Causes of iron deficiency anemia in adults. Why does iron deficiency anemia occur and how to treat it? Indications for parenteral administration of iron drugs

Iron deficiency anemia is the most common type of anemia. According to various sources, it accounts for 80 to 90% of all anemias. Medical observations say that 30% of adults have iron deficiency. In the elderly - 60%. The disease is more common among the female population.

In the International Classification of Diseases (ICD-10), iron deficiency anemia can be found in the class “Diseases of the blood... Diet-related anemias.” The assigned codes include:

secondary form of anemia due to chronic blood loss (D 50.0);
other species, including unspecified (D 50.8 and D 50.9).

Clinical classifications are more convenient for understanding the mechanism of the disease and choosing treatment.

Why does iron deficiency cause disease?

It has been established that the mechanism of the disease is associated with a deficiency of the iron mineral in the blood. It is difficult to exaggerate his role. Indeed, of the total amount, 70% are directly involved in the construction of hemoglobin. This means that iron is an indispensable material for the retention of oxygen molecules by red blood cells and the subsequent process of transfer from the lung vesicles to the tissues.

Any variant of iron deficiency leads to a decrease in hemoglobin synthesis and oxygen starvation of the entire body.

Other mechanisms affecting iron levels

It is important not only to receive the mineral from food (the body does not produce iron), but also to the correct process of its absorption and transfer.

A special protein (transferrin) is responsible for the absorption of iron molecules from the duodenum. It delivers Fe to the bone marrow, where red blood cells are synthesized. The body forms a “warehouse” in the liver cells for rapid replenishment in case of acute deficiency. The reserves are stored in the form of hemosiderin.

Inventory and losses

If you decompose all the iron-containing forms into parts, you get the following:

2/3 is hemoglobin;
for reserves in the liver, spleen and bone marrow in the form of hemosiderin - 1 g;
for the transport form (serum iron) - 30.4 mmol/l;
for the respiratory enzyme cytochrome oxidase - 0.3 g.

Accumulation begins at prenatal period. The fetus takes some of the iron from the mother's body. Maternal anemia is dangerous for the formation and laying of internal organs The child has. And after birth, the baby should receive it only with food.

On the left is an erythrocyte with hemoglobin molecules, which absorbs oxygen from the lungs, then it is in a bound state and transfers oxygen to the cells

Excess mineral is eliminated through urine, feces, and sweat glands. Women from adolescence to menopause still have a path of menstrual bleeding.

About 2 g of iron is excreted per day, which means that no less amount should be taken from food.

Maintaining the necessary balance to ensure tissue respiration depends on the correct functioning of this mechanism.

Causes of anemia

The causes of iron deficiency anemia can be simplified as follows:

lack of iron intake;
increased output;
uncompensated expense;
difficult transfer from the intestine to the hematopoietic organs.

Increased consumption is generated by:

with heavy physical activity among athletes, with intense training;
in pregnant women, during lactation;
with profuse sweating in the heat, high fever.

The norm of 2 g is no longer enough.

Intestinal diseases associated with diarrhea and impaired absorption contribute to a lack of absorption of iron from food. Similar complications of varying severity are expected after operations to remove part of the stomach and duodenum. Because it is in the stomach and duodenum that iron combines with hydrochloric acid and is bound by the carrier protein transferrin. The condition of the pancreas has a significant impact. With pancreatitis, the absorption function is impaired.

Types of chronic blood loss

The most common cause is considered to be chronic blood loss. It first proceeds covertly (latent period), then causes clinical signs. The sources of such blood loss are:

stomach and intestines (peptic ulcer, necrotizing colitis, anal fissures, esophageal varices and hemorrhoids, malignant tumors);
disease of the genital organs in women (dysfunctional uterine bleeding, uterine tumors, endometriosis);
prolonged hemoptysis (pulmonary tuberculosis, malignant tumor in the lung tissue or bronchi, bronchiectasis);
blood in urine ( urolithiasis disease, polycystic kidney disease, malignant tumor, polyps);
frequent nosebleeds (with hypertension, vascular pathology).

Other reasons

Insufficient dietary intake is the most common cause of the development of iron deficiency anemia in childhood and adolescence, in vegetarians, and in people who force themselves to semi-starvation diets.

Genetic consequences have been identified for girls born from mothers who had anemia during pregnancy: in girls there are possible early manifestations iron deficiency state.

During long-term chronic infections (tuberculosis, sepsis, brucellosis), iron molecules are captured by immune cells, and a deficiency is detected in the blood.

Symptoms

Iron deficiency anemia does not manifest itself in any way during the initial latent course of the disease. Clinical symptoms are masked by various other conditions and do not cause suspicion in the patient.

The most often discovered “retrospectively” are:

increasing weakness
dizziness,
increased fatigue,
headache.

These manifestations are disturbing during physical activity and nervous tension.

Drowsiness occurs even with a normal night's sleep

The symptoms of the underlying disease contributing to anemia are more pronounced.
Subsequently, the condition becomes more serious: drowsiness, impaired ability to work, noise in the head, and pale skin appear. With such complaints, patients are forced to consult a doctor.

Diagnosis of iron deficiency conditions

To accurately diagnose anemia, the doctor must compare clinical symptoms with blood counts.

A general blood test reveals a reduced level of red blood cells, a low color index, and insufficient hemoglobin content.

The number of red blood cells in women is determined to be less than 3.7 x 10¹² /l, in men less than 4.0 x 10¹² /l.
The color indicator is the conditional calculated content of hemoglobin in one red blood cell, indicating the usefulness of the synthesized blood cells. Normally, the indicator is 0.85 - 1.05. Depending on its value, anemia is distinguished into normochromic, hyperchromic (saturation exceeds 1.05) and hypochromic (a reading below 0.85 indicates “poor-quality” red blood cells).
The allowed lower hemoglobin level for men is 130 g/l, for women 120 g/l.

The concentration of iron in the blood serum is determined by biochemical methods - the lower normal limit is 12 - 32 µmol/l for men, 10 - 30 for women.

The ability of transferrin to bind and transport iron is called the iron-binding function of blood serum. Normally, it is 54 – 72 µmol/l in men, 45 – 63 in women. In iron deficiency conditions, the figure increases.

The level of ferritin in the blood (a protein that converts iron from divalent to insoluble trivalent, which subsequently accumulates) shows the correctness of the process of iron absorption and the body’s ability to accumulate. Its norm is 12 – 300 ng/ml for men and 12 – 150 for women. With anemia, it decreases even in mild cases of the disease.

All indicators are important for a complete diagnosis.

How is the severity of the disease determined?

Determining the degree of clinical manifestations is necessary to decide on treatment, choice of drug, and route of administration. The simplest classification of anemia is based on hemoglobin level.

There are 3 degrees of severity:

with mild hemoglobin is reduced, but remains about 90 g/l;
with average hemoglobin ranges from 90 to 70 g/l;
in severe cases, hemoglobin is less than 70 g/l.

