Causes of iron deficiency. Iron deficiency anemia (IDA)

Content

Weakness, loss of strength, chest pain can be symptoms of a serious illness. Anemia caused by a lack of iron in the body threatens with complications for the nervous system, heart, kidneys and liver. Children often suffer from it, as well as women during pregnancy. Pathology responds well to treatment with diet and medication.

What is iron deficiency anemia

The body begins to accumulate iron even before birth. The fetus takes it from the mother's blood. Throughout life, a person receives a trace element with food. The body absorbs it from the intestines and redistributes it. The substance contains:

protein and respiratory enzymes;
Bone marrow;
muscles and liver;
hemoglobin in the blood.

Iron-deficiency anemia, or IDA - a disease that occurs when there is a lack of iron or a violation of its absorption.

Pathology, if left untreated, threatens with various complications:

Children lag behind in development, have memory problems, often get sick due to a decrease in immunity.
If the fetus does not receive the required amount of iron, it slows down the formation of organs. Often there is prematurity, and at birth the child has a small weight.
Adults suffer from heart and kidney failure, bronchial asthma, tachycardia. In severe cases, an anemic coma occurs, the death of the patient.

The disease over time leads to the fact that:

The intake of iron in the body decreases, its excretion increases.
Decreased production of hemoglobin.
The synthesis of enzymes that contain iron is disrupted.
Tissue hypoxia develops.
Skin, mucous membranes are affected.
There is an IDA.

iron deficiency

The trace element affects the functioning of the whole organism. The main functions of iron:

supports immunity;
supplies oxygen to tissues;
participates in cell division and regeneration;
destroys harmful microorganisms;
helps to remove toxins;
provides growth of muscles and nerves;
participates in the work of the brain;
included in enzymes.

According to the norms, it is customary to consider the amount of iron per 1 kg of mass. For newborns, this is 75 mg, for men - from 50 mg. Women lose blood every month during menstruation, so for them the norm is 35 mg. More than half of the substance is contained in hemoglobin.

A blood test will help determine its amount.

Hemoglobin norms for different categories of people:

for newborns– 145–220 g/l;
children from 2 to 16 years old– 115–155 g/l;
women– 121–140 g/l;
men– 135–160 g/l.

Decreased hemoglobin

Your body needs oxygen to function. Its transport through the vessels occurs with the help of hemoglobin. This substance makes up the bulk of erythrocytes, or red blood cells.

Hemoglobin has two components: a non-protein part - heme, which contains an iron atom, and a globin protein.

The substance is involved in the process of respiration:

Blood passes through the capillaries of the lungs.
Iron atoms in hemoglobin attach oxygen to themselves.
Enriched blood flows through the arteries.
Oxygen enters the tissues.
Chemical reactions take place in cells.
Carbon dioxide is released.
Hemoglobin attaches carbon dioxide and transports it through the veins to the lungs.
The gas is expelled from the body during breathing.

With a low level of hemoglobin in the blood, iron deficiency anemia develops. Problems arise:

dysfunction of the nervous system;
decreased immunity;
oxygen starvation of cells;
disorder of the brain;
mental disorders;
diseases of the heart, gastrointestinal tract and other organs;
personality degradation.

Causes

In order for all body systems to work, a balance between iron intake and its release is important. One of the main causes of the disease is chronic blood loss. Iron deficiency is caused by the following factors:

anal fissures;
bleeding in the digestive tract;
stomach ulcer;
loss of blood during menstruation;
defeat by worms;
haemorrhoids;
uterine bleeding;
trauma;
hemophilia;
tumors;
blood donation by donors.

The cause of IDA may be a high need for iron. Anemia occurs during pregnancy and during breastfeeding.

The woman needs treatment so that the child does not have a congenital iron deficiency condition.

The disease causes a lack of intake of a substance in the body due to a number of reasons:

vegetarianism;
lack of meat in the diet;
diets low in animal products;
prolonged fasting.

Deficiency of a substance occurs when it is poorly absorbed or not absorbed in the intestines. This happens due to a number of reasons:

drinking alcohol;
operations on the stomach and intestines;
cancerous tumors;
diarrhea;
removal of the stomach;
late initiation of breastfeeding.

The transport protein transferrin is needed to distribute iron throughout the body. The reason for the development of IDA may be a violation of its synthesis. Protein deficiency reduces the production of red blood cells in the bone marrow. The disease occurs as a complication of acute infectious pathologies, hepatitis and cirrhosis, tumors of the gastrointestinal tract.

IDA causes high physical exertion. The concentration of iron decreases with an increase in body temperature and chronic diseases of the digestive tract.

Pathology develops after taking several types of drugs:

Anti-inflammatory drugs Aspirin, Quinine. They cause stomach ulcers.
Preparations Desferal, Exjade- they bind iron. The substance is excreted from the body.
Antacids Almagel, Rennie- violate the absorption of the element.

Severity

Blood tests for hemoglobin can determine the severity of the disease. With mild IDA, the protein concentration is above 90 g/l, with moderate IDA, 71–90 g/l, and with severe, less than 70 g/l. There is a classification of iron deficiency anemia according to the severity of the signs of the disease. There are 5 degrees of severity:

Symptoms are not observed.
There is weakness and dizziness after exercise.
The patient has all the symptoms of an iron deficiency state.
Severe form of the disease.
Anemic coma ending in death.

signs

At the initial stage, it is difficult to understand that a person has an iron deficiency state. The signs are similar to those of other diseases. The patient has the following symptoms:

dyspnea;
chest pain;
weakness and drowsiness;
increased fatigue;
pressure drop;
feeling short of breath;
memory impairment;
pale skin;
swelling.

Hidden or latent iron deficiency disrupts the synthesis of enzymes that regulate the functioning of the body. At this stage, the following symptoms of IDA occur:

dry skin;
fragility of nails and hair;
atrophy of the mucous membranes;
violation of the perception of smells;
diseases of the teeth and gums;
convulsions;
dizziness;
muscle weakness.

With the development of iron deficiency anemia, the symptoms become more pronounced. A person often has colds and infectious diseases. Signs of IDA in severe stage:

violation of intelligence and attention;
tachycardia;
nervousness;
numbness of hands and feet;
indigestion;
darkening in the eyes;
loss of consciousness.

IDA is very dangerous for children. The child lags behind in development, his liver and spleen increase.

Symptoms of an iron deficiency state depend on age:

Newborns often cry, spit up milk, sleep poorly. Infants have impaired motor skills.
Older children complain of headaches, fainting. Severe arousal, urinary incontinence, caries, gastrointestinal diseases are possible.

With another type of anemia - with B12 deficiency - the function of the papillae of the tongue is disrupted, the taste changes. In an iron-deficient state, such changes do not occur. The fall in hemoglobin disrupts the production of enzymes that are involved in cell respiration. An iron deficiency condition causes such changes:

cracks, peeling and dry skin;
fragility, thinning of nails;
pale skin due to a deficiency of red blood cells;
dullness and hair loss;
early gray hair.

Iron is involved in the formation of muscles. Lack of oxygen in the cells reduces energy production in the body. These causes in IDA lead to the most striking symptoms of anemia:

muscle atrophy;
high fatigue;
poor exercise tolerance;
weaknesses.

Diagnostics

If symptoms of IDA appear, you should visit a therapist. The doctor conducts an external examination, measures arterial pressure. It is important to distinguish the disease from pathologies with similar symptoms. Methods for diagnosing IDA:

Laboratory tests. Examine blood, feces, less often - gastric juice.
Instrumental methods. They discover the cause of the disease.
Puncture of the bone marrow. The study determines the violation of the formation of blood cells.

