Are you IRON DEFICIENT?
Iron deficiency anaemia during pregnancy can make you feel weak and tired. Know the risk factors, symptoms and what you can do to avoid it
IRON DEFICIENCY is when your body doesn’t have enough iron to meet its daily needs and it starts using its iron stores. Iron deficiency anaemia is when your body’s iron stores are depleted, and your body is unable to produce sufficient haemoglobin, which carries oxygen to the rest of your body.
Iron deficiency is common during pregnancy as you have higher requirements for the growth of the placenta and a healthy baby.
Iron deficiency in pregnancy may result in the foetus not receiving enough iron, which is needed for development. It can also result in excessive tiredness and increased risk of preterm labour. Iron deficiency is also common after giving birth, due to the blood loss.
If you notice any of these signs and symptoms, it’s best to see your caregiver…
• Fatigue
• Headaches
• Dizziness or light-headedness
• Breathlessness
• Paleness
• Unusual food cravings, such as dirt and ice (known as pica)
• Brittle nails
• Swelling or soreness of the tongue
• Frequent infections
• Poor concentration
• Irritability
LACK OF IRON IN THE DIET
Your body gets the iron it needs from the food you eat. Iron-enriched foods include meat, eggs and leafy green vegetables and iron-fortified foods. If you follow a restricted vegetarian diet, you may have a greater risk of iron deficiency.
TEST FOR IRON DEFICIENCY
With Ferricheck® you can test your iron levels quickly. Ferricheck is an easy, rapid screening test for iron deficiency, available at your local pharmacy clinic. Do a quick finger-prick test, check your results; follow up with your healthcare professional if you are deficient to find the cause and discuss treatment.
TREATMENT VERSUS SUPPLEMENTS – WHAT’S THE DIFFERENCE?
Supplements have 24mg or less elemental iron. Based on international and local treatment guidelines, this is insufficient to treat your iron deficiency. These guidelines recommend 100200mg elemental iron per day for the treatment of iron deficiency and iron deficiency anaemia.
WHAT ARE THE BENEFITS OF CONTROLLED ABSORPTION?
Reliable correction of iron levels. The body only absorbs the iron it needs. Significantly fewer gastrointestinal side effects. FERRIMED® iron is absorbed in the body by an active and controlled manner.
OTHER ABSORPTION BENEFITS
The convenience of taking it with food. Does not interact with other commonly used medications.
NAUSEA. FOOD AVERSIONS. Water retention. Fatigue… As if you didn’t have enough to deal with already, nature goes and throws in some pregnancy constipation for good measure. Yay! You’re not alone, though: 39 percent of women experience constipation during the first trimester and 35 percent suffer from it during the second trimester, according to Dr Khalid Coovadia, a gastroenterologist at Mediclinic Panorama, Cape Town.
The (somewhat) good news? It’ll probably ease up in the third trimester. “It may continue into the third trimester and up until the post-partum period, however the incidence declines with time to 20 percent and 17 percent respectively,” he explains.
CONSTIPATION OR IRREGULARITY?
While some irregular bowel movements are to be expected when you’ve got a human being growing in close proximity to your colon, this shouldn’t be confused with all-out constipation. The real thing, says Dr Karina Janse van Rensburg, an ob/gynae also practising from Mediclinic Panorama, is characterised by “infrequent passage of stools for more than a week, abdominal bloating and/or discomfort, passage of hard stools and/or pain when passing stools”.
Dr Coovadia adds that to medically diagnose constipation, you must have experienced at least two of the following symptoms over the past three months:
• Fewer than three spontaneous bowel movements per week.
• Straining for more than 25 percent of defecation attempts.
• Lumpy or hard stools for at least 25 percent of defecation attempts.
• Sensation of anorectal obstruction (blockage) for at least 25 percent of defecation attempts.
• Sensation of incomplete defecation for at least 25 percent of defecation attempts.
• Manual manoeuvring required to defecate for at least 25 percent of defecation attempts.
CAUSES AND CURES
A range of lifestyle factors can cause constipation, says Dr Janse van Rensburg, ranging from not drinking enough fluids – especially water – to not eating enough fibre and not exercising enough, or being too inactive in general. Iron supplements commonly prescribed during pregnancy can also cause you to become blocked up. But, as is the case with most pregnancy niggles, the biggest culprit is hormones. “Hormonal changes are thought to be the main driver toward constipation,” says Dr Coovadia.
“Progesterone induces smooth muscle relaxation, resulting in decreased intestinal mobility. In addition to this, it has been proposed that pregnant women have increased colonic absorption of water due to higher levels of aldosterone in the blood, which is induced by hormones such as oestrogen and progesterone.” Last, but not least, your enlarged uterus pushing down on your bowels can also impede free flow. Luckily, constipation is easily treatable with a combination of lifestyle changes and, if needed, medication.
Dr Coovadia always recommends first trying nonpharmacological methods to relieve constipation for pregnant women. This includes increasing dietary fibre, adequate fluid intake and exercise.
He adds that eating larger portions – especially in the second trimester – may worsen constipation; therefore eating small portions more frequently is also worth a try. He also recommends trying fibre-containing bulk agents, such as Metamucil or Citrucel.
If you are taking iron supplements, Dr Janse van Rensburg advises discussing whether you really need them with your doctor.
As a last resort, she says stool softeners could be taken, but should only be done so under the supervision of a medical professional.
Stool softeners are called “osmotic laxatives”, adds Dr Coovadia, and they contain lactulose, sorbitol, polyethylene glycol (PEG), which are considered safe during pregnancy. “The American Gastroenterological Association considers PEG to be a low-risk drug and the preferred drug for chronic constipation in pregnancy,” he notes.
Both Dr Coovadia and Dr Janse van Rensburg warn against taking “stimulant laxatives” – medication that triggers the bowels to contract – as these are considered unsafe for pregnancy. “Mineral oil, castor oil and saline hyperosmotic should also be strictly avoided,” stresses Dr Coovadia.
IS IT DANGEROUS?
While uncomfortable and sometimes painful, constipation is general not harmful to you or your baby. However, if it’s chronic constipation, Dr Coovadia points out that it can lead to some more serious medical issues. These include haemorrhoids, which can result in rectal bleeding, perianal fissures that make defecation extremely painful and faecal impaction, which may require hospitalisation. A few good reasons to nip constipation in the bud…