Another option takes into account the clinical manifestations of anemia:

first degree - no clinical symptoms;
second degree - moderate weakness, dizziness;
third - all the clinical symptoms of anemia are present, the ability to work is impaired;
the fourth - represents a severe condition of precoma;
the fifth is called “anemic coma”, lasts several hours and leads to death.

How to treat anemia with diet

A mild form of iron deficiency can be treated with a special diet, provided there is no damage to the stomach, intestines, or pancreas.

It is important to take into account that iron from food proteins and fats is absorbed only by 1/4 - 1/3, and from fruits and vegetables - by 80%. It turned out that vitamins play a significant role, and there are more of them in vegetables and fruits than in meat. Particularly important is the content of B vitamins and folic acid, vitamin C.

Useful for increasing iron levels in the blood

You can add vitamin C from currants, citrus fruits, sorrel, and cabbage.

In all cases, treatment for iron deficiency anemia is prescribed by a doctor after assessing blood counts and the condition of internal organs.

Drug therapy

Modern therapy with iron supplements is carried out starting from the second degree of iron deficiency anemia. Medicines must meet the requirements for compensation and restoration of hematopoiesis. Treatment with iron supplements is used when this cannot be achieved with diet alone.

Considering that the main way of iron absorption is through the intestines, tablets are preferred in therapy. The effectiveness of intramuscular administration is lower than when taking tablet drugs. When treated with injectable drugs, side effects are more often found.

It is best to use drugs in the form of capsules that protect the gastric mucosa

For therapeutic effects, 80 to 160 mg of pure iron (320 mg of sulfate) is sufficient. Dosage control is carried out by a doctor.

All medications are divided into ferrous and ferric iron preparations. Their differences require supplementing treatment with vitamin C in the first case, and amino acids in the second.

Popular ferrous iron preparations:

Sorbifer durules,
Tardiferron Ferrofolgamma,
Ferretab,
Aktiferrin,
Totem,
Hemofer prolongatum (sulfate).

Medicines containing ferric iron:

Maltofer,
Biofer,
Ferrum lek,
Ferlatum,
Venofer,
Cosmopher
Argeferr.

During pregnancy and lactation, treatment must be coordinated with a gynecologist and pediatrician.

Side effect drugs manifests itself in:

pain in the epigastric region, prolonged constipation;
dark plaque on the teeth after taking tablets or syrup;
allergic reactions.

Nettle decoction can be drunk with honey

Folk remedies can be used in addition to the general treatment complex.

At home, you can prepare and mix beet, radish and carrot juices in equal volumes. It is recommended to take a tablespoon before meals for 3 months.
A decoction of rose hips and clover is infused after boiling for half an hour. You can drink it instead of tea.
Nettle is boiled alone or in combination with dandelion roots and yarrow flowers. You can add a little honey for taste.
Grated horseradish with honey is recommended for pregnant women, take a teaspoon before meals.
Prepared blackcurrants with sugar will protect the whole family from anemia.

There is one contraindication to using these methods: an allergic reaction to the components.

Prevention of iron deficiency anemia requires maintaining a balanced diet. No diet can be used without losses for the body. Passion for vegetarianism and fasting can cause severe pathology. Against the background of overeating meat and lack of fruits and vegetables in food, it is also impossible to maintain health.

Of particular importance is the diagnosis and treatment of chronic bleeding (nasal, hemorrhoidal, menstrual). The upbringing of boys and girls should not be based on “shameful” diseases. In adulthood, we have men who categorically refuse to be examined by a proctologist and are admitted to hospital with an inoperable form of cancer, and women who drive themselves into complete anorexia with diets. Don't miss the opportunity to replenish your iron deficiency in time and regain your health.

Iron deficiency anemia is a blood disease characterized by insufficient intake of iron or impaired utilization of iron. This pathological condition is not a primary disease, since its appearance is always caused by some kind of pathology. Iron deficiency anemia is considered the most common pathology of the blood system; according to the World Health Organization, representatives of the fairer sex often suffer from this disease, which is associated with pregnancy, breastfeeding and blood loss during menstruation.

Table of contents:

Iron deficiency anemia: causes of development

Doctors identify several main factors that can lead to the development of the condition in question.

Insufficient intake of iron from food

Malnutrition can lead to the development of iron deficiency anemia at any age; this pathological condition is especially often observed during prolonged fasting, under the condition of an unbalanced diet, a monotonous diet with a minimum content of animal products.

Note:in a newborn baby Iron-deficiency anemia excluded if he is breastfed and the mother does not have anemia. If the baby is transferred to artificial feeding too early, then iron deficiency anemia can develop even at such a young age.

Increased body needs for iron

We are talking about conditions such as pregnancy or breastfeeding.. And this despite the fact that during pregnancy some of the iron is retained in the body, since there are no monthly bleedings! And the development of iron deficiency anemia during pregnancy is associated with the fact that the mother’s body transfers this valuable microelement to the fetus; the placenta also needs it. Then, during childbirth and the postpartum period, blood loss occurs, which also leads to a decrease in iron levels in the body.

Congenital deficiency of iron in the body

This factor may be associated with severe iron deficiency anemia in the mother, multiple pregnancies and the birth of a premature baby. In all these cases, the concentration of iron in the blood of the newborn will be low, and the symptoms of the disease in question will be present from the first days of life.

Iron malabsorption

Complete absorption of iron into duodenum will only happen if the mucous membrane of this part of the intestine functions normally. If a person has a disease gastrointestinal tract, this will cause damage to the intestinal mucosa, which will lead to a decrease in the rate of iron entry into the body.

TO Similar diseases that lead to impaired iron absorption include:

inflammation of the mucous membrane of the small intestine -;
autoimmune;
history of removal of the stomach and/or small intestine;
– celiac disease;
atrophic processes in the gastric mucosa – atrophic gastritis;
an autoimmune disease associated with damage to the mucous membrane of the entire intestine and other internal organs -;
violation of the secretion of all glands of the body of a hereditary nature -;
and/or duodenum.

Impaired transferrin synthesis

Such disorders may be associated with various hereditary diseases, but the newborn will not have symptoms of iron deficiency anemia, since this important trace element will be ingested through breast milk.

It is worth noting that transferrin is synthesized exclusively in liver cells, therefore its various pathologies (,) also lead to the development of iron deficiency anemia.

Increased blood loss

If a one-time loss of even a large amount of blood occurs, this, as a rule, does not lead to the development of iron deficiency anemia - the iron reserves in the body are sufficient to compensate for blood loss. At the same time, with minor but constant bleeding per day, several milligrams of iron are lost and this is already fraught with serious consequences.

Causes of chronic blood loss can be:

If the cause of constant blood loss is not diagnosed in time, this will certainly lead to the development of iron deficiency anemia.

Damage to the gastric mucosa also occurs with prolonged consumption of alcohol in large quantities. This is due, first of all, to the intake of ethyl alcohol, which is contained in any alcoholic beverages. In addition, ethyl alcohol has a depressing effect on the processes of hematopoiesis in the red bone marrow, and this also causes the development of the disease in question.

