About This Condition

Iron-Deficiency Anemia

What is iron-deficiency anemia?

The most common cause of anemia is iron deficiency. Iron is needed to form hemoglobin, part of red blood cells that carry oxygen to the body. Iron is mostly stored in the hemoglobin. About one-third of iron is also stored as ferritin and hemosiderin in the bone marrow, spleen, and liver.

What causes iron-deficiency anemia?

Iron-deficiency anemia may be caused by the following:

  • A diet low in iron. You get iron from foods you eat. But, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested. If you have a poor diet, you may suffer from some degree of iron-deficiency anemia.
  • Body changes. Your body needs more iron and more red blood cells when it’s going through changes, such as growth spurts, or during pregnancy and lactation.
  • Gastrointestinal tract abnormalities. Your body can’t absorb iron well after some forms of gastrointestinal surgeries. Most of the iron taken in by foods is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter how well you absorb iron. Surgery or medications that stop stomach acid production will also decrease iron absorption.
  • Blood loss. Loss of blood can cause a decrease of iron. Sources of blood loss may include GI bleeding, menstrual bleeding, or injury.

Who is at risk for iron-deficiency anemia?

People who have an increased need for iron are at risk for iron-deficiency anemia. This includes:

  • Infants, young children, and teens because of their rapid growth
  • Teen girls and women of childbearing age because of their menstruation
  • Pregnant women
  • Anyone with blood loss
  • People on dialysis because of kidney failure
  • People who have had gastric-bypass surgery because of reduced absorption of iron

What are the symptoms of iron-deficiency anemia?

The following are the most common symptoms of iron-deficiency anemia. However, each person may experience symptoms differently. Symptoms may include:

  • Paleness or lack of color of the skin
  • Irritability
  • Lack of energy or tiring easily (fatigue)
  • Increased heart rate (tachycardia)
  • Sore or swollen tongue
  • Enlarged spleen
  • A desire to eat strange things such as dirt or ice (a condition called pica)

The symptoms of iron-deficiency anemia may look like other blood conditions or medical problems. Always consult your health care provider for a diagnosis.

How is iron-deficiency anemia diagnosed?

Your doctor may suspect Iron-deficiency anemia based on your symptoms and a complete medical history and physical exam. This condition is usually found through a blood test that measures the amount of hemoglobin (number of red blood cells) present, and the amount of iron in the blood. Other tests may include:

  • Additional blood tests for iron
  • Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells. This test is usually not necessary.
  • Upper and/or lower endoscopy. These tests may help rule out a source of blood loss.

How is iron-deficiency anemia treated?

Specific treatment for iron-deficiency anemia will be determined by your health care provider based on:

  • Your age, overall health, and medical history
  • Extent of the anemia
  • Cause of the anemia
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the anemia
  • Your opinion or preference

Treatment may include:

Iron-rich diet

Eating a diet with iron-rich foods can help treat iron-deficiency anemia. Good sources of iron include the following:

  • Meats, such as beef, pork, lamb, liver, and other organ meats
  • Poultry, such as chicken, duck, turkey, (especially dark meat), liver
  • Fish, such as shellfish, including clams, mussels, and oysters, sardines, anchovies
  • Leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards
  • Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
  • Yeast-leavened whole-wheat bread and rolls
  • Iron-enriched white bread, pasta, rice, and cereals

Iron supplements

Iron supplements can be taken over several months to increase iron levels in the blood. Iron supplements can irritate the stomach and discolor bowel movements. They should be taken on an empty stomach, or with orange juice, to increase absorption. They are much more effective than dietary changes alone.

Evaluation for a source of blood loss

This may include upper endoscopy or colonoscopy.

Can iron-deficiency anemia be prevented?

The best way to prevent iron-deficiency anemia is to eat a well-balanced diet that includes iron-rich foods. If you or your child is unable to eat an iron-rich diet, you have heavy monthly periods, or other risk factors, talk with your health care provider about taking an iron supplement.

Living with iron-deficiency anemia

Iron-deficiency may be temporary. However, if you have heavy monthly periods or other risk factors, you may need to address this problem on an ongoing basis. Eat a well-balanced diet that includes iron-rich foods and talk with your health care provider about taking an iron supplement. It is also important to address any underlying blood loss or condition that may be the cause of your anemia.

Key points about iron-deficiency anemia

  • Iron-deficiency anemia is the most common cause of anemia and is due to a low level of iron in the blood.
  • Iron-deficiency anemia can be caused by a diet that is low in iron, growth spurts, pregnancy, lactation, abnormalities of the GI tract, or blood loss.
  • Common symptoms of iron-deficiency anemia include fatigue, paleness, irritability, and fast heart rate.
  • Treatment includes eating iron-rich foods, taking an iron supplement, and determining if there is underlying blood loss.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.