Blood Disorders

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Iron-Deficiency Anemia

What is iron-deficiency anemia

Iron-deficiency anemia is the most common cause of anemia worldwide in both developed and under-developed countries. Iron-deficiency anemia results from either decrease intake of iron or excess loss of iron (more common). Loss of iron can occur through bleeding, which may be slow and not observed (occult), or through the breakdown of red blood cells in the circulation and loss of the iron in the urine.  Some diets, such as strict vegetarian diets, may be low in iron and result in iron deficiency.

Symptoms of iron-deficiency

The symptoms of iron deficiency anemia include the symptoms of anemia (link) but may also include cravings for ice chips or clay (pica), dryness and cracking of the lips and tongue, nail bed changes, hair loss, and restless leg syndrome.

Diagnosis and work-up

The diagnosis of iron deficiency can be made by simple blood tests including a CBC with blood smear and iron studies (iron, iron binding capacity, transferin saturation, ferritin).  Although iron stores can be assessed in the bone marrow, a bone marrow biopsy is generally not needed to diagnose iron deficiency.  Once iron deficiency is established, then the cause of the low iron should be assessed by a detailed history, blood and urine tests, and in some cases, gastrointestinal procedures such as colonoscopies or EGDs.

Treatment of iron deficiency

The treatment of iron deficiency involves treating the cause of the iron loss if present and repletion of the body’s iron stores usually with iron pills.  In some cases where the iron pills are not absorbed or poorly tolerated, iron can be delivered through the veins as an infusion.