Iron-deficiency Anaemia

iron def anemia

Blood is made up of fluid called plasma which contains:

  • Red blood cells - which take oxygen around the body.
  • White blood cells - which are part of the immune system and defend the body from infection.
  • Platelets - which help the blood to clot if we cut ourselves.
  • Proteins - and other chemicals that have various functions.

Red blood cells are made in the bone marrow. Millions of them are released into the bloodstream each day. A constant supply of new red blood cells is needed to replace old ones that break down. Red blood cells contain a chemical called haemoglobin. Haemoglobin transports oxygen from the lungs to all parts of the body.

What is iron-deficiency anaemia?

You have fewer red blood cells than normal;


You have less haemoglobin than normal in each red blood cell.

In either case, a reduced amount of oxygen is carried around in the bloodstream. Anaemia caused by a lack of iron is called iron-deficiency anaemia.

What are the causes of iron-deficiency anaemia?

A normal balanced diet will usually contain enough iron for your body's needs. A low level of iron, leading to anaemia, can result from various causes. Some are more serious than others, and include the following:

  • Heavy menstrual periods
  • Pregnancy
  • Poor absorption of iron
  • Bleeding from the gut (intestine)
  • Sometimes the bleeding is not obvious. A constant trickle of blood into the gut can be passed unnoticed in the stools (faeces). The iron that you may lose with the bleeding may be more than you eat.


Some medicines can sometimes cause bleeding into the gut without causing symptoms. The most common example is aspirin.
Bleeding from the kidney

Dietary factors

Not eating foods with enough iron is sometimes the cause of iron-deficiency anaemia. A restricted diet such as a vegan or a limited vegetarian diet sometimes does not contain enough iron.

Hookworm infection

What are the symptoms of iron-deficiency anaemia?

Common symptoms are due to the reduced amount of oxygen in the body. These include tiredness, lethargy, feeling faint and becoming breathless easily. Less common symptoms include headaches; irregular heart beats (palpitations), altered taste, sore mouth and ringing in the ears (tinnitus). You may look pale.

Possible complications

You can develop fragile and broken nails, hair loss and heart failure. A lack of iron can also affect the immune system so you may become more likely to develop infections. Anemia in pregnancy increases the risk of complications in both mother and baby. For example, there is an increased risk of: having a low birth weight baby, preterm (premature) delivery and postnatal depression.

How is iron-deficiency anemia diagnosed?

A blood test can confirm that you are anemic. A test called the full blood count (FBC) is the main test.

You may need another blood test to confirm that the cause of the anemia is due to lack of iron. This blood test measures a protein called ferritin. The level of this protein usually reflects the total body iron stores.

Do I need any further tests?

It is important to find the cause of the iron deficiency. Tests that may be advised include one or more of the following:

Tests to look into the gut to see if there is any internal bleeding.

What is the treatment for iron-deficiency anaemia?

Iron tablets are usually prescribed to correct the anaemia. Your doctor may refer you to hospital to have iron given in a different way if your anaemia does not improve on tablets, or you find it difficult to take the tablets.

Iron tablets

Various iron tablets and liquid medicines are available. Your doctor will advise on one. The length of course will depend on how bad the anaemia is. A blood test after a few weeks will show if the treatment is working. Drinking orange juice when you take your iron tablets can increase the absorption of iron into your body.

When your blood level is back to normal, you should continue to take iron for at least three further months. This will build up your stores of iron in your body. Blood tests at regular intervals after that will ensure you do not become anaemic again.

Some people have side-effects when taking iron. These include: feeling sick (nausea), an upset stomach, constipation, or diarrhoea. Possible ways to reduce the problem with side-effects are:

  • Taking the iron tablets with meals.
  • Taking a lower dose, but again a longer course will be needed to correct the anaemia.
  • Drinking plenty of fluids if constipation develops.

REMEMBER to keep iron tablets away from children, who may think that they are sweets. An overdose of iron tablets can be very dangerous in children.

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