Laboratory tests

Diagnostic methods for symptoms of IDA:

Complete blood count for iron deficiency anemia. Shows a decrease in hemoglobin - less than 100 g / l, the number of red blood cells - 3.5-4 x 10 12 / l, platelets - 180-300 / l.
Biochemical study of blood. Determines the level of ferritin - more than 200 ng / g.
Analysis of the acidity of gastric juice which is decreased in anemia.
tumor markers for cancerous tumors.
Stool analyses. Detect occult blood, the presence of helminths.
Determining the amount of iron in urine per day– more than 0.3 µg/g.

Instrumental Methods

To find the source of blood loss and distinguish anemia from other diseases with similar symptoms, hardware studies are used:

ultrasound internal organs. Tumors, enlargement of the spleen, liver are detected.
ECG- to study the work of the heart. With anemia, a violation of the rhythm is observed.
X-ray with contrast. Detects a stomach ulcer, duodenal ulcer, excludes lung diseases.
Colposcopy. Shows ulcers, polyps on the mucous membrane of the cervix.
Rectomanoscopy and colonoscopy. Determine the source of blood loss in the intestine.

Puncture of the bone marrow

To choose the right treatment regimen, you need to assess the state of the system that produces blood cells. At the initial degree of anemia, bone marrow puncture does not reveal changes. In severe iron deficiency, an increase in the number of cells from which red blood cells are formed is observed.

Treatment

The choice of therapy tactics depends on the degree of IDA and the results of the tests. Treatment of iron deficiency anemia includes the elimination of the causes of the disease and the source of blood loss. Doctors prescribe to patients:

Diet food.
Taking medications that eliminate iron deficiency (necessarily with folic acid).
Addition of ascorbic and succinic acid for better assimilation of the element.
Blood transfusion (hemotransfusion).

With persistent bleeding, the patient develops chronic iron deficiency anemia. Differences in her treatment:

Medicines that contain iron are not administered intramuscularly or intravenously.
Prescribe pills. The course of treatment is at least a month with the control of hemoglobin levels.
No blood transfusion required.

Diet

With proper nutrition, the condition of the patient with IDA will be better, and the body will receive the necessary substances. Diet is good for early stage anemia. The main principles of catering:

meal- 6 times a day.
Cooking methods- baking, boiling, stewing, steaming.
Meal temperature– 20–50 °С.
Exclusion of alcohol.
Salt- up to 12 g per day.
Amount of liquid- up to two liters per day.

Using iron-rich foods is an important part of treating anemia. To improve the absorption of the substance, the diet should include cheese, cottage cheese and milk. Products with which iron enters the body:

beef and lamb;
sea fish;
rabbit meat;
chicken, beef liver;
vegetable oils;
egg yolk;
boiled carrots, beets;
veal.

In an iron-deficient state, the diet includes plant foods:

buckwheat and millet;
seaweed;
peaches, apples and persimmons;
almonds and peas;
blackcurrant, blueberry, pomegranate;
spinach, parsley;
rose hip;
sunflower seed.

With iron deficiency anemia, foods that interfere with iron absorption should be removed from the diet:

lamb and beef fats;
pickles that destroy blood cells;
cakes with fat cream;
Tea coffee;
wheat bran;
fatty fish, pork;
chocolate;
goose meat, lard.

Iron preparations

Many drugs in the treatment of anemia are contraindicated. Other drugs have specific uses, so they must be prescribed by a doctor. In iron-deficient conditions, products with ferrous iron are often used. Medicines are taken in the form of tablets, drops or capsules, washed down with water. To improve absorption, you need to additionally take vitamin C, folic acid. This group of drugs:

Ferretab comp;
Ferro foil;
Sorbifer durules;
Aktiferrin;
Fenyuls.

Along with ferrous iron, ferric iron is used, which also effectively increases the level of hemoglobin. It may be prescribed in a higher dosage. Amino acids are used at the same time. These medicines do not have side effects. In the severe stage of anemia, injections are often prescribed - Ferrum Lek, Kosmofer and Venofer.

Maltofer

The medicine is released in the form of drops, syrup and injection. Maltofer contains ferric salts, is used for anemia during pregnancy, blood donation by donors. Features of the drug:

increases the level of hemoglobin;
used from the first days of life;
the effect depends on the degree of anemia;
the course of treatment and the dose is prescribed by the doctor.
contraindications - anemia that is not associated with iron deficiency;
side effects - headache, darkening of teeth;
the price of drops is 220 rubles / 30 ml.

Ferroplex

The medicine is produced in the form of a dragee. Ferroplex contains ferrous sulfate and ascorbic acid, which improves the absorption of the substance in the small intestine. The drug is prescribed for iron deficiency anemia in adults and children from four years of age. Treatment continues up to three months. The dosage depends on the severity of the disease. Short description:

contraindications - sensitivity to components;
side effects - diarrhea, nausea, heartburn;
price - 1050 rubles / 100 pcs.

Ferrum Lek

The drug is produced in the form of a solution for injection, chewable tablets and syrup. Ferrum lek contains ferric salts, participates in oxygen transport, increases hemoglobin. The course of treatment of latent anemia is a month, in severe forms - up to five. The price of the syrup is 125 rubles / 100 ml. When prescribing a medicine, the doctor takes into account:

contraindications - cirrhosis of the liver, 1st trimester of pregnancy;
side effects - vomiting, fever, skin rashes.

Sorbifer durules

As part of the drug - ferrous sulfate and ascorbic acid. Sobifer durules is rapidly absorbed and increases hemoglobin in the blood. The medicine is prescribed for iron deficiency anemia in adults and children from 12 years of age. The dosage and course of treatment depend on the degree of the disease. In severe cases, the reception lasts six months. Features of the drug:

Contraindications - anemia that is not associated with iron deficiency, bleeding, intolerance to components.
Side effects - stool disorders, abdominal pain.
Price - 370 rubles / 30 tablets.

Ferro-foil

The drug is often prescribed to pregnant women. It contains iron sulfate, folic acid and vitamin B 12 necessary for the development of the fetus. Features of the drug:

Release form - capsules.
Action - binds iron to plasma protein.
With moderate anemia, the course of treatment is 3 months, with severe anemia - up to six months.
Contraindications - sensitivity to components, a disease that is not associated with iron deficiency.
Side effects - insomnia, diarrhea, constipation.
Price - 330 rubles / 20 capsules.

Blood transfusion

This method of treatment is used in severe forms of the disease. Indications for blood transfusion - hemoglobin level less than 70 g/l, large blood loss. The procedure for an iron deficiency state is prescribed before childbirth, a surgical operation. After transfusion, oxygen starvation is eliminated, immunity increases, blood supply improves. Order of conduct:

Determine the Rh factor and blood type.
Conduct a test for the compatibility of the donor and the patient.
Plasma with erythrocytes is transfused to a normal hemoglobin level.

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Anemia is a pathological condition of the body, which is characterized by a decrease in the level of hemoglobin in the blood. If a person is diagnosed with anemia, then he needs treatment. It will depend on the severity of the violation, as well as on the cause that led to the drop in hemoglobin.

Severity of anemia by hemoglobin level

Anemia develops against the background of other diseases, acting as a pathological symptom of many disorders in the body. However, it is always accompanied by a decrease in the level of hemoglobin in the blood. As a result of such changes, organs and tissues begin to suffer from a lack of oxygen. Oxygen starvation is called.

Normally, in adult men, the hemoglobin level should vary between 130-180 g / l. In women, this figure is 120-150 g / l.

If these values begin to decline, then doctors talk about anemia, which can have 3 degrees of severity:

The first degree of severity of anemia is characterized by a drop in hemoglobin levels to 90-120 g / l. This condition can be corrected proper nutrition, hospitalization of the patient is not required.

