Symptoms and causes of iron deficiency in the body: signs of iron deficiency in women and men

Chronic lack of iron in the body occurs due to iron deficiency and is characterized by impaired synthesis of hemoglobin, which is contained in red blood cells. The human body receives its first reserves of iron from the mother through the placenta; after birth, iron is replenished through food intake or iron-containing medications. Iron is removed from the body by the urinary and digestive systems, sweat glands and during menstruation in women. About 2 grams of iron are excreted per day, so in order to prevent depletion of reserves, it must be constantly replenished. According to WHO, every 3rd woman and every 6th man in the world suffers from iron deficiency anemia. Pregnant women, children under 3 years of age and teenage girls are at risk.

Causes of iron deficiency anemia (IDA)

insufficient intake of iron from food: fasting, vegetarianism, or a diet depleted in iron and protein, followed for a long time. In breastfed children, the cause may be iron deficiency anemia of the mother, early transfer to artificial feeding, late introduction of complementary foods
impaired iron absorption: enteritis (inflammation of the mucous membrane of the small intestine caused by infection or helminthic infestation), gastritis and peptic ulcer of the stomach and duodenum; hereditary diseases (cystic fibrosis and celiac disease); autoimmune damage to the intestinal mucosa and possibly the stomach (Crohn's disease); condition after removal of the stomach and/or duodenum; stomach and intestinal cancer
chronic blood loss. This is the most basic reason. This includes losses due to: gastric and duodenal ulcers, nonspecific ulcerative colitis, Crohn's disease, hemorrhoids and anal fissures, intestinal polyposis, bleeding from disintegrating tumors of any location and varicose veins of the esophagus; hemorrhagic vasculitis; pulmonary hemorrhages, pulmonary hemosiderosis; chronic pyelonephritis, polycystic disease and cancer of the kidneys and bladder; losses during hemodialysis; uterine fibroids, endometriosis, hyperpolymenorrhea, cervical cancer; nosebleeds
congenital deficiency of iron in the body (prematurity, birth from multiple pregnancy, severe iron deficiency anemia in the mother, pathological bleeding during pregnancy and childbirth, fetoplacental insufficiency)
alcoholism (the mucous membrane of the stomach and intestines is damaged, making it difficult to absorb iron)
use of medications: non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, aspirin) reduce blood viscosity and can promote bleeding, in addition, these drugs can provoke the occurrence of stomach and duodenal ulcers; antacids (Almagel, Gastal, Rennie) reduce the production of hydrochloric acid, which is necessary for effective absorption of iron; iron-binding drugs (desferal), these drugs bind and remove free iron and iron in ferritin and transferrin, and in case of overdose can lead to iron deficiency states
donation (with donations more than 4 times a year, iron deficiency develops)
disruption of transferrin synthesis. Transferrin is an iron transport protein that is synthesized in the liver.

Normal hemoglobin level in the blood: in women – 120-140 g/l, in men – 130-160 g/l

Causes of iron deficiency

Two common reasons for ferrum shortages are insufficient supply and increased demand.

In the first case, we are talking about malnutrition, in the second, deficiency can be caused by : • active growth; • pregnancy (fetal needs); • impaired absorption; • blood loss (menstrual or internal intestinal); • taking medications for the treatment of gastrointestinal diseases (antacids, proton pump inhibitors, H2 blockers).

The most unobvious cause of Fe deficiency is intense exercise. Although physical activity is beneficial for the body, it also increases its need for microelements. The more calories burned, the more iron required for erythropoiesis.

Clinical manifestations of IDA

Anemic syndrome - occurs due to a decrease in the level of red blood cells and hemoglobin in the blood, reducing the saturation of cells and tissues with oxygen. The signs of anemic syndrome are difficult to recognize, but they help to suspect the presence of anemia and, in combination with the data of other examinations, make a diagnosis. These are general weakness, high fatigue and decreased performance, dizziness, tinnitus and flashing “spots” before the eyes, periodic palpitations, shortness of breath with little physical exertion, and fainting. Upon examination, pallor of the skin and visible mucous membranes, slight swelling of the legs, feet, face (mainly the area around the eyes), tachycardia, various types of arrhythmia, moderate heart murmurs, and muffled heart sounds are revealed.

