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Symptoms of Low Iron and Iron Deficiency Anemia


Symptoms of Low Iron and Iron Deficiency Anemia

Eating this one food can reveal that you might have iron deficiency!

“Symptoms of low iron and iron deficiency anemia include fatigue, low energy levels, shortness of breath, lightheadedness, fast heart rate, and palpitations.”

Conditions Associated With Symptoms of Low Iron and Iron Deficiency Anemia

Low iron and iron deficiency anemia is a common, worldwide epidemic worsened by poor nutrition. It is important to know the symptoms of low iron and iron deficiency anemia which include fatigue, low energy levels, shortness of breath, lightheadedness, fast heart rate, and palpitations. The following conditions have been found to be associated with iron deficiency anemia:

  • Young menstruating women
  • Pregnant women
  • Anyone with recent blood loss
  • Anyone who recently donated blood or donates blood regularly
  • Vegetarians with higher rates in vegetarian women than vegetarian men
  • Any suspicion of iron deficiency, you should be screened
  • Gastrointestinal blood loss
  • Malabsorbtion, malnutrition and celiac disease
  • History of gastric bypass
  • Hemolysis, blood, and bone marrow diseases
  • Those with Restless Leg Syndrome have 9 times higher rates of iron deficiency (8)
  • Those that chew or desire to chew ice, clay, soil or paper (9)
  • 6-12 month infants with a low birth weight, premature birth
  • Vegetarian children
  • Red-colored urine which occurs after eating beets (beeturia) may be a sign of iron deficiency anemia (13).

“Red-colored urine which occurs after eating beets (beeturia) may be a sign of iron deficiency anemia (13).”

Screening for Iron Deficiency Anemia

Hemoglobin, hematocrit, and iron tests directed by a physician should be checked whenever iron deficiency is suspected. The U.S. Preventive Services Task Force (USPSTF) recommends prevention of iron deficiency for 6-12 month infants with a low birth weight, premature birth, or those at increased risk to reduce the risk of iron deficiency with formulas and cereals fortified with iron. This includes vegetarian children. The CDC recommends screening for iron deficiency in teenage women every 5-10 years. If hemoglobin is under 9, one should be referred to a Hematologist and/or GI physician. Generally, men and women after age 50 do not need to be screened.

The US Preventive Services Task Force recommends screening for iron deficiency in pregnant women without symptoms of anemia. Iron deficiency while pregnant may contribute to lower birth weight and may lead to poor mental development of the child. Iron supplements should be given to iron deficient pregnant women. Vegetarian women are also at high risk of iron deficiency. It is important to know that excessive iron from supplements can be harmful. It is extremely important to make sure you are not losing blood from the gastrointestinal tract. Your physician will provide a proper evaluation and diagnosis of low iron and iron deficiency anemia. Your physician will help you investigate this starting with a fecal occult blood test to find out if there is any detectable blood within the stool. Ferritin, complete blood count and several other diagnostic blood tests are usually done by your physician to diagnose the type of anemia, investigate the cause of anemia and to assess iron stores.

Recommendations for Daily Iron Intake

The Food and Nutrition Board Institute of Medicine recommendations for daily iron intake: infants 0-6 months, 0.27 mg; 7-12 month olds, 11 mg; children 1-3 years old, 7 mg; 4-8 year olds, 10 mg;  9-13 year olds, 8 mg; males 14-18 years old, 11 mg; females 14-18 years old, 15 mg; all males over 18 years old, 8 mg, females age 19-50, 18 mg; females over age 50, 8 mg; all pregnant women, 27 mg; lactating females under age 18, 10mg; and lactating females over age 18, 10 mg (1). Iron has been proposed to be maintained as a serum ferritin concentration of 15 mg/ml.. Pregnant patients should supplement with iron at a dose of 30 mg daily during pregnancy or 60-120 mg if iron deficiency anemia is found.

