Iron Deficiency

Iron deficiency anaemia is the most common type of anaemia

According to the World Heath Organization in 2019, global anaemia:

  • Occurred in 29.9% of women of reproductive age, equivalent to over half a billion women aged 15-49 years;
  • 5% of pregnant women was diagnosed with it; and
  • 8% of children aged 6-59 months, equivalent to 269 million children, suffered from it.

The prevalence of anaemia in children under five was the highest in the African Region, 60.2%.

What is iron deficiency?

It is a condition in which blood lacks adequate healthy red blood cells.

Iron deficiency anaemia is due to insufficient iron.  Without enough iron, your body can’t make enough haemoglobin, the substance in red blood cells that enables them to carry oxygen throughout the body.  As a result, iron deficiency anaemia may leave you tired and short of breath.  Iron is also necessary to maintain healthy cells, skin, hair and nails.

Iron from the food we eat is absorbed into the body by the cells that line the gastrointestinal tract.  The body only absorbs a small portion of the iron we ingest.  The iron is then released into the blood stream, where a protein, called transferrin, attaches to it and delivers the iron to the liver.  The liver store iron as ferritin and releases as needed to make new red blood cells in the bone marrow.  When red blood cells are no longer able to function (after about 120 days in circulation), they are re-absorbed by the spleen.  Iron from these old cells can also be recycled by the body.

Symptoms of iron deficiency

Initially, iron deficiency anaemia can be so mild that it goes unnoticed.  However, as the body becomes more deficient in iron and anaemia worsens, the signs and symptoms intensify.

Iron deficiency anaemia signs and symptoms may include:

  • Unexplained fatigue or lack of energy.
  • Unexplained generalized weakness.
  • Pale skin or having yellow “sallow” skin.
  • Chest pain, rapid heartbeat or shortness of breath.
  • Headache, dizziness or light-headedness.
  • Cold hands and feet.
  • Inflammation or soreness of the tongue.
  • Brittle nails or hair loss.
  • Poor appetite, especially in infants and children.
  • Difficulty concentrating.
  • Pica (a condition in which people crave non-food items like ice, chalk, paint, clay or starch).

Diagnosing iron-deficiency anaemia

Iron-deficiency anaemia is diagnosed with blood tests.  Your healthcare provider might:

  • Conduct a complete blood count (CBC).
  • Examine the red blood cells under a microscope for cell size and colour. If you have iron-deficiency anaemia, your red blood cells will be pale instead of bright red and smaller than usual.
  • Calculate hematocrit (Hct). This is the percentage of your blood volume that is made up by red blood cells.  Lower than normal hematocrit levels show anaemia.
  • Determine haemoglobin (Hg) levels. Lower than normal haemoglobin levels indicate anaemia.
  • Measure serum iron (FE), the amount of iron in the blood. Low serum iron levels result in anaemia.
  • Measure the amount of ferritin in the blood. Ferritin is the protein that helps store iron in the body, and a low level of ferritin usually indicates a low level of stored iron and thus iron deficiency.
  • Measure transferrin. The liver makes transferrin.  When the body’s stores of iron run low, the liver makes more transferrin to get more iron into the blood.  High transferrin levels signal iron-deficiency.

If you have iron-deficiency anaemia, your healthcare provider may do additional tests to find the cause.