Sideropenic syndrome - caused by iron deficiency in tissues, which causes a decrease in the activity of many enzymes (protein substances that regulate many vital functions), manifested by numerous symptoms:

change in taste (desire to eat unusual foods: sand, chalk, clay, tooth powder, ice, as well as raw minced meat, unbaked dough, dry cereals)
tendency to eat hot, salty, spicy foods
distortion of the sense of smell (attracted by the smell of gasoline, acetone, the smell of varnishes, paints, lime)
decreased muscle strength and atrophy
dry, flaky skin; fragility and hair loss; dullness, transverse striations, spoon-shaped concavity of nails; Minor injuries and abrasions do not heal for a long time
dryness and cracks in the corners of the mouth in 10-15% of patients
feeling of tongue fullness, redness and atrophy, frequent periodontal disease and caries
dryness of the esophageal mucosa, which causes pain when swallowing and difficulty swallowing solid food, the development of atrophic gastritis and enteritis
urgency to urinate, inability to hold urine when coughing, laughing, sneezing, episodes of bedwetting
the symptom of “blue sclera” is characterized by a bluish coloration of the sclera
prolonged increase in body temperature to subfebrile levels (37.0-37.9°C) for no apparent reason
frequent ARVI

Diagnosis of IDA

clinical blood test: decreased level of hemoglobin, red blood cells, decreased hemoglobin content in one red blood cell, often increased ESR
biochemical blood test: decrease in serum iron level, increase in total iron-binding capacity of serum, decrease in ferritin content in blood serum

If an iron deficiency is detected in the patient’s body using tests, then the next step will be to search for the causes of this deficiency. To identify the cause of iron deficiency, a comprehensive examination is carried out, including esophagogastroduodenoscopy, sigmoidoscopy, colonoscopy, bronchoscopy, chest x-ray, ultrasound examination of the abdominal organs, pelvis and kidneys, examination by a gynecologist, urologist, hematologist, stool analysis for occult blood and eggs. helminths, as well as examination of red bone marrow from the sternum or ilium (sternal puncture, trephine biopsy).

Why does the body need iron?

Men and women have different iron reserves. The discrepancy is due not only to different masses of bodies. Women regularly lose blood during menstruation, and along with it, a much-needed microelement goes away. A sufficient amount of iron is a prerequisite for erythropoiesis - the process of formation of red blood cells (erythrocytes). They contain the protein hemoglobin, which is responsible for transporting oxygen to all cells of the body.

Hemoglobin accounts for about ¾ of the total supply of ferrum in the body. The remaining ¼ is distributed between: • ferritin (the protein that accumulates it); • transferrin (iron transport protein); • tissue enzymes; • myoglobin (oxygen-binding protein of the heart muscle); • hemosiderin (a breakdown product of hemoglobin). Its deficiency disrupts metabolic processes and reduces the protective capabilities of the immune system. The endocrine system also suffers, since enzymes containing iron are needed to produce thyroid hormones.

Complications of IDA

Complications arise with prolonged anemia without treatment and reduce the patient’s quality of life: decreased immunity, increased heart rate, which leads to heart failure; in pregnant women, the risk of premature birth and fetal growth retardation increases; in children, iron deficiency causes retarded growth and development; a rare and severe complication is hypoxic coma; hypoxia due to iron deficiency complicates the course of existing cardiopulmonary diseases (coronary artery disease, bronchial asthma, chronic cerebral ischemia, etc.) until the development of emergency conditions, such as acute or repeated myocardial infarction and acute cerebrovascular accident (stroke).

How to replenish iron deficiency in the body?

There is no cure for iron deficiency anemia as such. If a blood test shows a deficiency of this important microelement, it is necessary to replenish it. Then the symptoms of the disease will disappear.

To overcome Fe deficiency, the following are usually prescribed: • A therapeutic diet. The diet must include meat, offal (tongue, liver), and seafood. • Oral iron supplements. Usually presented in the form of salts (sulfates, fumarates, gluconates). • Injections. Recommended in extreme cases (if oral medications are ineffective or there is large blood loss) due to the risk of complications.

The standard course of treatment is at least six months. In the first two months, the disease itself is eliminated, and in the remaining time the level of the microelement is normalized. Usually, a course of vitamin C is prescribed in parallel. It improves the absorption of ferrum and, accordingly, increases the effectiveness of therapy.

Treatment of IDA

The basic principles of treatment for iron deficiency anemia include eliminating the cause of iron deficiency, correcting the diet, and replenishing iron deficiency in the body.

