IRON DEFICIENCY ANEMIA
Abstract. Iron deficiency anemia (IDA) represents the most prevalent nutritional disorder globally, affecting populations across all age group, particularly women of reproductive age, infants and adolescents. It poses significant public health implications due to its impact on cognitive development, physical performance and maternal fetal outcomes.
Objective: This review aims to summarize current evidence on the etiology,
pathophysiology, diagnostic approaches and management strategies of iron deficiency anemia.
Methods: A comprehensive analysis of recent literature and epidemiological data was conducted to evaluate the burden, risk factors and advancements in diagnostic and therapeutic modalities related to IDA.
Keywords: Iron deficiency anemia, hemoglobin, ferritin, iron supplementation, eating disorders.
Queries:
- What are the most significant risk factors contributing to iron deficiency anemia in different population groups?
- How does dietary iron intake correlate with the prevalence of iron deficiency anemia among women of reproductive age ?
- How effective are oral versus parenteral iron supplementation therapies in improving hemoglobin levels and iron stores ?
- What is the role of nutrition education and food fortification programs in preventing iron deficiency anemia in developing countries ?
Theoretical view:
As we know Iron deficiency anemia is the hematological disorder characterized by reduced hemoglobin synthesis due to insufficient iron availability, leading to microcytic, hypochromic red blood cells and impaired oxygen transport. IDA is the most common form of anemia worldwide, affecting an estimated two billion people.
In the survey we conducted around 150 students have participated which helped us to this thesis.
And for this most of them around 60% are aged between 22-32.
Pic 1: Age
Age group of 22-32 is the most affected adult group due to menstrual blood loss, pregnancy and lactation (increased iron demand), inadequate dietary intake. IDA in this age group can lead to fatigue, reduced productivity and complications in pregnancy.
Evidence has been attached above.
Pic 2: Gender
In this survey mostly females are prone to IDA. Females are at higher risk of developing iron deficiency anemia due to menstrual losses and pregnancy related demands. Males are less frequently affected and IDA occurs it often indicates chronic blood loss or gastrointestinal disease rather than dietary deficiency.
Evidence has been attached above.
DO YOU FEEL WEAKNESS OR TIRED?
Among 87.3% of 150 response are feeling tired and weakness.
The reason for the tiredness is due to :
1) decreased hemoglobin and reduced oxygen transport , muscles don’t get enough oxygen for energy production so they tire easily.
2) Impaired cellular energy production – cells produce less energy, leading to generalized weakness and leathargy.
3) Compensatory cardiovascular strain- body tries to compensate for low oxygen by increasing heart rate and cardiac output.
4) Reduced myoglobin in muscles – muscles fatigue quickly even with mild effort.
5) Brain hypoxia – mental and physical tiredness.
Evidences are attached above.
HOW OFTEN DO YOU FEEL TIREDNESS OR WEAKNESS?
In most of the responses they feel weakness or tiredness in weekly bases. Depends on severity of anemia we feel slight tiredness , constant fatigue and extreme exhaustion. In our survey 0.61% of people feel tiredness after daily activities like walking, running and playing and its due to muscles and brain tissues lack oxygen and energy. 14.2% of people feels every time and its due to low level of hemoglobin and ferritin levels and 20% of people feel tiredness weekly and its due to low intake of iron and its supplements or by diet.
Evidences are attached above.
DO YOU FEEL SHORTNESS OF BREATH OR FAST HEART BEAT?
Reasons for shortness of breath or fast heart beat in IDA
- Reduced oxygen carrying capacity – iron is the essential for hemoglobin, the molecule that carries oxygen in red blood cells. In IDA hemoglobin levels drop so the blood carries less oxygen to tissues and organs. The body senses low oxygen and tries to compensate.
- Compensatory increase in heart rate – to make up the reduced oxygen delivery the heart beat faster to pump more blood per minute. This is called compensatory tachycardia. It helps temporarily but also cause palpitations.
