What you should know about iron deficiency anemia:

• Iron deficiency is the commonest cause of anemia
  
  
• Iron is an essential element for hemoglobin synthesis.Thus any deficiency will eventually lead to anemia
  
  
• Deficiency is usually due to an imbalance between needs and intake.This occurs more readily in certain periods of life such as:growing children or teen –agers,pregnant women,elderly
  In new born babies,iron stock is enough to assure the needs for the 4-6 first months of life.After this and if the diet is poor in iron, deficiency occurs.Premature babies are prone to iron deficiency before the fourth month because they lacked time to constitute their stocks and their rate of growth is faster.
  Noteworthy that the maternal milk is  richer in iron than the dry milk.More over some kids develop  intolerance to cow milk which will worsen iron deficiency
  During adolescence the need for iron increases (growth and /or menses) and due to alimentary bad habit intake is lessened.
  In elderly (>65 years old) ,iron deficiency is the most common cause of anemia.It can be due to reduced intake (lonely people,homecare patients…) but most commonly it results from chronic blood loss mainly from the digestive tract(gastric or duodenal ulcer,anti inflammatory drugs,vascular dysplasia,tumor) 
  • Malabsorption is also a cause of deficiency and is generally due to digestive tract anomalies
  • Acute or chronic blood losses.
    Menstruated women develop anemia whenever the losses are not compensated by intake(a woman looses 30-40 ml of blood per month and 1 ml of blood contains =0.5 mg of iron!) .So one should be careful to the amount of loss .

  The other major cause of blood loss is occult gastro-intestinal bleeding
  Iron is essential to many enzymes .It is present in the body in many forms.
  Transferrin is the protein involved in iron transport through different fluids
  Ferritin is the protein that fixes iron molecules and stock them in some tissues    

How does it feel to be anemic?

The chief complaint of anemic patient is fatigue. Dyspnoea,tachycardia can also be present
Palor is a major feature.It is most evident in the cujunctiva (inside of the eye).
However a slowly  progressive installing anemia can remain silent until it is discovered during a check up
Iron deficiency itself can manifest with some signs as:
-Red smooth and painful tongue
-Dry and crackled lip’s margins
-Breakable and concave nails
How does it manifest in the lab?
You can suspect an iron deficiency anemia on some features of the CBC (Blood Cell Count):
   -RBC is low
   -Hematocrit and hemoglobin( Hc and Hb) are low
   -Mean corpuscular volume (MCV),Mean corpuscular hemoglobin (MCH) are low
   -The blood film may show some irregularities (anisocytosis,polychromasia,poïkilocytosis…)
There is also some tests to evaluate iron state
Iron is usually low but it reflects recent intake of iron and is subject to variability mainly by inflammatory process
Total Iron Binding Capacity (TIBC) is l ow
Transferrin is high
Ferritin is low

What is the treatment?

First step is to correct the cause of the anemia (digestive or genital hemorrage…),then to restore iron stocks
This can be done by oral therapy (iron sulfate or ferrous fumarate which is more tolerated).100-200 mg a day is often enough to correct anemia as hemoglobin rises about 2 g a week.The treatment should be continued enough to restore the stock(i.e 3 months).However side effects are frequent mainly as digestive incomfort
Alimentary source of iron are variable.Meat contains iron in the most absorbable form.Liver is rich in iron too.Vegetables (green vegetables),cereals,whole wheat,egg yolk,dry fruits  are also rich.
The daily recommended apport vary depending on age,sex,dietary regimen.But a daily apport of 10 mg for man and 15 mg for woman is adequate