The diet for iron deficiency anemia consists of eating foods rich in iron. Patients are advised to have a nutritious diet with the obligatory inclusion in the diet of foods containing heme iron (veal, beef, lamb, rabbit meat, liver, tongue). Plant foods rich in iron include beans, beans, lentils, peas, spinach, cauliflower, potatoes, carrots, beets, bananas, apricots, peaches, apples, blueberries, raspberries, strawberries, almonds and walnuts. It should be remembered that ascorbic acid, which is found in bell peppers, cabbage, rose hips, currants, citrus fruits, sorrel, enhances the absorption of iron in the gastrointestinal tract, and oxalates and polyphenols (coffee, tea, soy protein, milk, chocolate) worsen the absorption of iron. calcium, dietary fiber and other substances. However, no matter how much meat we eat, only 2.5 mg of iron will enter the bloodstream per day - this is exactly how much the body can absorb. And 15-20 times more is absorbed from iron-containing complexes - that’s why the problem of anemia cannot always be solved with the help of diet alone, and therefore iron-containing drugs are prescribed
Oral iron supplements differ from other medications by special rules of administration: - short-acting iron-containing preparations are not taken immediately before or during meals. The medicine is taken 15-20 minutes after meals or in the pause between doses; prolonged medications (sorbifer durules, tardiferron-retard, etc.) can be taken before meals and at night (1-2 times a day); - iron supplements are not taken with milk and milk-based drinks (kefir, fermented baked milk, yogurt) - they contain calcium, which will inhibit the absorption of iron - tablets (except for chewable ones), dragees and capsules are not chewed, are swallowed whole and washed down with plenty of water, rosehip decoction or clarified juice without pulp Oral iron supplements (in tablets, drops, syrup, solution) are the initial treatment for mild to moderate anemia; if there is pregnancy, the intake is agreed with an obstetrician-gynecologist. The duration of treatment is 4–8 weeks until hemoglobin levels normalize, then the drug is taken for 4–6 weeks at half the dose. The most commonly prescribed: - sorbifer durules/fenuls 100 mg, 1-2 tablets 1-2 times a day until hemoglobin levels are restored (in pregnant women, for prevention, 1 tablet 1 time a day, for treatment, 1 tablet 2 times a day) - ferretab comp . 1 capsule per day, up to a maximum of 2-3 capsules per day in 2 divided doses, minimum period of use is 4 weeks - maltofer/actiferrin comes in three dosage forms (drops, syrup, tablets), intake 40-120 drops/10-30 ml syrup / 1-3 tablets per day in 1-2 doses - tardiferron 80 mg, 1-2 tablets per day, pregnant women 1 tablet per day, II-III trimester - totema (combined preparation of iron, copper and manganese) 2- 4 ampoules per day, solution diluted in 1 glass of water, taken for 3-6 months - ferlatum 15 ml 1-2 bottles per day in 2 divided doses
Injectable iron preparations (venofer, likfer, cosmofer, ferrinject) are used exclusively in the hospital (it is necessary to have the ability to provide anti-shock care), contraindicated during pregnancy and lactation
Hemotransfusion (transfusion of red blood cell-containing blood components) is performed in case of severe anemia, according to strict indications and in a hospital setting.

Diet-related reasons

A person receives two varieties of this chemical element with food. Heme (divalent) is found in products of animal origin, primarily in meat. It is this that predominantly becomes a component of hemoglobin, since it is better absorbed in the intestine. The non-heme type (trivalent) is obtained from plant foods. It is more difficult to absorb because it must first be broken down to divalent.

Moreover, some substances weaken the absorption of Fe3+: • tannins contained in tea; • antibiotics; • bran; • vegetable phytofibres.

Only vitamin C can increase the intensity of absorption of non-heme iron. The daily requirement of men for this element is at least 10 g, for women - at least 20 g. Against the background of eating disorders or a vegetarian lifestyle, a person develops a persistent lack of iron.

Forecast and prevention of iron deficiency anemia

In most cases, iron deficiency anemia can be successfully corrected. However, if the cause is not addressed, iron deficiency may recur or progress. Iron deficiency anemia in infants and young children can cause delayed psychomotor and intellectual development.

In order to prevent iron deficiency anemia, annual monitoring of clinical blood test parameters, nutritious nutrition with sufficient iron content, and timely elimination of sources of blood loss in the body are necessary. Persons at risk may be advised to take prophylactic iron supplements.

Symptoms of iron deficiency

The first symptoms appear at the stage when the microelement is no longer sufficient, but this has not yet affected the hemoglobin level. The general condition of a person worsens. He gets tired quickly, is constantly cold, experiences shortness of breath when exerting himself, his skin turns pale, peels, and his hair begins to fall out.

More specific symptoms indicate the development of iron deficiency anemia: • Koilonychia. The nail plates take on a concave shape. • Restless legs syndrome. There is a pathological need to move the limbs at rest. • Pica. Food perversions, craving for inedible things. • Glossitis. Inflammation of the tongue, accompanied by burning or pain. • Cheilitis. Inflammation of the red border of the lips with cracks in the corners of the mouth.

If iron levels drop to critical levels, swallowing problems and loss of consciousness may occur. In children, due to a lack of Fe, development slows down.