Iron Intake for Vegetarians

The Food and Nutrition Board Institute of Medicine expressed that vegetarians should double the recommended daily allowance of iron since the non-heme iron found in plant foods is not is well observed as the heme-iron found in meats: Vegetarian men appeared to be able to obtain enough iron from diet alone (2). It is important to discuss with your physician the importance of being screened for excess iron stores prior to starting iron supplements. It is also worthwhile to attempt using iron rich vegetarian foods instead of iron supplements due to the unknown risk of using and supplements for the long term.

Cook in Cast Iron Pots for Low Iron and Iron Deficiency Anemia

Cooking in an iron pot increase the iron content of foods (14).  A pilot study showed that the iron content in foods increases by about 16% after the food is cooked in iron cookware and after 4 months, increased hemoglobin in study subjects by 7.9% (15).

How to Replenish Iron for Symptoms of Low Iron and Iron Deficiency Anemia

Once you are determined to be iron deficient, it takes quite some time to restore iron stores from diet alone. You may consider taking an iron supplement as advised by your physician and iron containing foods over the long term. Here is the iron content for over 8000 foods from the USDA database so you can plan your iron intake.

Your Physician Will Guide You With Symptoms of Low Iron and Iron Deficiency Anemia

Most physicians prescribe iron sulfate or iron polysaccharide which many people have trouble tolerating due to side effects. Once it is determined that you cannot tolerate iron sulfate, your physician may unfortunately advise an IV iron such as iron dextran. Why not avoid the side effects from the common iron supplements? To give our patients the best chances, we now recommend iron protein succinylate for all of the patients at our clinic. You will see after reviewing the research for tolerability of different iron supplements, it is apparent that iron protein succinylate is tolerated better than all other available iron supplements. Iron protein succinylate is combined with milk protein to improve assimilation. This form of iron has much lower rates of adverse reactions (mainly nausea, constipation, and abdominal pain) at about 7% compared with 47% for iron fumarate, about 32% for iron sulfate, 31% for iron gluconate, and about 24% for iron glycine sulfate (7).

Iron Protein Succinylate for Symptoms of Low Iron and Iron Deficiency Anemia

Iron protein succinylate results in greater iron absorption compared to iron sulfate. When these two agents were compared after being taken for 30 days by blood donors, serum iron increased over baseline in the iron protein succinylate group only (4). A controlled double-blind trial by Liquori L (3) with 95 iron deficient patients took iron protein succinylate at a dose of 120 mg of elemental iron and another group took iron sulfate with 105 mg of elemental iron. After 60 days, the hemoglobin, hematocrit, and ferritin were greater in iron protein succinylate group. The adverse reactions were about 12% in the iron protein succinylate group, and about 26% (more than double the rate ) in the iron sulfate group. For iron deficient individuals, iron protein succinylate can be considered at a dose of 120 mg for 60 days then reassess iron levels and hemoglobin. Alternatively, you can consider eating iron containing foods in the diet, plus or minus lower doses of iron supplements, then reassess iron levels and hemoglobin.

More About Iron Supplements for Symptoms of Low Iron and Iron Deficiency Anemia

Again, if you decide to start on any iron supplements, they are best advised by your physician. Over the counter iron supplements are only available in much lower doses than prescription doses. There are many interactions between iron supplements and other drugs. The majority of these are a reduction in iron absorption by antacid medications, because iron needs an acidic environment to be absorbed. In some circumstances, the iron reduces absorption of other medications. Be sure to check the drug interactions of iron supplements or ask your pharmacist.

Iron Deficiency in Children

Ensure adequate iron intake in children help them avoid developing symptoms of low iron and iron deficiency anemia. Iron supplementation improved attention and concentration in anemic adolescents and increased intelligence (IQ by 2.5 points) (10). Sachdev H P et al found that iron supplementation was beneficial in mental development and in intelligence scores (IQ scores) in children 7 years or older and in those who are initially anemic or iron-deficient anemic (11). Iannotti LL, performed a review of 26 randomized controlled trials which evaluated the iron supplementation in children (aged 0-59 months) and found that many trials showed that iron supplementation improved mental and motor development, but it may reduce a child’s weight gain and is associated with nausea and constipation (12).