3) Increased cardiac workout – heart works harder to deliver oxygen even at rest in severe anemia.
- Low oxygen in tissues – leads to fatigue, breathlessness and dizziness even with minimal exertion.
According to our survey 63.1% people feels shortness of breath or palpitations during walking or workout or any physical activities due to the one or more than one reason that we discussed above.
Evidences are attached above.
HAVE YOU EVER CONSULTED DOCTOR ON THESE SYMPTOMS?
Among all responses mostly 62.5% people of these symptoms like shortness of breath , palpitations, eating disorders, tiredness or weakness have consulted a doctor and found their treatment plans. Other 37.5% people didn’t recognize these symptoms that they can be mild and nonspecific.
Common reasons for not consulting a doctor:
- Mild or gradual onset – fatigue or weakness is often attributed to stress or overwork
- Lack of awareness – people may not know these symptoms indicate anemia.
- Socioeconomic factors -limited access to health care or cost concerns.
- Cultural or selfcare beliefs – some rely on home remedies or dietary changes instead of medical help.
- Fear or stigma – fear of diagnosis or medical procedures.
RISKS FOR NOT GETTING MEDICAL HELP
- The underlying cause like bleeding, poor absorption, or chronic disease may remain untreated.
- IDA can worsen over time leading to severe fatigue, heart strain or pregnancy complications.
- Self -medicating with iron supplements can be harmful is the anemia has another cause.
Evidences are attached above.
DO YOU HAVE DIFFICULTY IN SWALLOWING?
Among 160 responses 67.5% people have difficulty in swallowing and remaining 32.5% have no swallowing symptoms.
Dysphagia in IDA occurs mainly due to a condition called Plummer vinson syndrome. Its due to iron deficiency leads to atrophy of the mucosa in the pharynx and upper esophagus, sometimes formation of esophageal webs- thin membranes of mucosa that partially block the esophageal lumen.
# Iron is essential for the maintenance and repair of epithelial cells.
# Lack of iron which leads to epithelial atrophy then mucosal fragility and inflammation.
# Healing leads to fibrosis and web formation in the post cricoid area ( upper esophagus)
# These webs obstruct food passage – intermittent or progressive dysphagia, especially for solids.
# Seen more commonly in middle aged women.
# Associated with an increased risk of upper esophageal and hypopharyngeal carcinoma, so early detection and treatment of IDA is important.
# Iron supplementation – often improves mucosal health and relieves dysphagia.
# In persistent cases – endoscopic dilation of esophageal web.
Evidences are mentioned above.
DO YOU HAVE DIFFICULTY IN CONCENTRATING?
According to our survey 64.4% of people have difficulty in swallowing, 30% have no symptoms and others face difficulty in swallowing sometimes.
Why do IDA people have difficulty in concentrating?
- Reduced oxygen supply to the brain – hemoglobin levels are low which leads to hypoxia results in slow thinking, poor concentration, mental fatigue and forgetfulness.
- Impaired Neurotransmitter function – iron is a cofactor for enzymes involved in producing key brain neurotransmitters (dopamine, serotonin, norepinephrine)
- Decreased brain energy metabolism – without enough iron the brain cells have less ATP, leading to mental tiredness and slower processing speed.
- Sleep disturbance and fatigue- poor sleep worsens attention and concentration problems.
Evidences are mentioned above.
HOW OFTEN DO YOU EAT GREENY VEGETABLES?
According to our survey 48.8% people had green vegetables sometimes, 40.6% people eats rarely and other 10.6% people only eats daily .
Why green vegetables are important in IDA?
- Source of non heme iron
- Rich in folate and other nutrients
- Vitamin C boost helps absorption
- Note on oxalates and phytates
Evidences are mentioned above.
DO YOU HAVE HAIR LOSS?
According to our survey 80% of people have hair loss and 20% of people have normal hair growth.
