Download Iron deficiency anaemia

Iron deficiency anaemia
What is it, why is it common
and how can it be managed?
What is Iron Deficiency Anaemia?
Symptoms
At its simplest level, iron deficiency anaemia (IDA) is a condition where a
lack of iron in the body (iron deficiency) reduces the number of oxygencarrying red blood cells circulating around the body (anaemia).1
A common indicator of IDA is a feeling of
exhaustion - those with IDA often report
feeling drained of energy, lethargic and
weak. Other common symptoms include
shortness of breath, irregular heartbeats,
headaches and dizziness.
Normal level
Anaemia
Those with IDA may also have some physical
signs such as paleness in the eyes, lips, skin
and nails or hair loss.5
Why does iron deficiency cause anaemia?
Iron is an essential mineral, important for maintaining healthy skin, hair and
nails. However, its critical role is transporting oxygen around the body.1,2
Iron is present in haemoglobin, a protein found in all healthy red blood
cells. The iron here is able to bind with oxygen molecules to move them
around the body.1,2
Anaemia occurs where there is a low level of haemoglobin in the red blood
cells. There are a number of reasons for this, though the most common is
a deficiency in iron.1 But despite being a common condition (over 71,000
patients treated in hospital in 2014/15)3 the management of IDA is often
poor with most sufferers not being identified appropriately.4
Fast heartbeat
Shortness of breath
Headache
Tiredness
What causes IDA?
There are three main causes of IDA:
1
In pre-menopausal
women, menstrual blood
loss is the most common
cause of IDA; in men and
post-menopausal women
blood loss from the gut is
the most common cause.4
These three main causes of IDA can be
related to underlying chronic conditions,
as shown in the graph below.
INFLAMMATION
Blood loss
2
People with certain
long term inflammatory
conditions frequently
have IDA as the
inflammation can
cause iron uptake in
the gut to be blocked.6
Inflammation
3
Reduced
absorption of iron
Reduced absorption
of iron (malabsorption)
- those with damage to
their gut have a reduced
ability to uptake iron and
are at high risk of IDA.4
Chronic
kidney disease
Chronic
obstructive
pulmonary
disease
Rheumatoid
arthritis
Gluten allergy
Gastritis
Menstrual
blood loss
Bowel cancer
Gut infection
Chronic heart
failure
Inflammatory
bowel disease
Blood loss
from the gut
BLOOD
LOSS
Surgical patients
Kidney dialysis
Certain
medications
MALABSORPTION
Partial
or total
removal of
the gut
How is IDA diagnosed?
Contact
your GP
if you
experience
symptoms
of IDA.1
Low levels of haemoglobin are defined by the World
Health Organization and are different for men and
women (<120g/L in adult women; <130g/L in adult men).7
It is critical to understand the cause of the anaemia. Iron
deficiency is the most common cause and can easily be
identified by testing the amount of a substance called
If your GP
suspects IDA
they will ask
for a sample
of blood.
The blood sample
will be tested for
low haemoglobin
levels to confirm
a diagnosis of
anaemia.
ferritin in the blood.1
After a diagnosis of IDA your GP may ask you a series of
questions or do physical examinations to understand why
you have IDA or iron deficiency. Following this it may be
necessary to visit a specialist doctor.
How can IDA be managed?
Good sources of iron1
Anybody diagnosed with IDA should be provided with
treatment to restore the levels of iron in the body and cure
the anaemia.4 This can be done in a number of ways:
• Dark
green leafy vegetables, such as
curly kale and watercress
• Tablets containing iron
• Pulses
and beans
• Iron injected directly into the blood
• Nuts
and seeds
• Blood
transfusion (only used in severe cases where
haemoglobin levels are extremely low)
• Fish
A GP or a dietician can also provide advice on how to
include more iron into your diet, as well as what to avoid
as some types of food and drink may decrease how much
iron is absorbed.1
• Dried
fruit
Unfortunately, IDA may recur after successful treatment,
particularly if the underlying cause remains.8 As such,
someone with IDA should monitor for recurrence of
symptoms to allow for early treatment.4
• Coffee
• White and red meat
•Brown rice
•Eggs
Negative impact on iron levels1
• Tea
• Calcium
(dairy products such as milk)
• Indigestion medication
• Wholegrain cereal
More information
There is no patient support group with a direct focus on IDA, however more information
on IDA and conditions associated with it can be found at the following:
NHS Choices
http://www.nhs.uk/Conditions/Anaemia-iron-deficiency-/Pages/Introduction.aspx
Crohn’s & Colitis UK
https://www.crohnsandcolitis.org.uk
Kidney Research UK
http://www.kidneyresearchuk.org
British Kidney Patient Association
http://www.britishkidney-pa.co.uk
CIRCA
http://www.cicra.org
CORE
http://corecharity.org.uk/conditions/crohns-disease
References
1 NHS Choices. Iron deficiency anaemia. Available
at: http://www.nhs.uk/Conditions/ Anaemia-irondeficiency-/Pages/Introduction.aspx. Accessed
May 2016.
5 Gasche C. Anemia in Inflammatory Bowel Diseases.
Bremen: UNI-MED Verlag, 2008.
2 ASH. Iron Deficiency-Anemia. Available at: http://www.
hematology.org/Patients/ Anemia/Iron-Deficiency.
aspx. Accessed May 2016.
7 WHO. Worldwide prevelance of anaemia 19932005. WHO Global Database of Anaemia 2008. Iron
Deficiency Anaemia. 2001.
3 Hospital Episode Statistic Data 2014/15, NHS
Information Centre for Health and Social Care (under
a commercial re-use license via Harvey Walsh Ltd).
8 Kulnigg S, et al. Am J Gastroenterol 2009; 104: 14601467.
6 Stein J & Dignass AU. Ann Gastroenterol 2013; 26: 104113.
4 Goddard AF, et al. Guidelines for the management of
iron deficiency anaemia. Gut 2011;60:1309–1316.
UK/OTH/15/0243b | Date of preparation: May 2016
This leaflet was produced by Vifor Pharma UK Ltd