Anemia of moderate severity develops when the hemoglobin level drops to 70-90 g/l. in this case, it will no longer be possible to get rid of the disorder only with the help of a diet; medicines. If a person feels satisfactory, then he is not hospitalized.

The third degree of severity of anemia is characterized by a decrease in hemoglobin levels of less than 70 g / l. In this case, a person is placed in a hospital, where complex treatment is carried out. Depending on the cause that led to the development of anemia, therapy can be either conservative or surgical.

If a person develops anemia of 1 mild degree, then there are usually no symptoms of the disorder. Therefore, the patient may not even suspect that he has pathological changes in the concentration of hemoglobin in the blood. This can be determined using laboratory tests.

Symptoms that may occur with mild anemia include:

Weakening of concentration.

Increased pulsation.

Deterioration in performance.

Weakening of memory.

Fatigue, a feeling of constant fatigue, despite proper rest.

Paleness of the skin and mucous membranes.

Orthostatic hypotension may be a sign of anemia of the first degree. At the same time, a person’s pressure drops when the body position changes (with a sharp rise from the bed), which is expressed in darkening in the eyes. Also at this time, an increase in heart rate is possible. This symptom is called orthostatic tachycardia.

Periodically, a person may be harassed. Fainting for the first degree of anemia is not typical.

Causes. The reasons for the development of anemia can only be determined by a doctor. To install them, you will need to donate blood. Iron deficiency anemia is the most common type of anemia in humans, where a lack of iron causes a drop in hemoglobin levels. After all, it is this microelement that is necessary for the normal production of Hb. According to average data, iron deficiency anemia affects up to 50% of children at an early age, up to 15% of women in the childbearing period of their lives and up to 2% of adult men. As the analysis of statistics shows, every 3rd inhabitant of the Earth has a latent tissue iron deficiency. From all types of anemia, it takes about 80-90%.

Sharply iron deficiency anemia develops rarely. First, a person has a so-called pre-latent iron deficiency. Microelement reserves are depleted only in tissues. As the disease progresses, the level of not only deposited, but also transport, as well as erythrocyte iron decreases. The severity of iron deficiency anemia can be minimal or completely hidden.

Treatment. Treatment of mild anemia requires nutritional correction, although it all depends on the reasons that provoked this disorder. However, the diet of the patient will need to be observed without fail. It is followed until the level of hemoglobin in the blood returns to normal. Be sure to include in the menu products that are rich not only in iron, but also in vitamin B.

These foods include: red meat, fish, eggs, nuts, spinach, beets, pomegranates. Be sure to include tomatoes, carrots, fresh herbs, legumes (peas, lentils and beans), oatmeal, buckwheat, bread, honey in the diet. In order for iron to be better absorbed by the body, you should enrich your menu with foods that are rich in vitamin C. It increases the bioavailability of this trace element, which allows it to more easily penetrate into the blood. In addition, citric and succinic acid improves iron absorption. Succinic acid is present in sufficient quantities in kefir, curdled milk, sunflower oil, sunflower seeds, barley, Borodino bread, green gooseberries, apples, cherries, and grapes.

There are also foods that, on the contrary, slow down the absorption of iron. These are those drinks and dishes in which the content of tannin, polyphenols and oxalates is exceeded. Therefore, it is recommended to refrain from drinking coffee, tea, soy proteins, whole milk, chocolate.

If anemia of the first degree of severity is detected, treatment should not be delayed. Otherwise, the violation will progress and lead to serious consequences for the body. Self-selection of therapy is not allowed.

As a rule, taking medications for mild anemia is not required. They are prescribed only in the case when the correction of nutrition does not eliminate the existing problem. The doctor can prescribe medicines for a minimum period of 1.5 months and in minimal dosages. If after the specified time the hemoglobin level returns to normal, then the dose is halved and the treatment is continued for another month. This measure is aimed at consolidating the result. In addition to pure iron preparations, it is possible to prescribe multivitamin complexes, which must necessarily include iron and folic acid.

Often, patients with mild anemia are prescribed drugs such as:

Ferro-foil containing not only ferrous sulfate, but also ascorbic acid, folic acid and cyanocobalamin. With a mild degree of anemia, 1 capsule is prescribed 3 times a day. Take the drug after a meal.

Ferroplex is represented by a complex ascorbic acid and ferrous sulfate. With a mild degree of anemia, 1 tablet is indicated 3 times a day.

Hemofer prolongatum is prescribed 1 tablet 1 time per day.

After the start of taking iron supplements, signs of anemia will be stopped already on the 3rd day of treatment, but this does not mean that it is time to stop therapy. Normalization of hemoglobin levels in the blood will occur no earlier than 6 weeks from the start of therapy.

Be sure to develop anemia of the first degree of severity should be checked for people at risk. They may not have symptoms of anemia, but their health status indicates a high likelihood of developing anemia. People at risk include:

Pregnant women.

Children under the age of 3 years. This is especially true for children born prematurely or with low body weight.

Children born as a result of multiple pregnancy.

Children born to a woman who suffered from anemia during pregnancy.

Children and adults with diagnosed helminthiases and diseases of the digestive system.

To prevent the development of mild anemia, you need to monitor your diet, and if you are at risk, regularly take blood tests to determine the level of hemoglobin.

Anemia of moderate severity is characterized by a much more pronounced decrease in the level of hemoglobin in the blood, which causes the severity of symptoms. Now it will be impossible not to notice anemia.

Its symptoms are:

Frequent dizziness.

Increased shortness of breath. If earlier it arose only against the background of physical effort, or was completely absent, now shortness of breath will appear even at rest.

The appearance of "flies" before the eyes.

Swelling of the skin. In the morning, swelling under the eyes, the so-called "bags", is especially noticeable.

Memory impairment.

Joint problems.

Pale skin and pale mucous membranes. The skin becomes dry, prone to peeling, cracks form on it.

Hair turns gray before the due time, falls out more, becomes dull. The same applies to the nail plate. In patients with anemia, the nails become pale, lose their natural luster.

The skin becomes pasty in the area of the legs, face and feet.

Taste perversion is observed in many patients already in the second degree of anemia. At the same time, a person may feel the desire to eat clay, sand, ice, chalk, coal, raw dough, raw minced meat or cereals. Most often, taste perversion occurs in children, adolescents, and young women. They have increased cravings for sour, spicy and spicy foods.

Perversion of smell is possible. A person will begin to like to inhale the aromas that healthy people cause disgust (acetone, paint, varnish, etc.).

The patient's muscle strength is reduced.

In 10% of patients, angular stomatitis is observed, which is popularly known as "zaedy".

There may be pain in the tongue, as well as a feeling of fullness of the tongue from the inside.

The eye sclera may acquire a bluish color, or a rich blue color. Iron deficiency provokes violations in the production of collagen in the sclera of the eyes, which leads to their thinning. The vessels of the eye begin to shine through the sclera, which gives it a characteristic color.

The person may experience an urge to empty the bladder. It will be difficult for him to keep urine in his bladder when laughing, sneezing or coughing a lot.

A person with anemia of the 2nd degree begins to suffer more often from acute respiratory viral infections and other inflammatory and infectious diseases, as the efficiency of leukocytes decreases, immunity falls.

It should be noted that the full listed symptoms are observed in patients not only with iron deficiency anemia, but also suffering from a lack of other vitamins, minerals and nutrients.

Treatment. Depending on what exactly caused the development of anemia, the doctor selects a treatment regimen. In addition to the diet, the patient will need to take medications.