How hair loss is happening in IDA?
Hair loss in iron deficiency anemia happens because iron is vital for hair follicle health and growth.
- Reduced oxygen supply to the hair follicles – hemoglobin levels low
- Disruption of the hair growth cycle – IDA shortens the growth phase and causes more hairs to enter the shedding phase
- Iron needed for cell division – hair follicle divide rapidly.
- Visible signs like overall thinning, dry brittle hair, slow regrowth and sometimes pale skin.
Evidences are mentioned above.
DO YOU HAVE EATING DISORDER?
According to our survey 56.3% of people have eating disorder and the others 43.8% of people have eating disorder in which they eat non eating items like chalk, ice, pencil lead, etc.,
Why IDA people have eating disorder?
IDA can cause loss of appetite, altered taste, aversion to meat or certain foods.
- Iron deficiency can affect brain and mood- iron is essential for making neurotransmitters like dopamine, serotonin, norepinephrine, which control mood, appetite and behaviour.
- Pica – people with IDA develop cravings for non-food items like clay or soil, ice, starch, chalk, paper due to dopamine activity.
Evidences are mentioned below.
DO YOU NOTICE YOUR SKIN, TONGUE OR INSIDE YOUR EYELIDS?
According to our survey 71.9% of people have discoloration of skin, tongue or eyelids, and other 28.1% of people have no other skin symptoms.
- Skin changes
* pale skin – especially in the palms, face and nail beds
* itchy skin, dry and rough
* sometimes brittle nails or spoon shaped nails
Reason: low hemoglobin -à pallor
Low iron à dryness and fragility
- Eyelid changes ( conjunctiva changes)
*pale inner eyelids – one of the easiest clinical signs of anemia
*Normally the inner eyelid is pink due to rich blood flow.
Reason: IDA à reduced blood cells à less blood pigment à pale conjunctiva
- Tongue changes
*Glossitis- inflamed, smooth, shiny tongue
*Pain or burning sensation
*Sometimes small cracks or soreness
Reason: IDA àatrophy of papillae
Mucosal thinning and inflammationà loss of taste buds àsmooth red or shiny tongue
Evidences are shown above.
DO YOU HAVE HEAVY MENSTURAL BLEEDING?
According to our survey 48.8% people have heavy menstural bleeding and remaining 51.2% have normal flow of bleeding.
Why heavy menstural bleeding in IDA ?
Actually the relationships between and heavy menstural bleeding works in both directions:
- Heavy bleeding can cause IDA
- IDA itself can worsen menstural bleeding.
- Impaired platelet function – iron is important for normal platelet production and function. This cause impaired blood clotting leading to prolonged or heavier menstural bleeding.
- Reduced clotting factor activity- Iron helps in the proper functioning of enzymes involved in the coagulation cascade. Deficiency leads to delayed clot formation.
- Uterine lining – low iron and oxygen delivery can cause endometrial hypoxia àfragile blood vessels and poor healing after mensturation.
- Vicious cycle-heavy periodsàiron lossàIDAàWeaker clottingàheavier periods again.
Evidences are mentioned below.
Conclusion:
Iron deficiency anemia remains a significant global health concern, particularly among women of reproductive age, children, and individuals with poor nutritional intake. Early recognition an appropriate management are essential to prevent complications such as impaired cognitive function, reduced work capacity and increased morbidity. Emphasis should be placed on dietary modification, iron supplementation and addressing underlying causes such as chronic blood loss or malabsorption. Public health strategies focusing on education, nutritional awareness and regular screening can play a pivotal role in reducing the prevalence and burden of IDA. Continued research and community based interventions are vital to ensure effective prevention and long term control of this common yet preventable condition
Bibilography:
- Iron deficiency anemia
- Age wise incidence
- Heavy bleeding in IDA
- Eating disorder in IDA
- Hair loss in IDA
- Importance of greeny vegetables in IDA
- Palpitations in IDA
