Anemia (anemia), iron deficiency anemia

At a Anemia (anemia) respectively Iron deficiency anemia it is a deficiency or disorder of red blood cells (erythrocytes). Since the red blood cells are responsible for the transport of oxygen from the lungs to the cells, there is an undersupply of oxygen in the course of the process. Likewise, the body is supplied with less iron due to the anemia. The main consequences are tiredness and paleness. Since anemia is usually triggered by other diseases, there are many other symptoms and should always be examined by a doctor.

What is anemia (anemia), iron deficiency anemia?

Anemia is anemia, more precisely a reduced number of red blood cells (erythrocytes) or the red blood pigment (hemoglobin). The most common form of anemia is iron deficiency anemia. An estimated 600 million people are affected worldwide. An iron deficiency has to last a long time before the reserves are used up and it can lead to anemia.

In addition to the reduced red blood cells and the red blood pigment, it is typical in the laboratory that the erythrocytes in iron deficiency anemia are particularly small and appear quite pale. An additional reduced iron storage marker (ferritin) and a reduced occupation of the iron transport molecule confirm the diagnosis.

causes

The most common cause of anemia (anemia), iron deficiency anemia, depends on age. In young women, menstruation and diet-related relative iron deficiency with the resulting anemia are paramount. The latter occurs especially when there is an increased need. For example, during pregnancy and breastfeeding.

During breastfeeding there is often a manifestation of a previously unrecognized iron deficiency, as the blood loss during childbirth and the weekly flow intensify.

Benign tumors of the uterus are also often the cause, as these can lead to increased and prolonged menstrual bleeding. Not to be forgotten is the medically induced iron deficiency anemia with regular blood donations.

From middle age onwards, chronic blood losses, especially from the gastrointestinal tract, are primarily to be mentioned. Bleeding from the stomach is classic if there is severe inflammation of the gastric mucosa or even an ulcer. A black colored bowel movement is pioneering, as blood in contact with stomach acid is converted into black hematin.

In addition to stress, alcohol and nicotine, risk factors include taking certain painkillers (aspirin, diclofenac) and cortisone preparations. If there is bleeding in the lower gastrointestinal tract, the stool is often freshly bloody. The causes are often hemorrhoids, benign and also malignant tumors of the intestine.

The cause is rarely a lack of iron absorption, which then leads to anemia. The situation arises when the corresponding section of intestine had to be surgically removed or is diseased. Examples are inflammatory bowel diseases (Crohn's disease, ulcerative colitis) and celiac disease.

Symptoms, ailments & signs

Because of the anemia, less oxygen reaches the various muscles and organs of the body. This lack of oxygen in turn causes symptoms. The signs of anemia are not always clear. However, there are typical symptoms that show up in every form of anemia.

These include headaches, dizziness and a decrease in physical and mental performance. In addition, the affected people feel tired and exhausted. In addition, the skin can lose color, which in turn is noticeable by paleness. Some patients also experience throbbing or hissing in the ears. Another sign of anemia is that people get cold quickly.

If the anemia is more severe, the heartbeat can accelerate. Furthermore, the pulse weakens and sweats appear. There is also a risk of breathing difficulties and fainting.

Anemia is particularly worrying in people who suffer from previous damage to their heart. In extreme cases, there is a risk of an increased heartbeat and even a heart attack due to the lack of oxygen supply to the organ.

If it is iron deficiency anemia, which is the most common form of anemia, cracks often form at the corners of the mouth. In addition, the nails become brittle and the hair can fall out more easily. Other possible signs are repeated aphthous ulcers, burning tongue and chronic itching.

course

An iron deficiency and also anemia often go undetected for a long time. If symptoms occur, these are usually very unspecific. At the beginning there is weakness, decreased performance and shortness of breath during exercise. Heart palpitations, headaches, dizziness and ringing in the ears can also occur. A physical examination reveals that the skin and mucous membranes are pale in severe anemia. Special iron deficiency symptoms are a burning sensation on the tongue, tears at the corners of the mouth, dry skin and brittle fingernails and hair.

Complications

Anemia (anemia) or iron deficiency anemia is nowadays very treatable and can be healed with transfusions without any complications. In general, anemia results in an insufficient supply of oxygen to the body, which is why compensatory measures must be initiated. the person breathes faster (tachypnea) to take in more oxygen and the heart beats faster (tachycardia) to move the blood quickly.

In severe anemia, this can lead to cardiac arrhythmias up to and including a heart attack. This results in cardiac insufficiency, which has to be treated for a lifetime and thus severely affects the quality of life of the person affected. The patient is characterized by chronic fatigue and a marked decrease in performance.

In addition, there are disturbances of consciousness that can lead to unconsciousness. Iron deficiency is caused by chronic blood loss. Excessive bleeding can lead to shock, blood pressure drops sharply and important organs are no longer supplied with enough blood, which can cause them to fail. This particularly includes the kidneys and lungs.