Taking medications

As a rule, iron deficiency anemia occurs when taking medicines only if this treatment was long-term and the medications were taken in large quantities. Most often, the disease in question is provoked by the following drugs:

non-steroidal anti-inflammatory drugs - for example,;
antacids - for example, Almagel or Rennie;
iron binders - Exjad, Desferal.

Note:doctors constantly remind their patients that the above medications cannot be taken without prescriptions from a specialist and that the duration and dosage should be adjusted independently .

Symptoms of iron deficiency anemia

It should be noted that the disease in question does not manifest itself immediately; it can be asymptomatic for quite a long time - the person leads a normal lifestyle and does not feel any discomfort, although the level of iron in the body is already reduced. In old age and childhood, on the contrary, the clinical picture of iron deficiency anemia will be pronounced literally from the first days of the development of the disease. In any case, the symptoms of iron deficiency anemia are identical:

disturbance of taste and smell;
susceptibility to infectious diseases;
damage to the mucous membranes (for example, stomatitis-type ulcers may appear in the oral cavity);
intellectual development disorders – decreases, the child begins to learn poorly educational material, memory decreases;
tongue damage;
increased fatigue;
changes in the skin (peeling and redness) and nails/hair (separation, loss);
muscle weakness.

Diagnostic measures

In principle, a doctor of any specialty can suspect the development of the disease in question. But the diagnosis of anemia, determination of the severity of its course and treatment is carried out by hematologist.

Diagnosis of iron deficiency anemia is not only an analysis of the patient’s interview, but also laboratory blood tests, bone marrow puncture (done rarely, but is characterized by maximum information content). If we are talking about establishing the cause of the development of iron deficiency anemia, then the patient may be prescribed a stool test for occult blood, and if the test gives a positive result, this will mean that the body has either a disintegrating tumor, or a peptic ulcer, or Crohn's disease is developing.

When diagnosing iron deficiency anemia, the hematologist necessarily invites an oncologist, surgeon, gynecologist, gastroenterologist, endocrinologist for a consultation - these specialists help to establish the true causes of the disease in question and prescribe adequate therapy.

Treatment of iron deficiency anemia

The process is not quick; the patient will not only have to take specific medications, but also make nutritional adjustments.

Diet for iron deficiency anemia

On our website there is already a complete information about what products should be consumed for the disease in question. We will only remind you that the most complete absorption of iron by the body occurs from meat products - they should become the basis of the diet. The menu of a patient with iron deficiency anemia must include pork and chicken liver, rabbit and chicken meat, cottage cheese and cow's milk, egg yolk and beef/lamb, seaweed and prunes, rose hips and sunflower seeds, buckwheat and peaches, apples and almonds.

Nutrition for the disease in question must be complete, that is, you cannot focus only on the listed products - the menu should include fish, seafood, vegetables with fruits/berries, a variety of cereals, and fermented milk products.

Note:Despite the fact that a diet can adjust the amount of iron in the body, it is not able to rid the body of a deficiency of this important microelement. Therefore, doctors warn about the need to take specific medications.

Drug therapy

The choice of doctors in the treatment of iron deficiency anemia falls on tablet forms of drugs. Intravenous and intramuscular administration of drugs is quite possible, but is more often used when it is necessary to quickly replenish the loss of iron (for example, in case of heavy bleeding) or impaired absorption of iron by the intestine.

Among all the drugs that are used to treat iron deficiency anemia, the following can be distinguished:

Note: some medicines have the ability to improve or worsen the absorption of iron by the body. Therefore, when taking iron-containing products and such “variable” drugs at the same time, it is necessary to take into account that ascorbic/succinic acids, fructose and sorbitol, cysteine and nicotinamide improve iron absorption, but calcium salts and phosphates, tetracyclines and tannin, antacids and phytins reduce absorption .

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The prognosis for iron deficiency anemia is usually favorable - recovery occurs relatively quickly. Of course, some factors can lead to difficulties in the treatment of iron deficiency anemia - for example, an incorrect diagnosis, violation of the dosage and regimen of medications, late treatment.

But in this case, complications of iron deficiency anemia may develop:
retardation in growth and development, which is especially typical for childhood;
anemic coma;
infectious complications;

failure of internal organs.

Iron deficiency anemia is a disease that can be easily treated in modern medicine. But to do this, you need to identify this problem in time and receive effective prescriptions from a specialist.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category

A disease of the blood system caused by iron deficiency in the body. Accompanied by changes in the parameters of its metabolism, a decrease in the concentration of hemoglobin in erythrocytes, their quantitative and qualitative changes, clinical signs of anemic hypoxia and sideropenia.

There are three stages of iron deficiency:
prelatent deficiency - a decrease in iron reserves in body tissues without a decrease in serum iron concentration;
latent - depletion of iron reserves in the “depot” due to maintaining the hemoglobin concentration in the peripheral blood above the lower limit of normal;

Iron deficiency anemia itself is a decrease in hemoglobin concentration below physiological values.

Iron, a vital element found in all cells of the body (cellular iron) plays an important role in biochemical reactions. As a component of hemoglobin, iron is involved in the transport of oxygen and is a cofactor for heme (catalase, cytochrome C) and non-heme (aldolase, NADH dehydrogenase) enzymes. Iron contained in the body can be divided into:

functional (composed of hemoglobin, myoglobin, enzymes and coenzymes),
transport (transfer, mobilferin),
deposited (ferigin, hemosiderin),
iron forming a free pool.

Of the 4-4.5 g of iron contained in the body, only 1 mg is involved in exchange with the external environment: excreted in feces, lost with hair loss, cell destruction. The daily iron requirement of an adult in a state of physiological equilibrium is 1-1.5 mg, for women during menstruation - 2.5-3.3 mg. At the same time, for the needs of hematopoiesis, the amount of iron that is released during the physiological breakdown of red blood cells is sufficient.

The absorption of iron from food products is “strictly limited”: from 8-14 mg that enter the body, from 0.5-1 to 2-2.5 mg are absorbed. Therefore, the predominance of iron loss over its intake in the body leads to iron deficiency anemia.

The development of iron deficiency anemia is based on various reasons, among which the main ones are:

chronic (recurrent) blood loss,
poor diet
malabsorption in the intestine,
increased need for iron (pregnancy, lactation, intensive growth),
disruption of iron transport,
intravascular hemolysis with hemoglobinuria.

Chronic or recurrent blood loss is the most important cause of iron deficiency anemia. Insignificant in volume, often unnoticeable to the patient, but ongoing blood loss leads to depletion of iron reserves with the subsequent development of iron deficiency anemia. It has been established that 1 ml of lost blood contains 0.5 mg of iron. With a daily blood loss of 10 ml, the loss of iron will be 5 mg. The daily absorption of iron from food is 2 mg, and the physiological loss of iron is from 1 to 1.5 mg. Thus, with the loss of a small volume of blood (10 ml), a gradual depletion of iron reserves occurs.