The principles of constructing a therapeutic regimen are as follows:

If there is hidden bleeding in the human body, then it must be established and stopped. Most often, ulcers bleed, located on the mucous membranes of the stomach and intestines. Therapy of organ diseases digestive system is in the competence of the gastroenterologist.

The patient is given preparations containing iron. These can be such drugs as: Ferroplex, Sorbifer Durules, Tardiferon, Ferretab, Maltofer, Fenyuls, Ferrum lect, etc.

To normalize the processes of blood coagulation in the body and to compensate for the lack of vitamins, vitamin complexes are prescribed. Perhaps the injection of vitamin B12 and vitamin B6.

Administration of folic acid for oral administration.

If it is not possible to eliminate the progression of anemia with the help of these drugs, then the patient may be prescribed a blood transfusion.

Corticosteroids (Prednisolone, Hydrocortisone, etc.) and antibiotics are prescribed for the development of inflammatory processes in the body.

Dietary nutrition involves eating the same foods as for anemia of the first degree of severity. It is important to bear in mind that foods of animal origin saturate the body with iron to a greater extent than foods of plant origin. Therefore, the emphasis should be on beef (meat and liver), pork (liver), chicken liver and eggs. Be sure to supplement the diet with juices: pomegranate, tomato, beet and apple.

A patient who is on outpatient treatment should not limit their physical activity. If he feels satisfactory, then the patient should spend time in the fresh air, maintain an orderly daily routine, and avoid stress. All medical recommendations must be followed impeccably. Otherwise, anemia of the 2nd degree will progress.

Anemia of 3 severe degree develops against the background of a pronounced drop in the level of hemoglobin in the blood.

This causes the development of severe symptoms, which is manifested by the following pathological changes:

Muscle weakness increases, muscle atrophy develops, which is caused by a lack of myoglobin and tissue respiration enzymes.

Dystrophic changes in the skin and its appendages continue to progress.

The nails acquire a characteristic spoon-shaped concavity. This symptom is called koilonychia.

The mucous membranes of the mouth and tongue suffer. Patients are diagnosed with glossitis, periodontal disease and caries. Characteristic of a severe course of anemia is the symptom of a “lacquered tongue” and atrophy of the papillae located on it.

In severe anemia, atrophic changes in the mucous membrane of the digestive system develop. The lining of the esophagus becomes very dry, which leads to difficulty swallowing food. Also, patients are diagnosed with atrophic enteritis and gastritis.

Bedwetting is often observed, which occurs against the background of weakening of the sphincters of the bladder.

The patient's temperature can rise to subfebrile levels and remain at this level for a long time.

Wounds and injuries of the skin heal over a long period of time.

Treatment. A patient with grade 3 anemia is hospitalized. In the hospital, he must receive complex therapy. Only diet and iron supplements in this case will not be enough. Therapy is supplemented with corticosteroids, anabolic steroids, androgens, cytostatics. Often, patients with grade 3 anemia are prescribed blood transfusions, intravenous administration of drugs. In emergency situations, the patient is referred for a bone marrow transplant operation. Sometimes the spleen needs to be removed.

Treatment of anemia of the 3rd degree without medical supervision is impossible. Often, tumors of the blood and bone marrow lead to the development of this severe pathology. Before starting therapy, the doctor must fully examine the patient. During treatment, his condition is monitored.

There are many reasons that can lead to the development of anemia. First of all, this concerns the deficiency of minerals and vitamins, although to exclude various diseases also shouldn't.

Cancer tumors of a malignant nature.

Uterine fibroids, accompanied by blood loss.

However, the most common type of anemia is iron deficiency. It often occurs in pregnant women against the background of toxicosis and profuse vomiting. At increased risk are women bearing 2 fetuses or more. Such diseases in a pregnant woman as pyelonephritis and hepatitis can also lead to the development of anemia.

With anemia of the first degree of severity, the following health problems are possible:

Increased stress on the heart and blood vessels.

The occurrence of nosebleeds, which is more often observed in childhood.

A drop in immunity, which can be expressed in an increase in episodes of acute respiratory viral infections in adults and children.

Deterioration of mental abilities.

For the fetus, maternal anemia is associated with a risk of intrauterine growth retardation. The child may be born prematurely.

In a woman who suffers from mild anemia, labor may be weakened. During pregnancy, toxicosis may pursue her. It also increases the chance of bleeding.

Untreated anemia of moderate severity can lead to the development of the following complications:

Myocardial dystrophy. Symptomatically, this is manifested by shortness of breath, tachycardia, arrhythmia, expansion of the borders of the heart to the left, deafness of heart tones, systolic murmurs.

Prolonged and severe anemia can lead to severe circulatory failure and heart failure.

Hypoxia of the brain leads to. The patient's quality of life is significantly reduced, he does not get enough sleep at night, he feels tired during the day.

The third degree of anemia is a formidable violation in the body, which can lead to severe consequences:

Cardiogenic shock.

Acute renal failure.

With a third degree of anemia, the likelihood is increased lethal outcome. All organs suffer from hypoxia, their performance is impaired. In addition, a weakened immune system becomes unable to fight off infections. All of them have a protracted and long course. Therefore, assistance to the patient should be provided urgently.

Severe anemia in pregnant women threatens with premature birth, preeclampsia, placental abruption, bleeding and other complications during labor.

Most often, anemia is well treated, but you need to seek medical help in a timely manner. If this is not done, then the violation will progress. In childhood, anemia is dangerous due to a delay in mental and physical development.

In order to timely detect an existing problem, you should regularly donate blood to determine the level of hemoglobin, do not refuse dispensary observation. If a person is at risk for developing anemia, then the doctor may prescribe him prophylactic iron supplementation.

Education: In 2013, he graduated from the Kursk State Medical University and received a diploma in General Medicine. After 2 years, the residency in the specialty "Oncology" was completed. In 2016, she completed postgraduate studies at the Pirogov National Medical and Surgical Center.

Iron deficiency anemia is a pathological condition characterized by a decrease in the amount of hemoglobin and red blood cells due to a lack of iron in the body, as well as trophic disorders (disturbances in tissue structure). Hemoglobin is an iron-containing blood protein whose main function is to carry oxygen from the lungs to the tissues, and from the tissues to the lungs it carries carbon dioxide.

Symptoms of iron deficiency anemia

All the symptoms of iron deficiency anemia are combined into two syndromes (a stable set of symptoms that occur for a single reason).

anemic syndrome:

general weakness;
decrease in working capacity;
dizziness;
fainting (clouding of consciousness);
noise in ears;
flashing "flies" before the eyes;
shortness of breath (rapid breathing) and rapid heart rate with little exertion.

sideropenic syndrome.

Damage to the epithelium (tissues covering the entire body and lining hollow organs) of any localization.
- Damage to the epithelium of the gastrointestinal tract:
  - cracks in the corners of the mouth;
  - difficulty swallowing dry and solid food;
  - burning and pain in the tongue that occurs spontaneously or after eating, smoothness of the papillae of the tongue (sideropenic glossitis);
  - teeth lose their luster, quickly collapse, despite the most thorough care for them;
  - intermittent dull aching pain in the epigastric region (in the middle of the upper abdomen).
- Damage to the skin and its appendages (hair, nails):
  - dry skin with multiple microcracks (especially hands, front surface of the legs);
  - nails - brittle nails, transverse striation, spoon-shaped impressions (koilonychia - “clumsy nails”);
  - hair - hair loss, dryness and brittle hair, premature graying.
- Perversion of taste (in the form of a desire to eat chalk, lime, coal, clay, raw cereals) and perversion of smell (addiction to unusual smells - acetone, kerosene, paints, feces).
- Violation of the activity of sphincters (circular muscles that close any hole: throwing food from the stomach into the esophagus, betalepsy (urine and fecal incontinence when coughing, laughing, straining, raising the leg on a step)).

