Iron deficiency anemia

What is iron deficiency anemia?

The most common cause of anemia is iron deficiency. Iron is needed to form hemoglobin. Iron is mostly stored in the body in the hemoglobin. About 30 percent of iron is also stored as ferritin and hemosiderin in the bone marrow, spleen and liver.

What causes iron deficiency anemia?

Iron deficiency anemia can be caused by:

  • Diets low in iron - Iron is obtained from foods in our diet, however, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested. A child unable to have a balanced iron-rich diet may suffer some degree of iron deficiency anemia.
  • Body changes - An increased iron requirement and increased red blood cell production is required when the body is going through changes such as growth spurts in children and adolescents, or during pregnancy and lactation.
  • Gastrointestinal tract abnormalities - Malabsorption of iron is common after some forms of gastrointestinal surgeries. Most of the iron taken in by dietary route is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and result in iron deficiency anemia.
  • Blood loss - Loss of blood can cause a decrease of iron and result in iron deficiency anemia. Sources of blood loss may include GI bleeding, menstrual bleeding or injury.

What are the symptoms of iron deficiency anemia?

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

  • Abnormal 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 peculiar substances such as dirt or ice (also called pica)

How is iron deficiency anemia diagnosed?

Iron deficiency anemia may be suspected from general findings on a complete medical history and physical examination of your child, such as complaints of tiring easily, pale skin and lips or a fast heartbeat (tachycardia). Iron deficiency anemia is usually discovered during a medical examination through a blood test that measures the amount of hemoglobin, or number of red blood cells, present and the amount of iron in the blood. In addition to a complete medical history and physical examination of your child, diagnostic procedures for iron deficiency anemia may include:

  • Additional blood tests
  • Bone marrow aspiration and biopsy - marrow may be removed by aspiration or a needle biopsy under local anesthesia. In aspiration biopsy, a fluid specimen is removed from the bone marrow. In a needle biopsy, marrow cells (not fluid) are removed. These methods are often used together.

Treatment for iron deficiency anemia

Specific treatment for iron deficiency anemia will be determined by your child's physician based on:

  • Your child's age, overall health and medical history
  • Extent of the anemia
  • Cause of the anemia
  • Your child's 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 - beef, pork, lamb, liver and other organ meats
    • Poultry - chicken, duck, turkey, liver (especially dark meat)
    • Fish - 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 cause irritation of the stomach and discoloration of bowel movements. They should be taken on an empty stomach or with orange juice to increase absorption.

The following is a list of foods that are a good source of iron. Always consult your child's physician regarding the recommended daily iron requirements for your child.

Iron-Rich Foods Quantity  Approximate Iron
Oysters 3 ounces  13.2
Beef liver 3 ounces  7.5
Prune juice 1/2 cup  5.2
 Clams  2 ounces 4.2 
 Walnuts  1/2 cup  3.75
 Ground beef  3 ounces  3.0
 Chickpeas  1/2 cup  3.0
 Bran flakes  1/2 cup  2.8
 Pork roast  3 ounces  2.7
 Cashew nuts 1/2 cup  2.65 
 Shrimp  3 ounces 2.6 
 Raisins 1/2 cup   2.55
 Sardines  3 ounces  2.5
 Spinach  1/2 cup  2.4
 Lima beans  1/2 cup  2.3
 Kidney beans  1/2 cup  2.2
 Turkey, dark meat 3 ounces   2.0
 Prunes  1/2 cup  1.9
 Roast beef 3 ounces    1.8 
 Green peas 1/2 cup   1.5
 Peanuts 1/2 cup   1.5
 Potato  1.1
 Sweet potato  1/2 cup  1.0
 Green beans  1/2 cup  1.0
 Egg  1  1.0

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