How much iron deficiency does a person have to have before it’s harmful? That’s a good question, and I’m glad you asked it. It’s a difficult question to answer because there isn’t a simple blood test for measuring iron levels (at least not yet). In fact, studies show that many people with anemia don’t show any symptoms at all, especially those who are anemic from chronic blood loss or periods of heavy bleeding.
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How Much Iron Deficiency
What Is Iron Deficiency Anemia?
Iron deficiency anemia is when your body doesn’t have enough red blood cells.
Red blood cells carry oxygen from your lungs to the rest of your body. Every organ and tissue in your body needs oxygen to work. Without enough oxygen in your blood, you may feel tired, weak, and short of breath.
You get iron deficiency anemia when your body is low in iron. You need iron to make hemoglobin, a protein that helps your red blood cells carry oxygen.
Your doctor will find out why your iron is low. Usually, you can treat iron deficiency anemia with supplements. Once your iron levels go up, you should start to feel better.
Symptoms of Iron Deficiency Anemia
Mild iron deficiency anemia often isn’t noticeable. When it gets more severe, you may have these symptoms:
- Fatigue or weakness
- Pale or yellow skin
- Shortness of breath
- Dizziness or lightheadedness
- Fast or irregular heartbeat
- Chest pain
- Cold feet and hands
- Brittle, cracked nails, spoon-shaped nails
- Hair loss
- Cracks near the side of your mouth
- Pica (cravings for things that aren’t food, like dirt, starch, clay, or ice)
- Sore and swollen tongue
- Restless legs syndrome (an urge to move your legs while you’re in bed)
Because these can also be symptoms of other conditions, see your doctor to get a diagnosis.
Causes of Iron Deficiency Anemia
It can happen if you don’t eat enough foods containing iron, your body can’t properly absorb iron, you lose iron through your blood, or you’re pregnant.
Your diet is low in iron. How much iron you need depends on your age and gender. Men need at least 8 milligrams daily. Women ages 50 and younger need more — 18 milligrams.
Your body can’t absorb iron. Iron from the foods you eat is absorbed in your small intestine. Conditions like celiac disease, ulcerative colitis, or Crohn’s disease can make it harder for your intestines to absorb iron. Surgery such as gastric bypass that removes part of your intestines, and medicines used to lower stomach acid can also affect your body’s ability to absorb iron.
Blood loss. Some conditions can make you bleed inside your body, including:
- Peptic ulcer
- Uterine fibroids
- Colon polyps
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Women with heavy periods can become low in iron.
Injuries. Any injury that causes you to lose blood can cause iron deficiency anemia. Frequent blood donations. You should wait at least 8 weeks between blood donations. Pregnancy. When you’re expecting, you need extra iron to nourish your growing baby. If you don’t get enough iron from your diet or supplements, you can become deficient. End-stage kidney failure. If you are getting dialysis for end-stage kidney failure, you can lose blood. Some people with end-stage kidney failure also take medications that can cause iron-deficiency anemia.
Medications. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause internal gastrointestinal bleeding. Proton pump inhibitors, used to control acid reflux, can prevent your body from absorbing enough iron.
Chronic health conditions that cause inflammation. This can include congestive heart failure as well as obesity.
Symptoms of Iron Deficiency
Causes and Risks
“Menstrual bleeding and blood loss from the gastrointestinal tract are the most common causes of IDA,” says Dr. Tracy Dozier, who works in the Academic Internal Medicine practice at Erlanger Health System. “Women of reproductive age who are menstruating are most at risk of developing IDA.” According to the Centers for Disease Control, 9 to 16 percent of menstruating women in the United States are iron-deficient. “The more blood loss, the more at risk you are,” Dr. Beeler explains.
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IDA is inadequate nutrition
Another common cause of IDA is inadequate nutrition. The amount of iron a person needs depends largely on their age and gender. Children need a lot of iron because they are growing, and teenage girls and women need more iron than men because they menstruate. Women whose diets are depleted of iron-rich food—such as eggs, meat, and dark green vegetables—are at a greater risk of developing IDA. This means that vegetarians are more at risk of developing the condition as well as overly-zealous dieters. Increasingly, IDA has been found among elderly people on restricted diets. The risk of IDA also doubles in lower socioeconomic groups, who may not have the means or ability to maintain a well-rounded diet.
Pregnant women are also at risk of IDA because their bodies need more iron to support their increased blood volume. Most experts agree that pregnant women need about twice as much iron as usual when pregnant. According to anemia.org, 20 percent of pregnant women in the U.S. have anemia.
Lastly, IDA may be caused by an inability to absorb iron. If a woman has had intestinal surgery, like gastric bypass, or has an intestinal disease, like Crohn’s disease or celiac disease, it doesn’t matter how many leafy greens, fish, or other iron-rich foods are consumed: her body will not be able to absorb and manufacture enough iron to produce healthy red blood cells.
How is anemia treated?
Your healthcare provider will decide on the proper treatment, depending on the type of anemia and what is causing it.
Your doctor must first find out if the anemia is being caused by a poor diet or a more serious health problem. You can then be treated for both the anemia and its cause.
Iron-deficiency anemia is treated by eating foods that are high in iron, or with oral (taken by mouth) iron supplements.
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What dose of iron is usually prescribed for the treatment of iron deficiency anemia?
Your doctor will tell you how much iron you need to take every day. For the treatment of iron deficiency anemia in adults, 100 to 200 mg of elemental iron per day has been recommended. The best way to take the supplement so that you absorb the greatest amount of iron is to take it in two or more doses during the day. However, extended-release iron products may be taken once a day.
Please note the following:
- Although the supplements work best on an empty stomach, you may want to take them with food so that they don’t upset your stomach.
- You shouldn’t take iron supplements with milk, caffeine, antacids, or calcium supplements. These can decrease the amount of iron that is absorbed.
- Try to take your iron supplement with vitamin C (for example, a glass of orange juice) to increase absorption.
When will I start to feel better?
When you should start to feel better depends on your particular situation. Normally, it may take from a week to a month (after you start your iron supplement) before you start to feel better. Continue to watch your symptoms and take note of side effects that might be caused by the supplements. If you have any questions or concerns, talk to your healthcare provider.
What are the side effects of oral iron supplements?
Oral iron supplements can cause the following side effects:
- Dark stools
- Upset stomach
- Constipation (you may need to take a stool softener)
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How long will I have to take an oral iron supplement?
Your doctor will let you know how long you will have to take the iron supplement. Usually, after your hemoglobin and iron levels are back to normal, you will continue to take the iron supplement for another six months. Afterward, you will have regular blood tests to measure your iron level.