Forms

Given the level of hemoglobin (a special substance of erythrocytes (red blood cells) that carries oxygen), iron deficiency anemia, like other forms of anemia, can be severe, moderate or mild.

Light degree: hemoglobin concentration 90-110 g / l (that is, grams of hemoglobin per 1 liter of blood).
Average degree: hemoglobin content 70-90 g/l.
Severe degree: hemoglobin level less than 70 g/l.

The normal level of hemoglobin in the blood is:

in women - 120-140 g / l;
in men - 130-160 g / l;
in newborns - 145-225 g / l;
in children 1 month. – 100-180 g/l;
in children 2 months. - 2 years. – 90-140 g/l;
in children 2-12 years old - 110-150 g / l;
in children 13-16 years old - 115-155 g / l.

However, clinical signs of the severity of anemia (symptoms of a hypoxic nature (lack of oxygen)) do not always correspond to the severity of anemia according to laboratory criteria. Therefore, a classification of anemia according to the severity of clinical symptoms has been proposed.

According to clinical manifestations, five degrees of severity of anemia are distinguished.

Mild degree of anemia- without clinical manifestations.
Moderate degree of anemia:
- fast fatiguability;
- weakness;
- malaise;
- reduced concentration of attention;
- pallor of visible mucous and nail beds.
Severe anemia:
- shortness of breath with moderate or slight exertion;
- headache, dizziness;
- rapid heartbeat (arrhythmia);
- noise in ears;
- sleep disturbance (eg, difficulty falling asleep, frequent awakenings at night);
- loss of appetite, changes in food habits in the form of rejection of previously favorite food;
- perversion of appetite (eating chalk, dirt, paints, etc.) and smell (like sharp smells of gasoline, paints, varnishes);
- pallor of visible mucous and nail beds, skin;
- increased sensitivity to cold - the patient is constantly cold;
- develop inflammation of the tongue (glossitis), lips (cheilitis);
- thinned, striated, brittle nails;
- frequent colds.
Anemic precoma:
- shortness of breath at rest without any exertion;
- progressive weakness, drowsiness;
- mental disorders (hallucinations, depressive syndrome);
- skin and mucous membranes are sharply pale with a bluish tint;
- tachycardia (rapid heartbeat).
anemic coma:
- low arterial (blood) pressure;
- vomit;
- tachypnea (rapid shallow breathing);
- loss of consciousness;
- involuntary urination;
- the absence of reflexes on the limbs (that is, reactions in response to irritation: for example, extension of the limb when struck with a hammer in areas of close proximity of the nerves under the skin or flexion of the toes when the finger is passed along the sole ceases to be determined).

Causes

- premature babies;

Alimentary factors (impaired intake of iron from food and absorption of iron in the intestine).
- Vegetarianism (eating only plant foods).
- With a monotonous diet with a high content of fats and carbohydrates.
- - stomach cancer;
  - removal of part of the intestine;
  - cystic fibrosis (a hereditary disease that is characterized by damage to all organs that produce mucus (liver, pancreas, glands of the intestinal mucosa, respiratory system, sweat and salivary glands);
  - celiac disease (a genetic disease in which the gluten protein causes damage to the lining of the small intestine, and the absorption process is disrupted);

- into the external environment, most often - bleeding from the gastrointestinal tract (from Meckel's diverticulum (congenital pathology of the small intestine in the form of a blind protrusion of the intestinal wall), with ulcers and erosion (mucosal defect) of the stomach and duodenum, varicose veins of the mucous stomach and intestines). Repeated, even mild, blood loss gradually leads to anemia due to the depletion of iron reserves in the body, which is necessary for the formation of hemoglobin (a special substance of erythrocytes (red blood cells) that carries oxygen). The daily intake of iron with food is small, about 11-28 mg, and about 1-3 mg is absorbed from it. , that is, approximately the same as is contained in 15 ml of blood. Therefore, the daily loss of this and even less amount of blood inevitably leads to a reduction in iron stores in the body and the occurrence of iron deficiency anemia;
- into the internal environment without reutilization (reuse) of iron - isolated hemosiderosis of the lungs ( chronic illness lung, manifested by repeated hemorrhages in the alveoli - air bubbles).

Increased iron intake - with tumor growth of any localization.

Diagnostics

Analysis of the anamnesis of the disease and complaints (when (how long ago) did general weakness, shortness of breath, dizziness, stabbing pains in the chest, etc. appear; with what the patient associates the occurrence of these symptoms).
Analysis of the life history (does the patient have any chronic diseases, are hereditary (passed from parents to children) diseases noted, does the patient have bad habits whether he took any drugs for a long time, whether he had tumors, whether he was in contact with toxic (poisonous) substances).
General examination (the color of the skin is determined (pallor is possible); the pulse may be rapid, arterial (blood) pressure - reduced).
Blood test. A decrease in the number of red blood cells (red blood cells, the norm is 4.0-5.5x10 9 / liter), a decrease in the level of hemoglobin (a special compound inside the red blood cells that carries oxygen, the norm is 130-160 g / l) can be determined. The color indicator (the ratio of the hemoglobin level multiplied by 3 to the first three digits of the number of red blood cells) decreases (normally this indicator is 0.86-1.05).

Blood chemistry:
- a decrease in serum iron levels (serum is the liquid part of the blood);
- increase in the level of TIBC (total iron-binding capacity of serum);
- decrease in the level of saturation of transferrin (blood protein, the main carrier of iron) with iron;
- a decrease in the level of ferritin (a complex protein in which iron is stored).
A study of bone marrow obtained by puncture (piercing with the extraction of internal contents) of a bone, most often the sternum (the central bone of the anterior surface of the chest to which the ribs are attached), is performed in some cases to assess hematopoiesis and identify the nature of anemia.
Trepanobiopsy (examination of the bone marrow in its relation to the surrounding tissues) is performed by taking a column of bone marrow with bone and periosteum, usually from the iliac wing (the area of the human pelvis closest to the skin), using a special device - a trephine. Most accurately characterizes the state of the bone marrow.
Electrocardiography (ECG). An increase in heart rate, malnutrition of the heart muscle, less often - heart rhythm disturbances are determined.
Consultation is also possible.

Treatment of iron deficiency anemia

Eliminating the causes of anemia is a very important factor in the treatment.
Daily routine: active lifestyle, daily walks in the fresh air.
Diet therapy:
- eat more foods high in protein (for example: cottage cheese, meat, fish, egg white, liver, kidneys, etc.);
- limit the use of fats (fatty meats, poultry, fish, lard, fatty sausages), give preference to easily digestible fats (butter, sunflower, soybean, olive oil);
- limit the consumption of milk (no more than 0.5 liters per day) and strong tea, as they prevent the absorption of iron in the intestine;
- the amount of carbohydrates is not limited, dishes from various cereals are recommended (for example: cereals, puddings), sugar, honey, jam, legumes, flour products, vegetables, fruits, berries;
- the use of an increased amount of B and C vitamins: yeast, liver, kidneys, legumes, egg yolks, meat, fish, milk, cottage cheese, bran (rice, wheat) are rich in B vitamins; vitamin C (ascorbic acid) is abundant in lettuce, green onions, cabbage, soybeans;
- consume a sufficient amount of iron-containing foods (for example: pork and beef liver, beef tongue, rabbit and turkey meat, cereals - buckwheat, oatmeal, barley, millet, blueberries, peaches; fish caviar, especially sturgeon).
Mandatory appointment of iron preparations: in the first three months of anemia treatment - in therapeutic doses, later - in preventive doses. Iron preparations are administered orally between meals, washed down with fresh fruit juices or water, and should not be taken with milk.
In severe cases of anemia, iron preparations are prescribed in intramuscular or intravenous injections, transfusion of erythrocyte mass (donor's erythrocytes).