Blood loss from the digestive system is the most common cause of iron deficiency anemia in menopausal women and men. It occurs in diseases such as periodontal disease, erosive esophagitis, varicose veins of the esophagus and cardial part of the stomach (liver cirrhosis, portal hypertension); hiatal hernia; acute and chronic gastric erosions; peptic ulcer of the stomach and duodenum; tumors of the stomach, small intestine, Meckel's diverticulum, terminal ileitis (Crohn's disease), ulcerative colitis, polyposis, hemorrhoids, etc.

The main factor in the development of iron deficiency anemia in women of childbearing age is uterine bleeding, which occurs when the menstrual cycle is disrupted (menorrhagia) of various origins, fibroids, malignant tumors of the uterus, and the use of intrauterine contraceptives.

Blood loss into closed cavities most often occurs with ectopic growth of the endometrium (endometriosis), pulmonary siderosis, and mitral stenosis. Frequent nosebleeds, hematuria, blood loss during hemodialysis, blood donation, iatrogenic blood loss, and the like can also lead to iron deficiency anemia.

Clinical manifestations of iron deficiency anemia are caused by a general anemic symptom complex and, above all, sideropenia syndrome (tissue iron deficiency). There is a violation of tissue trophism due to a decrease in the activity of iron-containing tissue enzymes (cytochromes). Skin hyposiderosis leads to dryness and thinning of the skin, and disruption of the integrity of the epidermis. Ulcerations and cracks with an inflammatory ridge appear in the corners of the mouth - “jams”, or angular cheilitis. Atrophy of the papillae of the tongue occurs: it becomes red, smoothed, in severe cases with irregularly shaped areas of redness ( geographical language) or completely hyperemic. Due to the dryness of the mucous membrane of the esophagus, its atrophy, there is difficulty swallowing dry solid food, a sensation of soreness and a foreign body in the throat (Plummer-Vinson syndrome). A typical clinical manifestation of hyposiderosis is increased hair loss, brittleness, splitting, and transverse striping of the nails. The nails become flat, sometimes acquiring a concave spoon-shaped shape (koilonychia).

Some sideropenic symptoms are pathognomonic; they are characteristic only of iron deficiency anemia. This is a perversion of taste, a craving for unusual products such as clay, earth, starched linen, ice; distortion of the sense of smell - attraction to the smells of mothballs, gasoline, acetone, printing ink, and the like. On examination, pale skin with an alabaster or greenish tint, cyanotic sclera (or a symptom of blue sclera) are noted. The latter is associated with dystrophic changes in the cornea, through which the vascular network is visible.

Hereditary anemia with impaired porphyrin synthesis affects men (transmitted via the X chromosome). Unlike iron deficiency, this hereditary anemia is characterized by an increased level of iron in the serum - iron-saturated, iron-refractory anemia. There appears to be an increased concentration of protoporphyrins in erythrocytes and feces. With erythropoietic porphyria, the urine of patients is brown or red. A characteristic sign is the appearance of burns, blisters and scars on the skin under the influence of sunlight, and an enlarged spleen. The main reason Acquired anemia associated with impaired porphyrin synthesis is lead intoxication.

How to treat iron deficiency anemia?

The main method is the administration of iron supplements orally. In this case, doses are selected that are tens of times higher than the iron content in food. Only if a high concentration of iron is created in the intestinal lumen does its absorption capacity for ionized divalent iron increase. Trivalent iron in the intestinal mucosa is not absorbed in either physiological or elevated concentrations and has an irritating effect.

The duration of treatment for iron deficiency anemia ranges from 2-3 months to 1 year. Evaluation of the effectiveness of treatment is carried out 2-3 weeks from the start of treatment.

Treatment effectiveness criteria:

increase in reticulocyte levels on days 8-12,
normalization of serum iron levels in the 4-5th week from the start of treatment.

However, clinical signs of improvement in the condition of patients are observed much earlier than the normalization of hemoglobin content, which is associated with the filling of tissue (cellular) iron reserves. Parenteral iron preparations (ferrumlek, venofer) are administered only in case of intestinal absorption disorders (enteritis, resection of the small intestine, exacerbation of peptic ulcer disease, intolerance to iron preparations when taken orally) in preparation for surgery. In this case, the increase in hemoglobin levels occurs 4-6 days faster than in the case of oral iron supplements. For injections, ferric iron compounds are used in combination with organic components. After parenteral (intravenous or intramuscular) administration, iron quickly enters the blood, where it binds to siderophilin, in case of insufficient amounts of which there is a danger of increasing the level of free iron in the blood, which is capillary poison. At the same time, vascular permeability increases, the tone of arterioles and venules decreases.

The degree of manifestation of adverse reactions can vary - from transient forms to shock and even death as a result of the penetration of red blood cells into the tissues of the brain, heart, and lungs. It is also possible allergic reactions, phlebothrombosis, abscesses, hemosiderosis.

For prevention side effects simultaneously with parenteral administration of iron, it is recommended to administer vitamin E, which prevents the activation of free radical reactions, damage to cell membranes, and hemolysis of red blood cells. In case of acute intoxication with iron preparations, the antidote desferal should be prescribed (60-80 mg/kg per day intramuscularly or intravenously). Blood transfusions for iron deficiency anemia are used when the hemoglobin level is low - less than 50-40 g/l.

What diseases can it be associated with?

Diseases that may be accompanied by iron deficiency anemia include:

periodontal disease,
erosive esophagitis,
varicose veins of the esophagus and cardial part of the stomach (liver cirrhosis, portal hypertension),
hiatal hernia,
acute and chronic gastric erosions,
peptic ulcer of the stomach and duodenum,
tumors of the stomach, small intestine,
Meckel's diverticulum,
terminal ileitis (Crohn's disease),
nonspecific ulcerative colitis,
polyposis,
haemorrhoids
menorrhagia (menstrual cycle disorders of various origins),
uterine fibroids, malignant tumors of the uterus,
endometriosis,
pulmonary siderosis,
mitral stenosis,
frequent nosebleeds,
hematuria.

Impaired absorption of iron is a common cause of iron deficiency in patients who have undergone gastrectomy, subtotal gastrectomy, or vagotomy.

Treatment of iron deficiency anemia at home

It can be performed in a hospital; more often this occurs with serious concomitant pathologies. If the doctor sees no objections, the patient can take the prescribed medications at home.

At the same time, patients should eat well: consume animal proteins in the form of meat products, since they contain iron. It is not advisable to recommend consuming raw or fried liver, since in this product a smaller part of the iron is contained in the form of heme, and the main part is in the form of ferritin and hemosiderin, of which iron absorption occurs more slowly.

Treatment of iron deficiency anemia must certainly be accompanied by a specially selected diet high in animal protein, vitamins and limited fat. The diet should include fresh vegetables, fruits, berries, especially fresh herbs. The priority products are pomegranate and buckwheat, liver and meat, black currants, rowan berries, blackberries, strawberries, viburnum, rose hips, and hawthorn. Iron is most favorably absorbed in combination with sufficient intake of vitamin C.