References for Symptoms of Low Iron and Iron Deficiency Anemia
1.Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, DC: National Academy Press, 2001. http://iom.edu/~/media/Files/Activity%20Files/Nutrition/DRIs/DRI_Elements.pdf
2.Hunt JR. Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr. 2003;78(3 Suppl):633S-639S.http://ajcn.nutrition.org/content/78/3/633S.full
3.Liguori L. Iron protein succinylate in the treatment of iron deficiency: controlled, double-blind, multicenter clinical trial on over 1,000 patients. Int J Clin Pharmacol Ther Toxicol. 1993 Mar;31(3):103-23. http://www.ncbi.nlm.nih.gov/pubmed/8468108
4.Landucci G, Frontespezi S. Treatment of iron deficiency conditions in blood donors: controlled study of iron sulphate versus iron protein succinylate. J Int Med Res. 1987 Nov-Dec;15(6):379-82. http://www.ncbi.nlm.nih.gov/pubmed/3325320
5.Köpcke W, Sauerland MC. Meta-analysis of efficacy and tolerability data on iron proteinsuccinylate in patients with iron deficiency anemia of different severity. Arzneimittelforschung. 1995 Nov;45(11):1211-6. http://www.ncbi.nlm.nih.gov/pubmed/8929242
6.Xing Y, Tong XM. Clinical study of iron protein succinylate oral solution for preventing and treating anemia of prematurity. Zhongguo Dang Dai Er Ke Za Zhi. 2013 Dec;15(12):1059-63. http://www.ncbi.nlm.nih.gov/pubmed/24342196
7.Cancelo-Hidalgo MJ, Castelo-Branco C, Palacios S, Haya-Palazuelos J, Ciria-Recasens M, Manasanch J, Pérez-Edo L. Tolerability of different oral iron supplements: a systematic review. Curr Med Res Opin. 2013 Apr;29(4):291-303. http://www.ncbi.nlm.nih.gov/pubmed/23252877
8.Allen RP, Auerbach S, Bahrain H, Auerbach M, Earley CJ. The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia. Am J Hematol. 2013 Apr;88(4):261-4. http://www.ncbi.nlm.nih.gov/pubmed/23494945
9.Kettaneh A, Eclache V, Fain O, Sontag C, Uzan M, Carbillon L, Stirnemann J, Thomas M. Pica and food craving in patients with iron-deficiency anemia: a case-control study in France. Am J Med. 2005 Feb;118(2):185-8. http://www.ncbi.nlm.nih.gov/pubmed/15694906
10.Falkingham M, Abdelhamid A, Curtis P, et al. The effects of oral iron supplementation on cognition in older children and adults: a systematic review and meta-analysis. Nutr J. 2010 Jan 25;9:4.http://www.ncbi.nlm.nih.gov/pubmed/20100340
11.Sachdev H P, Gera T, Nestel P. Effect of iron supplementation on mental and motor development in children: systematic review of randomised controlled trials. Public Health Nutrition 2005 Apr; 8(2): 117-132.http://www.ncbi.nlm.nih.gov/pubmed/15877905
12.Iannotti LL, Tielsch JM, Black MM, Black RE. Iron supplementation in early childhood: health benefits and risks. Am J Clin Nutr. 2006 Dec;84(6):1261-76.http://www.ncbi.nlm.nih.gov/pubmed/17158406
13.Watts AR, Lennard MS, Mason SL, Tucker GT, Woods HF. Beeturia and the biological fate of beetroot pigments. Pharmacogenetics. 1993 Dec;3(6):302-11. http://www.ncbi.nlm.nih.gov/pubmed/8148871
14.Charles CV, Summerlee AJ, Dewey CE. Iron content of Cambodian foods when prepared in cooking pots containing an iron ingot. http://www.ncbi.nlm.nih.gov/pubmed/21906213
15.Kulkarni SA, Ekbote VH, Sonawane A, Jeyakumar A, Chiplonkar SA, Khadilkar AV. Beneficial effect of iron pot cooking on iron status. Indian J Pediatr. 2013 Dec;80(12):985-9. http://www.ncbi.nlm.nih.gov/pubmed/23868537

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