In rare cases, iron deficiency can also lead to the so-called pica syndrome. This is a rare eating disorder that creates an appetite for inedible things like dirt or garbage. This can lead to severe intoxication and indigestion and malnutrition if the wrong substances are consumed.

When should you go to the doctor?

Anemia is a disease that often does not come to light through a conscious visit to the doctor, but rather as a result of a chance diagnosis. This is because typical symptoms such as severe tiredness, paleness or headache are often associated with stress, but not with anemia. In order to best avoid anemia in advance, it makes sense to have a blood test carried out, especially for the ferritin and hemoglobin levels, if you suspect an iron deficiency.

Once the iron deficiency or anemia has been determined, further visits to the doctor may be necessary to determine the cause, especially if the values ​​are very bad. This includes, among other things, the colon and gastroscopy as well as a visit to the gynecologist for patients.

If a drug is prescribed to relieve the anemia, further visits to the doctor usually follow, as blood diagnostics must be used to check after a few weeks whether the empty reservoirs are refilled. If they don't, an iron infusion or even a blood transfusion may be necessary. These forms of therapy are also only possible in a medical practice or a clinic.

In addition, the patient should always consult his family doctor if he has the feeling that the deficiency symptoms are getting worse. Heavy menstrual bleeding or blood in your stool should also prompt you to see a doctor.

Doctors & therapists in your area

Treatment & Therapy

Iron deficiency anemia must never be treated without clarifying the cause, as it can sometimes hide life-threatening clinical pictures. A stomach and colonoscopy should be done to rule out bleeding and tumors from the gastrointestinal tract. A supplementary gynecological examination should always be performed in women.

The main therapy is treating the cause. Depending on the findings, medication is sufficient, but surgical therapy may also be necessary. If a cause has been found, iron supplements can be prescribed. Many patients complain of stressful side effects in the gastrointestinal tract (nausea, constipation) during therapy. However, iron must be given for at least three months in order to replenish the empty stores.

Outlook & forecast

In general, iron deficiency anemia can be treated well. But this is only the case if the cause of the iron deficiency can also be remedied. The earlier iron deficiency anemia is recognized, the better and easier it is to treat it.

If an iron deficiency has already been determined, the doctor will regularly check the iron levels. With the introduction of appropriate therapeutic measures (e.g. taking iron supplements) the deficiency can be compensated for very quickly. However, since the prognosis for iron deficiency anemia is directly related to the cause of the deficiency symptom, a detailed examination for serious underlying diseases should be carried out.

A fundamental deficiency of iron in the body can be easily eliminated, iron deficiency anemia can be cured. However, if the anemia has a more serious underlying disease (e.g. tumors, chronic gastrointestinal diseases), then the underlying disease must first be treated. Iron deficiency anemia is also easily treatable if the cause is poor diet, bleeding after surgery or pregnancy.

In most cases, an improvement can be observed about three to six weeks after the start of therapy in order to completely replenish the iron stores, but it is recommended to take iron supplements for six months after this time.

Aftercare

Anemia only requires follow-up care in cases where the typical symptoms or causes persist. This should prevent complications. On the other hand, if infections or tumors were successfully treated as triggers, anemia usually does not occur. Even with anemia after an accident, there is usually no need for follow-up care.

One of the goals of aftercare is to prevent serious complications. Patients who suffer from hereditary hemolytic and renal anemia are particularly affected by this. Continuous blood tests are indicated here. In everyday life, patients often have to take nutritional iron supplements.

With megaloblastic anemia, the absorption of vitamins in the stomach and intestines is disturbed. The patient has to face this deficiency in everyday life. Sometimes vitamins even have to be injected. Anemia can be linked to specific living conditions. Endurance athletes and pregnant women are often affected. Sometimes you don't get enough iron.

In order to prevent harm to the unborn child, further monitoring during the course of pregnancy is advisable after the initial diagnosis. Strength athletes should also have their blood checked regularly due to the increased iron requirement. Because an average diet is usually not enough to cover the nutrients.

You can do that yourself

An improper diet can cause iron deficiency anemia to develop. Therefore, various self-help measures are used in eating behavior. Foods that are high in iron include animal offal and various other types of meat, millet, oats, and legumes.

Vitamin C promotes the absorption of iron, even if the iron content of the food remains the same. To improve iron absorption, anemics can therefore have a meal with a meal that is rich in vitamin C - for example a glass of orange juice or a serving of sauerkraut.

Conversely, some foods worsen absorption. These include coffee and black tea, which contain tannins.

Iron deficiency anemia often causes circulatory problems. If symptoms are severe, it is advisable to temporarily avoid excessive physical activity. Anemics should sit or lie down if they experience dizziness, see black spots, weak knees, or experience similar symptoms. This is especially true for patients who suffer from heart failure, for example. Any other secondary diseases and complications should also be taken into account in everyday life by anemics.

Correct use of prescribed medication plays an important role in treatment. Doctors advise patients who do not tolerate iron tablets well to take the tablet in the evening rather than in the morning. It is often recommended that you leave your last meal at least two hours apart. The iron tablet can also be combined with a glass of orange juice or something similar.