oritz, R., Toblli, J.E., Romero, J.D. Monterrosa, B., Frer, C., Macagno, E., et al. (2011) ‘Efficacy and safety of oral iron (III) polymaltose complex versus ferrous sulfate in pregnant women with iron-deficiency anaemia: a multicentre, ramdomised, controlled study’. J Matern Fetal Neonatal Med 2011; 24:1-6.
- Geisser, P. ‘In vitro studies on interactions of iron salts and complexes with food-stuffs and medicaments’. Arzneimittelforschung 1990; 40:754-760.
- Lundqvist, H., Sjoberg, F. ‘Food interaction of oral uptake of iron: a clinical trial using 59Fe’. Arzneimittelforschung 2007;57:401-416.
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