The importance of treating iron deficiency
Concluding Women’s Month, Dr Jade Mogambery, Specialist physician and infectious diseases specialist, writes about the importance of treating iron deficiency in women
Iron deficiency anaemia is extremely common among women. According to the World Health Organisation (WHO), close to 30% of females between the ages of 16 and 49 suffered from iron deficiency anaemia in 2019.
This translates to over half a billion women of child-bearing age, with this figure remaining stagnant over the last few years.
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• Tiredness and fatigue
• Weakness
• Palpitations
• Chest pain
• Shortness of breath
• Pica (craving soil or other unusual substances)
• A sore tongue
• Difficulty swallowing
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Iron is an element used to produce haemoglobin, a protein in the red blood cell to which oxygen attaches.
Haemoglobin transports and delivers oxygen to all cells and vital organs, without which cells are unable to produce energy, leading to the above-mentioned symptoms.
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This can be diagnosed by blood tests. If the haemoglobin is low and the size of the red blood cells (mean corpuscular volume) is reduced, this is highly suggestive of iron deficiency anaemia. The next test is an iron study which will confirm the diagnosis.
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Women, especially those of child-bearing
age, have monthly blood loss through menstrual bleeding. If the intake of iron is not sufficient to replace the blood loss, anaemia will follow.
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The first step is to identify the source of the blood loss. In the case of menstrual blood loss, it is important to determine whether the blood loss is normal or heavy.
In the case of heavy bleeding (menorrhagia), the aim would be to reduce or stop the bleeding. There are a few medical causes of menorrhagia, including hypothyroidism and bleeding disorders, but the vast majority of causes are gynaecological.
Your gynaecologist will be able to assist with an ultrasound, blood hormone level tests, and a pelvic examination to determine the cause.
Based on the cause of the menorrhagia, appropriate treatment can be offered.
The next step would be to increase the haemoglobin, and there are a few ways this can be done.
The first is by blood transfusion, which is a temporising measure used when the haemoglobin is extremely low and there is compromise to the heart.
The second measure is using iron. The most common form of iron replacement
is oral, and your doctor will be able to prescribe this for you if your blood tests confirm iron deficiency.
Sometimes iron supplements can be poorly tolerated, but there are many types available.
Intravenous iron is also available and can be used in select patients.
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In men and post-menopausal women, the diagnosis of iron deficiency requires urgent and further exploration.
Gastrointestinal (GI) bleeding is not uncommon, and a gastroscope and colonoscopy may be required.
In post-menopausal women, gynaecological malignancies need to be ruled out.
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Try to include iron-rich food in your diet, such as red meat, eggs, liver, spinach and beetroot.
Tannins found in tea and coffee reduce the absorption of iron. A regular tea or coffee drinker may benefit from reducing intake by a cup or two or spacing them two hours after a meal.
The use of non-steroidal antiinflammatories like Ibuprofen or diclofenac is a major cause of GI bleeding. These should be avoided unless absolutely necessary.
All women over 35 years of age should have regular pap smears.
Iron deficiency is common but easy to diagnose and treat. If you experience symptoms or have risk factors, contact your doctor for further evaluation.