Iron deficiency anemia is the most common nutritional anemia worldwide. It occurs when the body does not have enough iron to produce adequate hemoglobin — the protein in red blood cells responsible for carrying oxygen.
Understanding Normal Iron Metabolism
Iron is absorbed mainly in the duodenum and proximal jejunum. After absorption:
- Transferrin transports iron in the bloodstream to the bone marrow.
- The bone marrow uses iron for red blood cell production (erythropoiesis).
- Excess iron is stored as ferritin in the liver, spleen, and bone marrow.
When iron intake or absorption is inadequate, iron stores gradually decline before hemoglobin levels fall.
Definition
Iron deficiency anemia is defined as reduced hemoglobin concentration due to depleted body iron stores. It typically produces microcytic, hypochromic red blood cells — smaller cells with reduced hemoglobin content.
Who Is at Risk?
- Infants and adolescents during rapid growth
- Pregnant women
- Elderly individuals
- People with poor nutritional intake
Common Causes
- Inadequate dietary iron intake
- Chronic blood loss (e.g., gastrointestinal bleeding, heavy menstruation)
- Increased iron requirements (pregnancy, growth periods)
- Malabsorption due to gastrointestinal diseases or surgery
Clinical Manifestations
- Fatigue and weakness
- Pallor of skin and conjunctiva
- Glossitis and angular cheilitis
- Koilonychia (spoon-shaped nails)
- Pica
Laboratory Findings
- Low hemoglobin and hematocrit
- Low mean corpuscular volume (MCV)
- Low serum ferritin and serum iron
- Elevated total iron binding capacity (TIBC)
Management
Oral Iron Therapy
- First-line treatment
- Ferrous sulfate, fumarate, or gluconate commonly used
- Continue for at least 3 months after hemoglobin normalizes
Parenteral Iron Therapy
- Indicated if oral iron is not tolerated or malabsorption exists
- Used in severe cases requiring rapid correction
Role of Diet
- Iron-rich foods: red meat, liver, legumes, green leafy vegetables
- Vitamin C enhances iron absorption
- Avoid tea or coffee with meals as they reduce absorption
Complications
- Impaired cognitive development in children
- Pregnancy-related complications
- Reduced work capacity in adults
Conclusion
Iron deficiency anemia is common but preventable. Early diagnosis, appropriate treatment, and nutritional awareness ensure favorable long-term outcomes.