Complications and consequences

The prognosis for timely diagnosis and adequate treatment is favorable.

Complications.

Violation of the psycho-emotional state:
- memory decreases;
- impaired concentration;
- irritability appears.

Anemic coma (loss of consciousness with no response to external stimuli due to insufficient oxygen supply to the brain as a result of a significant or rapidly developed decrease in the number of erythrocytes (red blood cells)).
Deterioration of the condition of internal organs, especially in the presence of chronic diseases (for example, heart, kidneys, etc.).

Prevention of iron deficiency anemia

Primary prevention(that is, before the onset of the disease).

Taking iron supplements special groups people with the most high risk development of iron deficiency anemia - to donors.
A balanced and rational diet (eating foods high in fiber (vegetables, fruits, herbs), avoiding canned, fried, spicy, hot foods), eating animal products (eggs, caviar, meat, fish), and with vegetarianism (refusal to use food of animal origin) - the use of multivitamin complexes. Frequent fractional meals (5-6 times a day in small portions).
Prevention of chronic diseases that cause iron deficiency (for example, prevention of diseases of the stomach and intestines - regular meals, avoiding spicy and fatty foods, eating thoroughly washed vegetables and fruits, etc.).

Secondary prevention(that is, after the development of the disease) consists in regular preventive examinations of the population in order to detect anemia in them as early as possible.

Additionally

Hemoglobin is contained in erythrocytes - these are red blood cells.
Normally, the body of a healthy adult contains 4-5 g of iron.
Iron deficiency anemia is very common and accounts for 4/5 of all anemias (decreased hemoglobin levels in the blood).

Authors
Pediatrics - a textbook for medical schools. P. Shabalov, 2003
Extended description
- Low iron supply at birth:
  - premature babies;
  - children born to mothers with iron deficiency anemia;
  - children from multiple pregnancy (simultaneous bearing of two or more fetuses);
  - children from mothers with bleeding in recent months pregnancy or during childbirth.
- Alimentary factors (impaired intake of iron from food and absorption of iron in the intestine):
  - children on artificial feeding;
  - late introduction of complementary foods (after 5-6 months);
  - vegetarianism (eating only plant foods);
  - excess whole milk in the child's diet (more than 0.5 liters per day);
  - with a monotonous diet with a high content of fats and carbohydrates.
  - Hereditary disorders of iron transport (decrease in the activity of enzymes that transfer iron from the intestinal cavity into the blood).
  - Iron absorption disorders due to pathology of the gastrointestinal tract:
    - removal of the stomach or part of it;
    - stomach cancer;
    - removal of part of the intestine;
    - chronic pancreatitis (inflammation of the pancreas);
    - cystic fibrosis (hereditary disease, characterized by damage to all organs that produce mucus (liver, pancreas, glands of the intestinal mucosa, respiratory system, sweat and salivary glands);
    - celiac disease (a genetic disease in which gluten protein causes damage to the mucous membrane of the small intestine and the absorption process is disrupted);
    - enteropathy (non-inflammatory chronic bowel disease caused by a lack of enzymes in the intestine or defects in the structure of the intestinal wall), etc.
- Chronic blood loss of various origins (origin):
  - into the environment, most often - menstrual bleeding and from the gastrointestinal tract (from Meckel's diverticulum (congenital pathology of the small intestine in the form of a blind protrusion of the intestinal wall), with ulcers and erosion (mucosal defect) of the stomach and duodenum, varicose veins veins of the gastric and intestinal mucosa). Repeated, even mild, blood loss gradually leads to anemia due to the depletion of iron reserves in the body, which is necessary for the formation of hemoglobin (a special substance of erythrocytes - red blood cells - carrying oxygen). The daily intake of iron with food is small, about 11-28 mg, and about 1-3 mg is absorbed from it. , those. approximately the same as is contained in 15 ml of blood. Therefore, the daily loss of this and even less amount of blood inevitably leads to a reduction in iron stores in the body and the occurrence of iron deficiency anemia;
  - into the internal environment without recycling (reuse) of iron: isolated hemosiderosis of the lungs (a chronic lung disease manifested by repeated hemorrhages in the alveoli - air bubbles), endometriosis (growth of the inner lining of the uterus inside other organs).
- Increased iron intake:
  - during pregnancy (300 mg of iron goes to the needs of the fetus, 150 mg is found in the placenta, from 100 to 250 mg is lost during childbirth due to blood loss);
  - during lactation (100-200 mg of iron is excreted with milk during the feeding period);
with intensive growth of the body (mainly in adolescence, especially in combination with intense physical activity - young athletes), with tumor growth of any localization.

Anemia is a disease in which the amount of hemoglobin or red blood cells in the blood becomes lower than normal.

Blood consists of a liquid part - plasma and three types of cells:

leukocytes - white blood cells - are part of the immune system
systems and help fight infections;
erythrocytes - red blood cells - carry oxygen
through the body with the help of hemoglobin protein;
Platelets help blood clot during injury.

As blood passes through the lungs, red blood cell hemoglobin binds oxygen molecules and releases carbon dioxide molecules. After leaving the lungs, hemoglobin delivers oxygen molecules to the tissues of the body and absorbs excess carbon dioxide to deliver them back to the lungs.

Red blood cells are produced in the bone marrow found in large bones. Every day, millions of new cells are produced to replace old, destroyed cells.

There are several types of anemia and each of them has its own causes, but the most common is anemia caused by iron deficiency - iron deficiency anemia.

Other forms of anemia can be caused by a lack of vitamin B12, folic acid, blood loss, or, for example, bone marrow failure.

The main symptoms of anemia are fatigue and lethargy (lack of energy). See your doctor if you suspect you have anemia. For the initial diagnosis of the disease, you will need to take a blood test.

Treatment for anemia involves taking iron supplements to increase iron levels in the body. As a rule, such treatment is effective, and the disease rarely leads to complications. If anemia is left untreated, the likelihood of infectious diseases increases, since iron deficiency affects the immune system (the body's defense system). Severe types of anemia can interfere with the functioning of the heart and are especially dangerous during pregnancy.

Symptoms of anemia

Manifestations of anemia are very poor, sometimes almost invisible. Especially if the decrease in the amount of hemoglobin or red blood cells occurs for a long time and slowly.

The most common symptoms of iron deficiency anemia are:

fatigue;
loss of strength (lack of energy);
feeling short of breath (shortness of breath).

Less common symptoms include:

headache;
tinnitus - the perception of sound in one or both ears, coming from the inside, for example, ringing in the ears;
change in taste sensations;
picacism - the desire to eat inedible objects, such as ice, paper or clay;
irritation on the tongue;
baldness;
swallowing disorder (dysphagia).

You may also notice changes in appearance. For example, signs of possible anemia may include:

pallor;
unusually smooth tongue;
painful sores (open sores) at the corners of the lips;
dry, exfoliating nails;
spoon nails.

The severity of symptoms may depend on how quickly the anemia develops. For example, you may notice only a few symptoms, or their severity may increase gradually if the anemia is caused by chronic, slow blood loss, such as from stomach ulcers.

Causes of iron deficiency anemia

Iron deficiency anemia occurs when there is not enough iron in the body. Iron deficiency can be caused by a number of factors. Some of them are described below.