To prevent iron deficiency anemia in women with excessive or long (more than 5 days) menstruation, oral iron supplements should be prescribed monthly in weekly or monthly courses twice a year. Blood can be taken from female donors no more than 1-2 times, from male donors - 2-3 times a year. After donating blood, it is recommended to take iron supplements for 2 weeks (30-40 mg of elemental iron per day).

All patients with iron deficiency anemia and persons with risk factors (blood loss, after gastrectomy, adolescents, donors, etc.) must be registered at the clinic at the place of residence with mandatory monitoring (at least twice a year) of peripheral blood parameters and serum iron.

What drugs are used to treat iron deficiency anemia?

elementary - in a therapeutic dose of 100-120 mg, taken 1 hour before or 2 hours after meals,
- the dosage is calculated individually, taking into account the patient’s blood counts, weight, and concomitant diseases,
- calculated individually using the formula
- for iron intoxication, 60-80 mg/kg per day is prescribed intramuscularly or intravenously,
- 300 mcg per day.

The course of treatment is calculated in months; the attending physician will determine more specifically.

Treatment of iron deficiency anemia with traditional methods

Purpose treatment of iron deficiency anemia is to replenish the iron content in the blood, which is facilitated not only by taking pharmaceutical preparations of this element, but also by consuming foods and drugs based on them with a high iron content. It would be a good idea to discuss any of the recipes below with your doctor, as well as check with him about the combination of this folk method with prescribed medications, so as not to contribute to excessive intake of iron, which is also unfavorable.

Combine equal amounts of nettle leaves, yarrow inflorescences, and dandelion root; 1 tbsp. Brew the collection with 1.5 cups of boiling water, leave for 3 hours, strain; drink in 3-4 doses during the day, 20 minutes before meals.
Dissolve 1 tbsp in a glass of warm milk (3.2% fat). chicory juice; drink in 3 doses during the day, after meals.
Combine an equal amount of carrot, beet and white radish juice and place in a container that can be closed, but not tightly enough for a slight evaporation process to occur; place the container in the oven over low heat, where this evaporation will occur over the next 3 hours; take the drug 1 tbsp. three times a day.
2 tsp Brew a glass of dried rose hips (with a slide), strain after an hour; take 3 times a day after meals.

Treatment of iron deficiency anemia during pregnancy

Iron deficiency anemia is at risk of developing in a pregnant woman due to completely obvious circumstances - during this period there is an increased consumption of iron, necessary for the development of the fetus, which is associated with hormonal changes, development of early toxicosis, disturbances in the absorption of iron, magnesium, phosphorus in the gastrointestinal tract.

Iron deficiency anemia during pregnancy is an unfavorable condition that requires correction. Iron deficiency affects both the well-being of the mother and the development of the fetus:

general weakness and fatigue;
dizziness, headaches, tinnitus;
rapid heartbeat, discomfort in the heart area; Dystrophic changes in the myocardium and disturbances in its contractility often occur;
fainting;
insomnia;
perversion of taste, swallowing disorders;
development of edema;
degenerative processes in the uterus, disruption of its functions, the formation of placental insufficiency;
the fetus is deprived of the opportunity to receive nutrients and oxygen, and its development is delayed.

The main complications of pregnancy with iron deficiency anemia are:

threat of miscarriage;
gestosis;
arterial hypotension;
premature placental abruption;
delayed fetal development;
premature birth;
bleeding during childbirth.

At the same time, restoring a normal state is achieved quite simply; the main thing is to consult a doctor in a timely manner and follow all his recommendations.

According to WHO recommendations, pregnant women should undergo 3-6 month courses to replenish iron deficiency: 100 mg of iron (elementary) and 300 mcg of folic acid per day. All patients with iron deficiency anemia and persons with risk factors, including expectant mothers, should be registered at the clinic at their place of residence with mandatory monitoring of peripheral blood and serum iron levels.

For treatment of iron deficiency anemia Recommended for pregnant women:

oral medications,
Fe2+ preparations rather than Fe3+ (better absorption),
iron sulfate FeSO4,
preparations with delayed release of Fe2+ (better absorption and tolerability).

As already noted, the main sign of iron deficiency anemia is hypochromia of red blood cells with a decrease in color index of less than 0.85. Therefore, differential diagnosis is primarily carried out with other types of hypochromic anemia - conditions in which disturbances in hemoglobin synthesis are caused not by iron deficiency, but by other factors. This group includes hereditary and acquired anemias associated with impaired porphyrin synthesis.

For differential diagnosis, professional history is important:

contact with lead at the enterprise,
when mining ore,
application of paints,
production of batteries, whitewash, etc.

Defeat syndrome is characteristic nervous system- from asthenia and memory impairment to encephalopathy, cerebral edema, coma. Typical motor polyneuritis, tetraparesis. Disorders of the digestive system occur: loss of appetite, abdominal pain (“lead colic”), constipation.

When examining, pay attention to the earthy color of the skin, the “lead border” in the form of a narrow business strip along the edges of the gums of the front teeth. Basophilic punctuation of red blood cells and an increase in the number of reticulocytes (hemolysis) are detected in the blood. A characteristic laboratory sign is an increase in delta-aminolevulinic acid and lead in the urine (tens of times higher than normal). The iron content in blood serum is increased with hypochromia of erythrocytes.

Hypochromia of erythrocytes can also be observed in thalassemia - hereditary hemolytic anemia associated with a defect in globin synthesis. Characteristic signs: jaundice, hepatolienal syndrome, increased levels of indirect bilirubin, reticulocytosis, hypochromia and target-like form of red blood cells.

Differential diagnosis of iron deficiency anemia is also carried out with anemia due to a chronic disease. This term refers to anemia that accompanies various diseases of an inflammatory and non-inflammatory nature:

suppurative processes in the lungs, abdominal cavity,
osteomyelitis,
sepsis,
tuberculosis,
infective endocarditis,
rheumatoid arthritis,
chronic renal failure and etc.

In the case of a variety of pathogenetic mechanisms (acceleration of erythropoiesis, impaired erythropoietin synthesis, intravascular hemolysis, etc.) in these pathological conditions, a redistribution of iron is observed in the cells of the macrophage system - iron distribution anemia. They have a moderate hypochromic character, the iron content in the serum may be slightly reduced, increased level ferritin in the blood, which distinguishes them from iron deficiency anemia.

Treatment of other diseases starting with the letter - g

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Iron deficiency anemia (IDA) is one of the most common, but most hidden forms of anemia. The cause of iron deficiency anemia is a lack of iron necessary for the synthesis of hemoglobin.

The disease is manifested by such symptoms as: weakness, dizziness, dry skin, brittle hair. Iron deficiency anemia is diagnosed based on a complete blood count and determination of ferritin levels in the blood. The disease is treated with iron supplements.

Treatment of iron deficiency anemia

Treatment of iron deficiency anemia is long-term, but not complicated. As a rule, patients are recommended to take iron supplements for 2-3 months (100-200 mg per day), until the level of hemoglobin in the blood normalizes, and another 2-4 months in smaller doses (30-60 mg) to restore iron reserves in the liver.

