Anaemia and iron deficiency

By Lovely Ranganath, Dietician, Al Zahra Hospital, Sharjah 

Iron plays an important role in your body. Without iron, your body cannot produce the haemoglobin that carries oxygen throughout your body, to your organs and tissues. This can leave you feeling tired, weak, short of breath, dizzy, or confused.

Your body stores excess iron. If you do not get enough iron from your diet, your body will use your stored iron to make haemoglobin. If you deplete your iron store, you cannot make haemoglobin. This can lead to iron deficiency anaemia.

What is anaemia? 

Anaemia is the medical term that means you do not have enough red blood cells. Red blood cells are important because they contain haemoglobin, which carries oxygen from your lungs to your tissues and cells. Your body needs oxygen in order to survive and to give you energy.

When there are not enough red blood cells, you have less haemoglobin to carry oxygen throughout your body. As a result, your body’s organs and tissues do not get enough oxygen to do their work – this can leave you feeling very tired, weak, short of breath, or dizzy. Anaemia can affect the functioning of your heart, lungs, kidneys, and brain. 

What causes anaemia?

Some types of anaemia are caused by ‘simple’ reasons and are temporary. For example, anaemia can be caused by:

• Poor diet;
• Poor absorption or a shortage of iron, vitamin B12, or folic acid in your diet;
• Blood loss, such as during menstruation, surgery, or from a bleeding ulcer.

Other types o anaemia are chronic, meaning that they can last for a long time. These anaemias can be caused by cancer and cancer treatment, HIV / AIDS, chronic diseases, such as kidney failure, inherited blood disorders.

Common symptoms of anaemia?

• Extreme weakness and tiredness,
• Confusion or loss in concentration,
• Shortness of breath, especially with exertion,
• Rapid heartbeat,
• Chest pain,
• Headache,
• Dizziness or fainting,
• Difficulty sleeping.

How do you know if you have anaemia?

The only real way to know if you have anaemia is to have a blood test to check your red blood cells and, specifically, your haemoglobin. Depending on your haemoglobin level, your doctor will determine if you have anaemia. Not everyone experiences the symptoms of anaemia at the same haemoglobin level. Normal haemoglobin levels range between 120g / L to 160g / L for women and between 140g / L to 180g / L for men. 

Who is at risk for iron deficiency anaemia?

• Those with poor diets – At risk are low-income families and vegetarians (iron in vegetable is not as easily absorbed as iron in meat).
• Infants – After the age of six months, infants need a good dietary supplement of iron since the stores that they were born with are mainly used / depleted. Unfortunately, neither breast milk or cow’s milk are good sources of iron.
• Adolescents – Teens undergoing a growth spurt and teenage girls who have started to menstruate are at risk for iron deficiency.
• Women – Iron is lost with blood each month. Pregnant women require additional haemoglobin to support the developing fetus.
• Those with internal blood loss – Bleeding may occur as a result of hemorrhoids, (benign) polyps, ulcers, or cancer.
• Inflammatory or allergic bowel diseases – Celiac is an allergic reaction to gluten that can reduce the ability of the intestines to absorb iron and other nutrients. Inflammatory bowel diseases like Crohn’s disease may also result in poor iron absorption.

How is anaemia treated?

Treatment for anaemia depends on its cause. Iron deficiency anaemia can be prevented by following a few simple principles. Avoid giving cow’s milk for infants up to 12 months of age. Include iron-fortified formula or cereal for children over six months of age.

If anaemia is due to inadequate dietary intake of iron, B12 or folic acid, then modify the diet to include more iron-rich foods like red and white meat, fish, clams, oysters, dark green leafy vegetables, whole grains, beans, and iron-fortified breads and cereals. Increasing intake of vitamin C can help boost the absorption of iron.

Avoid food fads. The mistaken idea that children should maintain a low fat diet may result in undue restriction of animal foods, while a diet too high in fibre could inhibit iron absorption.

Iron supplements should never be taken without consulting a physician. Oral tablets or intravenous iron may be prescribed. For infants, iron drops or syrup may be recommended.

In cases of severe anaemia, a blood transfusion to increase red blood cell levels may be required. 

Which foods are high in iron?

Eating foods high in iron can help prevent iron deficiency anaemia. There are two forms of iron in our diets – haeme and non-haeme iron. Haeme iron is found in meats, liver, poultry and fish and is easy for the body to absorb. Non-haeme iron is found in fortified cereals, eggs, and certain plant foods and is not as easily absorbed. Try to eat at least two high iron foods each day. 

Iron content in foods

Tips to increase the iron content of your meals

• Try to include meat, chicken or fish on a daily basis.
• Choose breakfast cereals fortified with iron.
• Add dried beans, peas and lentils to soups and casseroles.
• Sprinkle dried fruits such as raisins and chopped dates on cereals, in salads or use in baking.
• Add blackstrap molasses to muffins, baked beans or other recipes.
• Sprinkle wheat germ on cereal or use in baking or preparing casseroles.
• Substitute baby cereal for some of the flour when baking.

How do you improve iron absorption from foods?

• Vitamin C helps your body to absorb more of the iron you eat. Vitamin C rich foods include 100% fruit juices, oranges, grapefruit, dried cranberries, strawberries, kiwis, tomatoes, asparagus, broccoli, red and green peppers, potatoes, spinach and squash.
• Adding heme iron (meats, poultry, and fish) to a meal will also increase your body’s ability to absorb the non-heme iron in foods.
• Tea, coffee, and cocoa (chocolates) can significantly decrease iron absorption in your body. Trying to avoid these can improve your iron absorption.

Some examples of iron-rich meals include:

Ms Lovely Ranganath, Dietician, M.Sc (Food Science & Nutrition), Dip. Fitness & Nutrition, Al Zahra Hospital, Sharjah and Al Zahra Medical Centre, Dubai will be regularly writing on Diet and Nutrition on womenone.org. 

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