Period. In women of reproductive age, the most common cause of iron deficiency is menstruation. Usually anemia develops only in women with particularly heavy periods. If you have heavy bleeding during your period for several months in a row, this is called menorrhagia (hypermenorrhea).

Pregnancy. It is very common for women to develop iron deficiency during pregnancy. This is because the expectant mother's body needs more iron to provide the baby with enough blood, as well as the oxygen and nutrients it needs. Many pregnant women need to take iron supplements, especially from the 20th week of pregnancy.

Gastrointestinal bleeding is the most common cause of anemia in men and women after menopause (when a woman stops menstruating). Causes of gastrointestinal bleeding can be:

Ibuprofen and aspirin are the two most commonly prescribed anti-inflammatory drugs. Gastric and duodenal ulcers can cause bleeding, which can lead to anemia. heavy bleeding leads to vomiting of blood or blood in the stool. However, if the ulcers bleed lightly, there may be no symptoms.
Cancer of the stomach or intestines is a rare cause of bleeding in gastrointestinal tract. The incidence of stomach cancer in our country is one of the highest in the world. Among malignant tumors, gastric cancer in Russia ranks second. If your GP suspects cancer, you will be referred immediately to an oncologist.
Angiodysplasia is an abnormality of the blood vessels in the gastrointestinal tract that can cause bleeding.

kidney failure can also cause anemia. Iron supplements are most often given intravenously for kidney failure, but ferrous sulfate tablets may be tried first.

Absorption disorder(when your body cannot absorb iron from food) can also cause anemia. This can happen in the following cases:

celiac disease, a disease that affects the intestinal wall;
gastrectomy, an operation to surgically remove the stomach, such as in the treatment of stomach cancer.

Nutrition. Anemia is rarely caused by a lack of iron in the diet, except during pregnancy. Some studies suggest that vegetarians are more prone to anemia due to the lack of meat in their diet. However, keeping vegetarian diet, you can get enough iron from other types of foods, such as the following:

beans;
nuts;
dried fruits, for example, dried apricots;
enriched breakfast cereal;
soy flour;
most dark green leafy vegetables, such as watercress and collard greens.

Pregnant women may need to increase the amount of iron-rich foods in their diet to prevent anemia.

Diagnosis of anemia

If you have symptoms of anemia, see your GP. To confirm the diagnosis, it is necessary to general analysis blood. This means that the number of all types of blood cells is counted in a blood sample.

If you have anemia, the test results will show the following:

you will have a low level of hemoglobin;
you will have a low content of red blood cells (erythrocytes);
red blood cells may be smaller or paler than usual.

Your doctor may also order a test for ferritin, a protein that stores iron. If you have low ferritin levels, your body does not have enough iron.

Blood levels of vitamin B12 and folic acid are tested to rule out other causes of anemia. Folic acid, along with vitamin B12, helps the body produce red blood cells. Anemia caused by a lack of vitamin B12 and folic acid is more common in people over 75 years of age.

To determine the cause of anemia, your therapist may ask you about your lifestyle and past medical conditions. For example, you might be asked the following:

your diet - to find out how you usually eat and whether there are foods rich in iron in your diet;
medications you take - whether you regularly take drugs that can cause bleeding in the gastrointestinal tract, such as ibuprofen or aspirin;
menstrual cycle - how plentiful menstruation, whether they occur regularly;
family history - you will be asked if any of your immediate family members have had anemia or bleeding in the gastrointestinal tract or blood disorders;
blood donation - do you regularly donate blood, and have you had heavy bleeding;
other illnesses - have you recently had another illness or any symptoms, such as weight loss.

Medical examination for anemia

For additional diagnosis, the doctor will examine your abdomen, and also check for signs of heart failure, for example, listen to the heart, measure blood pressure, and examine the legs for swelling. If necessary, you will be referred to a narrow specialists who will conduct special inspections.

Rectal examination. As a rule, a rectal examination is only necessary if there is rectal bleeding. The doctor will put on a glove, lubricate one finger, and insert it into the rectum to check for any abnormalities. There is no need to be embarrassed by a rectal examination, as the doctor often performs a similar procedure. You should not feel much pain or discomfort, just a slight sensation of movement in the intestines.

Gynecological examination. Women may be referred for a gynecological examination. During the examination, the gynecologist examines the perineum for bleeding or infection. An internal inspection may also be carried out. To do this, the doctor will insert lubricated gloved fingers into the vagina to check for enlargement or tenderness in the area of the ovaries or uterus.

In difficult cases of diagnosing anemia, the doctor will refer you to a consultation with a hematologist - a specialist in blood diseases.

Anemia treatment

Typically, treatment for anemia involves taking iron supplements to replenish the body's iron stores, as well as treating the cause of the anemia.

Your doctor will prescribe iron supplements to replenish your body's iron stores. They are usually taken orally (by mouth) two or three times a day. Some people may experience side effects when taking iron supplements, including the following:

nausea;
vomit;
abdominal pain;
heartburn;
constipation;
diarrhea;
black stool (feces).

Over time, these side effects should go away. To improve your tolerance to the drug, try taking it with or after a meal. Your doctor may also suggest taking only one tablet a day, instead of two or three, if you are having difficulty coping with side effects. In some cases, the drug is replaced by another, with less pronounced side effects.

If you have small children, keep iron supplements away from them, as an overdose of these drugs can be fatal to a small child.

To treat anemia, it is important to eliminate its cause. For example, if non-steroidal anti-inflammatory drugs (NSAIDs) cause bleeding in the stomach, the drug should be discontinued or replaced with a similar drug under the supervision of a physician. Abundant periods (hypermenorrhea) also require treatment by a gynecologist.

There are several ways to increase the amount of iron in the diet. Iron-rich foods include the following:

dark green leafy vegetables, such as watercress
and kale;
iron-fortified flakes;
whole grains, such as brown rice;
beans;
nuts;
meat;
apricots;
plums;
raisin.

To maintain a healthy, balanced diet, eat foods from all four major food groups. However, some foods and medicines can make it difficult for you to absorb iron. These include the following:

tea and coffee;
calcium found in dairy products such as milk;
antacids (drugs for indigestion);
blockers proton pump affecting the production of gastric juice;
Whole grain cereals – although they are rich in iron themselves, they also contain phytic acid, which can interfere with the absorption of iron from other foods and supplements.

If you find it difficult to include iron-rich foods in your diet, you may be referred to a dietitian (nutrition specialist) who can create a detailed plan for you to change your diet.

Health monitoring for anemia

Your doctor will schedule a follow-up visit 2-4 weeks after you start taking iron supplements to assess how your body is responding to treatment. You will need to have a blood test to check your hemoglobin levels. If the results of the blood test show improvement, you will be asked to return in 2-4 months for a second test.

Once your hemoglobin and red blood cell counts are back to normal, your doctor will likely recommend that you continue taking the drug for three months to replenish your body's iron stores. After that, depending on the cause of anemia, it will be possible to stop taking the drug. Then every three months during the year you will need to come for a checkup.

Continuous treatment of iron deficiency anemia

In some people, after the iron stores in the body are replenished, they begin to decline again. This can happen in the following cases:

you eat few foods rich in iron;
You are pregnant;
you have heavy periods (hypermenorrhea).

In this case, you may be prescribed to take iron supplements on a regular basis. As a rule, you need to take one tablet per day. This will prevent the anemia from returning.

Complications of iron deficiency anemia

Anemia rarely causes severe or chronic complications. However, some anemic patients notice that the disease affects their daily life.

Fatigue. Anemia can make you feel tired and low on energy, and you may become less productive and less active at work. It may become more difficult for you to stay awake and concentrate, not have enough strength for regular exercise.