The most famous drugs: Sorbifer and Ferrumlek. Medicines for iron deficiency anemia are taken 1 tablet 2-3 times a day (the exact dose is determined by the doctor), half an hour before meals with 100-150 ml of water.

Iron supplements should not be taken with milk, tea or coffee - these products bind iron and reduce its entry into the blood. Taking iron supplements can cause:

nausea,
vomiting
stomach ache,
constipation,
blackening of teeth (if drugs in the form of drops are used).

I would like to note that the preventive use of iron supplements is indicated for all people at risk of developing IDA. For everyone else, preventive treatment is recommended at the first manifestations of sideropenic syndrome.

How is iron deficiency anemia treated?

First of all, the cause must be eliminated. Continued bleeding will negate the effect of taking iron supplements. Therefore, with uterine bleeding, women, first of all, need examination and treatment by a gynecologist, with nosebleeds - an ENT consultation, recurrent hemorrhoids - a reason to meet with a surgeon, and if the cause is unclear, it is necessary to carefully examine the gastrointestinal tract (ultrasound, FGDS, radiography stomach and intestines, sigmoidoscopy).

If there is no exacerbation of a peptic ulcer, uncontrollable vomiting, or a significant part of the small intestine has not been removed, it is better to drink medications containing iron rather than receive them in the form of injections. There are salt (sorbifer, ferrogradumet, totema, etc.) and non-ionic (maltofer, ferlatum or ferrum-lek) preparations. The effectiveness of both groups is approximately the same, but non-ionic ones have fewer side effects (nausea, vomiting, stool problems and black staining of teeth) and a lower risk of poisoning in case of an accidental overdose.

Herbal medicine is quite acceptable as an addition to treatment, but does not replace iron supplements. The most commonly used in collections are:

nettle – it increases blood clotting and reduces bleeding;
strawberries - the microelements included in its composition stimulate hematopoiesis;
Rose hips – contain a large amount of vitamin C, which improves iron absorption; The juice of beets, pomegranates, and black currants is used for the same purpose.

Traditional methods of treating iron deficiency anemia

The fruits of the cinnamon rose hips and the fruits of the mountain ash are mixed in equal parts. Brew with boiling water like tea. Take a glass a day. Tea has an auxiliary vitamin effect during maintenance therapy in patients with anemia.

Tea is brewed from strawberry leaves (1-2 tablespoons of leaves are poured with 2 cups of boiling water). Take tea 3-4 times a day, a tablespoon. For anemia, this tea acts as a tonic and vitamin remedy. In addition, tea helps increase gastrointestinal secretion and improves appetite. Recommended for people with low hemoglobin levels.

Grate beets, radishes and carrots on a fine grater. The juice is squeezed out of the resulting pulp and poured into a dark bottle in equal quantities. The bottle is closed with a loose stopper so that the liquid can evaporate. The bottle is placed in the oven on low heat for 3 hours. Take the infusion 3 times a day before meals, 1 tablespoon. Duration of treatment - 3 months.

The fruits of cinnamon rose hips and wild strawberries are mixed in equal parts. 10 g of the resulting mixture is poured into 1 cup of boiling water and heated in a water bath for 15 minutes. After 45 minutes, when the broth has cooled, it is filtered, the raw materials are squeezed out and the amount of infusion is adjusted boiled water to the original volume. Take a quarter or half a glass 2 times a day. The infusion serves as a source of iron and ascorbic acid.

Take equal parts of stinging nettle and birch leaves. Brew two tablespoons of the mixture in 1.5 cups of boiling water, leave for 1 hour. After straining, add 1/2 cup beet juice. Drink 20 minutes before meals 3-4 times a day. The course of treatment is 8 weeks.

Symptoms of iron deficiency anemia

Iron deficiency leads to a disruption in the formation of new red blood cells and disrupts the functioning of tissue enzymes that contain iron.

Lack of iron in the body leads to the following phenomena:

Symptoms of iron deficiency anemia (anemic syndrome)

weakness,
decreased performance,
dizziness,
drowsiness,
shortness of breath,
rapid heartbeat.

The occurrence of these symptoms is associated with oxygen starvation of tissues, which develops due to a decrease in the total amount of hemoglobin in the blood, which is responsible for the transfer of oxygen.

Symptoms of iron deficiency (sideropenic syndrome)

skin atrophy,
dryness,
roughness of the skin,
the appearance of cracks in the corners of the mouth and cracks in the heels,
brittleness and splitting of nails,
intense hair loss,
brittle and dry hair,
dry mouth (to the point that a bolus of food comes with difficulty through the lumen of the esophagus),
frequent colds.

This syndrome is also characterized by a perversion of taste: patients with iron deficiency eat foods that are not directly intended for oral consumption - paper, chalk, sand, soil, raw dough or meat, etc. Diagnosis of iron deficiency anemia includes a general blood test, in which a decrease in the number of red blood cells, a decrease in the total hemoglobin content in one unit of blood volume, a decrease in the color intensity of red blood cells and a change in their shape are detected.

Iron deficiency anemia in children

IDA in children can be caused by many reasons. Pediatricians around the world deal with this disease every day. This group of diseases includes those associated with a decrease in the content of hemoglobin and/or red blood cells per unit volume of blood, which negatively affects the oxygen supply to the body’s tissues.

IDA is the most common of all anemias – accounting for 80% of all cases. In our country and Europe, the prevalence of IDA in young children is approximately 50%, and in older children - 20% or more. IDA in a child is a syndrome characterized by impaired hemoglobin synthesis, which is the result of a lack of iron in the body. It develops against the background of pathological processes and is manifested by signs of anemia and sideropenia.

Iron is one of the main microelements in the body of both children and adults. The body has hemoproteins, which contain about 70% of the total amount of iron, which is associated with porphyrin. Iron is contained in hemoglobin, myoglobin, peroxidases, cytochromes, catalases, etc. This element is stored in the body in the form of ferritin (the majority) and hemosiderin. In babies, most of the iron is stored in erythroid cells and very little in the muscles.

Causes of iron deficiency anemia in children

Iron is absorbed mainly in the duodenum and proximal jejunum. Only a twentieth of the amount of iron that a child consumes with food daily is absorbed. In many ways, the digestibility of this element depends on the state of the gastrointestinal tract. The body receives the most iron from meat products - from 9% to 22%.

Breasts get iron from their mother's milk, although it does not contain much of this microelement. Iron in mother's milk exists in the form of lactoferrin, which makes it difficult for the baby to absorb it. In human breast milk, lactoferin exists in saturated and unsaturated forms. Immunoglobulin A has an antibacterial effect only together with lactoferrin.

The causes of iron deficiency in a child are various. The main cause in infants is IDA in the mother, which occurred during pregnancy or occurred during pregnancy. The reasons are also:

violation of uteroplacental circulation;
complicated pregnancy;
fetal transfusion syndrome in multiple pregnancies;
fetomaternal and fetoplacental bleeding.

Intrapartum reasons:

There are postnatal causes of IDA in a child. This is, first of all, a child’s lack of iron through food. Infants who are fed unadapted formulas, goat's and cow's milk suffer the most from this. Also, postnatal causes of the disease are:

Iron deficiency anemia in pregnant women

Pregnancy does not entail a significant change in examination tactics. Treatment of pregnant women with IDA may be accompanied by poorer tolerance to iron supplements. In this case, it is often necessary to divide the recommended daily dose into several doses or prescribe iron supplements in doses lower than recommended.

Classification of IDA

The following types of IDA are distinguished:

Iron deficiency anemia, like other anemias, is classified according to severity:

Mild anemia - hemoglobin is in the range of 90-120 g/l.
Moderate anemia - hemoglobin content 70-90 g/l.
Severe anemia - hemoglobin concentration below 70 g/l.

IDA is differentiated by stages as follows:

Why does the body need iron?

The adult human body contains about 3-4 g of iron. Most of this amount of iron is part of hemoglobin and is involved in the transport of oxygen. Iron is an integral component of the hematopoiesis process. Without iron, hemoglobin synthesis and the formation of normal red blood cells are impossible.

In addition to the process of hematopoiesis, iron takes part in the synthesis and work of many cellular enzymes (special proteins that contribute to many metabolic processes) and thus ensures the regeneration (restoration) and growth of many types of cells, especially epithelial cells of the skin, gastrointestinal tract, oral cavity. Iron is also necessary for hair and nail growth.

Moreover, iron is part of many enzymes that provide tissue respiration. How common is iron deficiency and IDA? Iron deficiency affects 1.5 billion of the world's population, of which approximately 1.2 billion suffer from iron deficiency anemia. The risk group for IDA (age groups of the population in which a decrease in hemoglobin concentration occurs most often) includes:

children 0.5-3 years old,
teenagers,
women of childbearing age, especially pregnant and breastfeeding women,
elderly people.

Complications of iron deficiency anemia

The progression of the pathological condition and the lack of drug and dietary correction can cause the following complications:

Causes of iron deficiency anemia

Iron enters the body with food and is found mainly in meat, liver, fish, eggs, as well as legumes, green peas, spinach, raisins, nuts and other products. There are several causes of iron deficiency and the development of iron deficiency.

Insufficient intake of iron from food

unbalanced diet,
malnutrition,
long-term consumption of foods low in iron;
increased body need for iron, which exceeds the ability to absorb iron in the gastrointestinal tract.

The body's increased need for iron is observed

during increased growth and development of the body (children and adolescents),
during pregnancy (iron consumption for fetal development),
during breastfeeding (iron consumption for the formation of breast milk)

Impaired absorption of iron in the digestive tract - against the background of chronic diseases of the digestive system

chronic gastritis,
chronic enteritis,
chronic enterocolitis,
low stomach acidity,
intestinal dysbiosis

Iron loss due to bleeding

menstruation in women of childbearing age,
chronic bleeding from dilated veins of the esophagus,
chronic bleeding from stomach or duodenal ulcers,
chronic bleeding from hemorrhoidal veins (hemorrhoids),
blood loss during surgery, childbirth.

All of the conditions described above contribute to the occurrence of IDA either by reducing the intake of iron or by increasing its loss.

Diagnosis of iron deficiency anemia

To exclude anemia similar to iron deficiency and to identify the cause of iron deficiency, a complete clinical examination of the patient is necessary.

To identify the cause of iron deficiency anemia in women, a preliminary consultation with a gynecologist is required to exclude diseases of the uterus and its appendages, and in men, an examination by a proctologist to exclude bleeding hemorrhoids, as well as a urologist to exclude pathology of the prostate gland.

There are known cases of extragenital endometriosis, for example, in respiratory tract. In these cases, hemoptysis is observed; fiberoptic bronchoscopy with histological examination of a biopsy of the bronchial mucosa makes it possible to establish a diagnosis.

The examination plan also includes x-ray and endoscopic examination of the stomach and intestines to exclude ulcers, tumors, incl. glomic, as well as polyps, diverticulum, Crohn's disease, ulcerative colitis, etc. If pulmonary siderosis is suspected, X-ray and tomography of the lungs and sputum examination for alveolar macrophages containing hemosiderin are performed; in rare cases, histological examination of a lung biopsy is necessary.

If kidney pathology is suspected, a general urine test, blood serum testing for urea and creatinine are required, and, if indicated, an ultrasound and x-ray examination of the kidneys.

In some cases, it is necessary to exclude endocrine pathology: myxedema, in which iron deficiency can develop secondary to damage to the small intestine; polymyalgia rheumatica is a rare connective tissue disease in older women (less often in men). It is characterized by pain in the muscles of the shoulder or pelvic girdle without any objective changes in them, and in a blood test - a decrease in hemoglobin concentration and an increase in ESR.

Differential diagnosis

Iron deficiency anemia must be differentiated from:

thalassemia,
lead poisoning,
sideroachrestic anemia (impaired porphyrin synthesis),
B12 deficiency anemia,
hemolytic anemia,
anemia due to bone marrow failure,
iron redistribution anemia,
anemia with a decrease in the mass of circulating red blood cells.

Diet for iron deficiency anemia

The diet for iron deficiency anemia includes foods rich in iron:

meat,
liver and other animal entrails (heart, kidneys, spleen),
peas,
beans,
spinach,
apricot,
prunes,
pomegranate juice,
apples,
buckwheat grain,
oat groats,
chocolate.

In people already suffering from anemia, restoring hemoglobin levels through diet alone seems quite difficult, since a person is simply not able to eat so much food containing the required amount of iron (especially if the patient intensively uses it or loses it). A diet for the correction of amenia is usually prescribed simultaneously with the main treatment with iron-containing drugs and continues (if possible) throughout the period of continued risk of developing the disease.

Prevention of iron deficiency anemia

Prevention is required for latent iron deficiency without anemia, when there are conditions for the development of anemia, for example, in donors who constantly donate blood, especially in women, in pregnant women, especially in cases where heavy and prolonged menstruation was noted before pregnancy, when pregnancies follow one after another another.

Preventive administration of iron-containing drugs is necessary for all women who have had menstruation for many years lasting more than 5 days. Iron deficiency often develops in children of mothers with iron deficiency, as well as in premature babies. Iron deficiency is often observed with nosebleeds associated with Randu-Osler disease.

In all these cases, it is advisable to prevent iron deficiency with small doses of iron-containing drugs. It is necessary that the food contains a sufficient amount of absorbable iron, which is contained primarily in meat.

For prevention in pregnant women, regular donors, and people continuously losing blood, it is advisable to prescribe 1–2 tablets of ferroplex. Pregnant women with possible latent iron deficiency should take small doses of iron-containing medications throughout pregnancy, as well as for some time after childbirth during lactation.

Questions and answers on the topic "Iron deficiency anemia"

Question:Is IDA possible with cervical erosion? Menstruation is regular, plentiful, according to gynecology everything else is normal, the other day cauterization of the erosion was done. I am 33 years old. two children. Hemoglobin 90.