The immune system. Research has shown that anemia can affect the immune system, making you more vulnerable to illness and infection.

Complications in the heart and lungs. Severe anemia in adults can increase the risk of complications affecting the heart or lungs. For example, the following diseases may develop:

tachycardia (rapid heartbeat);
heart failure, in which the heart is not pumping blood around the body efficiently enough.

Pregnancy. Severe anemia in pregnant women increases the risk of complications, especially during and after childbirth. They may also develop postpartum depression (a type of depression that some women experience after having a baby). Studies have shown that children born to women with anemia are more likely to:

born prematurely (before the 37th week of pregnancy);
have a low birth weight;
have problems with the level of iron in the body;
have lower mental capacity.

Restless legs syndrome (RLS). In some cases, restless leg syndrome is thought to be caused by anemia. Doctors call this secondary restless leg syndrome. Restless legs syndrome is a common disease that affects the nervous system, causing an irresistible urge to move the legs. It also causes discomfort in the feet, calves and thighs. RLS caused by anemia is usually treated with iron supplements.

Which doctor should I contact for anemia?

For diagnosis and treatment of anemia, see or (for a child). In difficult cases of diagnosis, or if anemia is difficult to treat, which specializes in blood diseases.

If, in addition to the symptoms of anemia, you notice manifestations of another disease in yourself, use the section "Who treats it" to find the right specialist.

Localization and translation prepared by site. NHS Choices provided the original content for free. It is available from www.nhs.uk. NHS Choices has not been reviewed, and takes no responsibility for, the localization or translation of its original content

All materials on the site have been checked by doctors. However, even the most reliable article does not allow taking into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. Articles are prepared for informational purposes and are advisory in nature.

Iron deficiency anemia is a disease characterized by a decrease in the level of hemoglobin in the blood. According to the results of research 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, and almost all lactating women have anemia of varying degrees.

This anemia was first described in 1554, and drugs for its treatment were first used in 1600. It is a serious problem that threatens the health of society, as it has a significant impact on performance, behavior, mental and physiological development.

This noticeably reduces social activity, but, unfortunately, anemia is often underestimated, because gradually a person gets used to a decrease in iron stores in his body.

Causes of iron deficiency anemia

What it is? There are several causes of iron deficiency anemia. Often there is a combination of causes.

Iron deficiency is often experienced by people whose body requires an increased dose of this trace element. This phenomenon is observed with increased body growth (in children and adolescents), as well as during pregnancy and lactation.

Having adequate levels of iron in the body largely depends on what we eat. If the diet is unbalanced, food intake is irregular, the wrong foods are consumed at all, then in the aggregate all this will cause a lack of iron intake in the body with food. By the way, the main food sources of iron are meat: meat, liver, fish. Relatively a lot of 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 causes of this disease are as follows:

Insufficient intake of iron with food, especially in newborns.
Violation of absorption processes.
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 occult 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 intake, etc.).

How does IDA develop?

The body mobilizes iron reserves. There is no anemia, no complaints, a ferritin deficiency can be detected during the study.
Tissue and transport iron is mobilized, hemoglobin synthesis is preserved. There is no anemia, dry skin, muscle weakness, dizziness, signs of gastritis appear. The examination reveals a deficiency of serum iron and a decrease in transferrin saturation.
All funds suffer. Anemia appears, the amount of hemoglobin decreases, and then erythrocytes.

Degrees

Degrees of iron deficiency anemia according to hemoglobin content:

mild - hemoglobin does not fall below 90 g / l;
medium - 70-90 g / l;
severe - hemoglobin below 70 g / l.

The normal level of hemoglobin in the blood is:

in women - 120-140 g / l;
in men - 130-160 g / l;
in newborns - 145-225 g / l;
in children 1 month. – 100-180 g/l;
in children 2 months. - 2 years. – 90-140 g/l;
in children 2-12 years old - 110-150 g / l;
in children 13-16 years old - 115-155 g / l.

However, the clinical signs of the severity of anemia do not always correspond to the severity of anemia according to laboratory criteria. Therefore, a classification of anemia according to the severity of clinical symptoms has been proposed.

1 degree - clinical symptoms are absent;
Grade 2 - moderate weakness, dizziness;
Grade 3 - there are all clinical symptoms of anemia, disability;
4 degree - represents a serious condition of precoma;
Grade 5 - is called "anemic coma", lasts several hours and leads to death.

Signs of the 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 stress;
craving for salty and spicy, spicy foods;
sore throat;
dry pale skin, pallor of mucous membranes;
fragility and pallor of the nail plates;
dullness of hair.

A little later, an anemic syndrome develops, the severity of which is also determined by the erythrocytes in the body, as well as the rate of development of anemia (the faster it develops, the more pronounced the clinical manifestations), the compensatory capabilities of the body (they are less developed in children and the elderly) and the presence of concomitant diseases.

Symptoms of iron deficiency anemia

Iron deficiency anemia develops slowly, so its symptoms are not always pronounced. With anemia, nails often exfoliate, deform and break, hair splits, the skin becomes dry and pale, appear, there is weakness, malaise, dizziness, headache, flies before the eyes, fainting.

Very often, patients with anemia have a change in taste, an irresistible craving for non-food products, such as chalk, clay, and raw meat. Many begin to attract pungent odors, such as gasoline, enamel paint, acetone. A complete picture of the disease opens only after the general.

Diagnosis of IDA

In typical cases, the diagnosis of iron deficiency anemia is not difficult. Often, the disease is detected in analyzes taken for a completely different reason.

In a manual, blood color index, and hematocrit are detected. When performing OAC 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 regimen for anemia:

elimination of the etiological factor;
organization of proper nutrition;
taking iron supplements;
prevention of complications and relapses of the disease.

With the correct organization of the above procedures, you can count on getting rid of the pathology within a few months.

Iron preparations

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 ferrous sulfate tablets, it contains 60 mg of iron, and is taken 2-3 times a day.

Other iron salts, such as gluconate, fumarate, lactate, also have good absorption properties. Considering that the absorption of inorganic iron with food decreases by 20-60%, it is better to take such medicines before meals.

Possible side effects from iron preparations:

metallic taste in the mouth;
abdominal discomfort;
constipation;
diarrhea;
nausea and/or vomiting.

The duration of treatment depends on the patient's ability to absorb iron and continues until laboratory blood parameters (erythrocyte, hemoglobin, color index, serum iron level and iron-binding ability) normalize.

After eliminating the signs of iron deficiency anemia, it is recommended to use the same drug, but at a reduced prophylactic dose, since the main focus of treatment is not so much to eliminate the signs of anemia, but to replenish iron deficiency in the body.

Diet

The diet for iron deficiency anemia is the consumption of foods rich in iron.

A complete diet is shown with the obligatory inclusion in the diet of products containing heme iron (veal, beef, lamb, rabbit meat, liver, tongue). It should be remembered that ascorbic, citric, succinic acid contribute to the strengthening of ferrosorption in the gastrointestinal tract. Iron absorption is inhibited by oxalates and polyphenols (coffee, tea, soy protein, milk, chocolate), calcium, dietary fiber, and other substances.

However, no matter how much meat we eat, only 2.5 mg of iron will get into the blood from it per day - this is how much the body can absorb. And iron-containing complexes are absorbed 15-20 times more - that's why with the help of diet alone, the problem of anemia cannot always be solved.

Conclusion

Iron deficiency anemia is a dangerous condition that requires an adequate approach to treatment. Only long-term use of iron supplements and elimination of the cause of bleeding will lead to getting rid of the pathology.

To avoid serious complications from treatment, laboratory blood tests should be constantly monitored throughout the course of therapy for the disease.