Answer: The analysis data indicates that you have IDA of the second degree. Perhaps its appearance is associated with constant bleeding from erosion, which you may not have noticed. With amenia of this degree, examination by a therapist and treatment with iron-containing drugs is necessary.

Question:I’m 17 weeks pregnant, I donated blood three times, hemoglobin is 96-94, I took Totema, sorbifer, ferritab - nothing helps, tell me what to do.

Answer: In such a case, you should get tested at a hematology center (to confirm the diagnosis of anemia) and review your treatment plan with iron supplements.

Question:Hello. My boyfriend is 19 years old. His skin, visible mucous membranes, and nail plates are blue and pale, unnatural in color. Other symptoms of iron deficiency (weakness, poor appetite, etc.) are not observed. He himself is poorly aware of this. Tell me, can this be considered anemia without a blood test? Thank you.

Answer: Pale skin can indeed be a sign of anemia, however, a diagnosis cannot be made without a blood test.

Question:Can anemia be inherited? And can the father’s IDA affect the future child?

Answer: No, IDA is not inherited and responds well to treatment with iron supplements.

Question:I have low hemoglobin, I was registered. At the moment I have frequent dizziness and a pale complexion.

Answer: Hello. Please clarify what level of hemoglobin you have? Have you received treatment for this? Dizziness and pale facial skin are symptoms of iron deficiency.

The most common type of anemia. Manifestations of iron deficiency occur in 60% of the adult population after 50 years of age. Symptoms of iron deficiency anemia in the latent period are often missed or mistaken for other diseases.

The main causes of the disease: chronic bleeding, diseases of the stomach and intestines, lack of iron in food, pregnancy. Treatment requires a long period and medical supervision.

Types of symptoms of the disease

In iron deficiency anemia, it is customary to conditionally divide clinical manifestations into 2 classes, depending on the mechanism of the pathology:

signs of tissue oxygen deficiency associated with a drop in hemoglobin levels;
symptoms of sideropenia (low iron levels in the blood).

Both types of signs of iron deficiency anemia directly depend on the degree of iron deficiency.

In the initial stage of the disease, malaise manifests itself only with increased physical activity or strenuous work; general working capacity is preserved. Patients describe in more detail the manifestations of the underlying disease, which subsequently causes anemia.

Signs of hypoxia

Tissue hypoxia in anemia can be identified by characteristic signs:

general unmotivated weakness;
drowsiness;
dizziness with noise in the head;
tachycardia and heart rhythm disturbances (in half of the patients);
dyspnea;
constant feeling of cold;
weakness in the muscles of the arms and legs;
tendency to faint;
change in character towards irritability and tearfulness.

During the examination, the doctor pays attention to the following signs:

pallor of the skin and mucous membranes (89% of cases);
swelling of the face and fingers.

Decreased arterial pressure(90/60 and below), rapid pulse (more than 90 per minute), especially with little physical activity. Auscultation of the heart allows you to hear a typical murmur at the apex (60% of cases).

Signs of sideropenia

The cause of sideropenia is a lack of iron accumulation in tissues and a sharp decrease in the activity of the enzyme cytochrome oxidase, which ensures the biochemical process of energy production in cells. The patient is concerned about:

poor appetite;
perverted taste and smell (there is a constant desire to eat something inedible, sniff gasoline, acetone) in 19% of patients;
sore throat when swallowing liquid and solid food (1.3%).

Upon examination, the following is revealed:

dryness and flaking of the skin;
early wrinkles and aging;
striation of nails with transverse stripes (90% of cases);
brittle nails and hair (in 32% of patients);
increased hair loss on the head;
weeping, painful cracks (jams) in the corners of the mouth;
ulcers (aphthae) on the tongue.

The most common manifestation of iron deficiency

Variants of the clinical course of the disease

The clinical course of iron deficiency anemia in adults and children occurs in three variants: in the form of early chlorosis, chronic anemia and anemia during pregnancy.

Typical for early chlorosis:

initial manifestations are more common in girls during adolescence, since iron deficiency is caused by increased consumption of muscle tissue growth and the onset of blood loss during menstruation;
complaints of young people about frequent constipation and loss of appetite;
detecting pallor and swelling of the skin on the face, arms and legs in a teenager.

The causes of chronic anemia in men are prolonged hemorrhoidal bleeding of 100 ml or more per day, in women - heavy and prolonged menstruation. There may be hidden sources of bleeding in the stomach and intestines.

Nosebleeds due to vascular diseases, deviated nasal septum, and hypertensive crises cannot be excluded from the complex of causes contributing to anemia.

Iron deficiency anemia in pregnant women is formed as a result of uncompensated nutrition: the woman’s body gives iron to the fetus, so it must receive more from food. Consumption increases especially when infectious diseases in pregnant women. Complaints of a hypoxic series of manifestations are typical.

Iron deficiency in children

During the prenatal period, the fetus takes iron from the mother's body and accumulates it for its development. At birth, the baby has 0.4 g of the mineral (in premature babies, less than 0.1 g). Pediatricians have proven that a newborn up to four months old needs enough iron from mother's milk. When interrupted breastfeeding iron reserves are lost. Then it should be supplied with milk formulas.

Complementary foods must contain all useful substances

You can suspect the development of iron deficiency anemia in a child based on the following symptom complexes:

irritability,
tearfulness,
delay in the development of intelligence,
tendency to hypotension,
nocturnal enuresis,
dry skin,
frequent respiratory diseases,
unstable chair,
listening to unclear heart murmurs.

Signs of varying degrees of iron deficiency

Depending on the degree of deficiency, three stages are distinguished. They have characteristic features.

The first stage - the deficiency can be judged by the determination of hemosiderin in the bone marrow. It has no clinical manifestations.
The second stage (latent) - symptoms are revealed only after physical activity. In the general blood test, there is already a decrease in the color indicator, the average volume of red blood cells. Serum ferritin levels were slightly reduced.
The third stage (clinical) - all the described symptoms of tissue hypoxia and sideropenia, signs of cardiac and cerebral failure, urinary incontinence, and muscle weakness appear.

Diagnostics

Diagnosis of iron deficiency anemia is based mainly on laboratory tests.

In a general blood test, in addition to hemoglobin and red blood cells, more subtle indicators are determined, indicating low oxygen saturation of red blood cells and impaired synthesis:

Biochemical analysis determines the ability to accumulate and transport iron:

a decrease in serum iron levels is determined;
decrease in ferritin;
level of transferrin saturation with iron;
hidden ability of blood serum to bind iron.

The level of erythropoietin (a hormone that stimulates the production of red blood cells) indicates the processes of compensation for the synthesis of red blood cells.

Carrying out a test with Desferal or Defericolixam: normal when intravenous administration of the drug in a dose of 0.5 g, from 0.8 to 1.2 mg of iron is found in the urine. In iron deficiency anemia, excretion is reduced to 0.2 mg.

To identify hidden sources of chronic blood loss, mandatory esophagogastroscopy and colonoscopy are performed to exclude peptic ulcer, tumors.

If any unmotivated weakness, fatigue, or dizziness occurs, it is necessary to check a blood test for anemia.