Anemia (anemia) or iron deficiency anemia 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, it comes in the course of an undersupply of oxygen. Likewise, the body is supplied with less iron due to anemia. The consequences are mainly fatigue and pallor. Since anemia is usually triggered by other diseases, many other symptoms are present and should be examined by a doctor in any case.
What is anemia (anemia), iron deficiency anemia?
Anemia is anemia, more specifically 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 worldwide are affected. Iron deficiency must have existed for some time before reserves are depleted and it can lead to anemia. In addition to the reduced red blood cells and red blood pigment, a typical feature of iron deficiency anemia in the laboratory is that the erythrocytes are particularly small and appear quite pale. An additional reduced iron storage marker (ferritin) and a reduced occupation of the iron transport molecule ensure the diagnosis.
Causes
The most common cause of anemia (anemia), iron deficiency anemia in each case depends on age. In young women, menstruation and nutritional relative iron deficiency with resulting anemia are first. The latter occurs especially when there is an increased need. This is the case, for example, during pregnancy and lactation. During lactation, a previously unrecognized iron deficiency often manifests itself, as the blood losses of childbirth and the lactational flow exacerbate it. Benign tumors of the uterus are also not infrequently causative, as these can lead to increased and prolonged menstruation. Not to be forgotten is the medically induced iron deficiency anemia caused by regular blood donations. From middle age onwards, chronic blood loss, especially from the gastrointestinal tract, is a priority. Bleeding from the stomach is classic when there is severe gastritis or even an ulcer. A black stool is a sign of bleeding, since blood is converted to black hematin when it comes into contact with gastric acid. Besides stress, alcohol and nicotine, risk factors are the intake of certain painkillers (aspirin, diclofenac) and cortisone preparations. If bleeding occurs in the lower gastrointestinal tract, the stool is often freshly bloody. Causes are often hemorrhoids, benign and also malignant tumors of the intestine. Rarely, the cause is a lack of absorption of iron, which then leads to anemia. The situation is when the corresponding section of the intestine had to be surgically removed or is diseased. Examples include inflammatory bowel disease (Crohn’s disease, ulcerative colitis) and celiac disease.
Symptoms, complaints, and signs
Anemia causes less oxygen to reach the various muscles and organs of the body. This lack of oxygen, in turn, triggers symptoms. The signs of anemia do not always turn out clearly. However, there are typical complaints that are evident with any form of anemia. These include headaches, dizziness and a decrease in physical and mental performance. In addition, affected individuals feel tired and weary. In addition, the skin may lose color, which in turn becomes noticeable through pallor. Some patients also experience throbbing or ringing in the ears. Another sign of anemia is that sufferers get cold quickly. If the anemia is more pronounced, this can result in an acceleration of the heartbeat. Furthermore, the pulse weakens and sweating appears. Furthermore, there is a risk of breathing difficulties and fainting. Anemia is particularly alarming in people who suffer from a pre-damaged heart. In extreme cases, the lack of oxygen supply to the organ can lead to an increased heart rate and even a heart attack. 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, nails become brittle and hair may fall out more easily.Other possible signs include recurrent aphthae, burning tongue, and chronic itching.
Course
Iron deficiency and also anemia often remain undetected for a long time. If symptoms occur, they are usually very nonspecific. At the beginning, weakness, loss of performance and shortness of breath on exertion become apparent. Palpitations, headaches, dizziness and ringing in the ears may also occur. Physical examination reveals pallor of the skin and mucous membranes in cases of pronounced anemia. Specific iron deficiency symptoms include a burning sensation on the tongue, tearing at the corners of the mouth, dry skin, and brittle fingernails and hair.
Complications
Anemia (anemia) or iron deficiency anemia is very treatable nowadays and can be cured by transfusions without any complications. In general, anemia leads to a lack of oxygen supply to the body, which is why compensatory measures must be taken. The affected person breathes faster (tachypnea) to take in more oxygen and the heart beats faster (tachycardia) to transport the blood quickly. In the case of severe anemia, this can lead to cardiac arrhythmias and even a heart attack. This results in heart failure (cardiac insufficiency), which must be treated for the rest of the patient’s life and thus severely impairs the patient’s quality of life. The patient is characterized by chronic fatigue as well as a severe decrease in performance. In addition, there are disturbances of consciousness, which can even lead to unconsciousness. Iron deficiency results from chronic blood loss. Excessive bleeding can lead to shock, blood pressure drops sharply and important organs no longer receive sufficient blood supply, whereupon they can fail. This includes in particular the kidneys and the lungs. In rare cases, an iron deficiency can also lead to the so-called pica syndrome. This is a rare eating disorder that causes an appetite for inedible things such as soil or waste. This can lead to severe poisoning and indigestion, as well as malnutrition if the wrong substances are ingested.
At what point should you go to the doctor?
Anemia is a disease that often comes to light not through a deliberate visit to the doctor, but because of an accidental diagnosis. This is because typical symptoms such as severe fatigue, pallor or headaches are often associated by those affected with stress, but not with anemia. In order to avoid anemia in advance, it is therefore advisable to have a blood test, especially of the ferritin and hemoglobin levels, carried out if an iron deficiency is suspected. Once the iron deficiency or anemia has been established, further visits to the doctor may be necessary to determine the cause, especially if the values are very poor. These include colonoscopy, gastroscopy and a visit to the gynecologist for female patients. If a drug is prescribed to correct the anemia, further visits to the doctor are usually also necessary, since blood diagnostics must be used to check after a few weeks whether the empty stores are replenished. If they do not, 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, patients should also consult their family doctor whenever they feel that the deficiency symptoms are becoming more severe. Heavy menstrual bleeding or blood in the stool should also prompt a visit to the doctor.
Treatment and therapy
Iron deficiency anemia should never be treated without clarification of the cause, since in some cases life-threatening clinical pictures may be hidden behind it. Gastroscopy and colonoscopy should be performed to rule out bleeding and tumors from the gastrointestinal tract. In women, a complementary gynecological examination should always be performed. The main therapy is to treat the cause. Depending on the findings, medications may be sufficient for this purpose, but surgical therapy may also be necessary. If a cause has been found, supplementary iron supplements may be prescribed. Many patients complain of adverse side effects in the gastrointestinal tract (nausea, constipation) during therapy. However, iron must be given for at least three months to replenish empty stores.
Outlook and prognosis
Usually, anemia due to iron deficiency can be well treated.However, this is only the case if the cause of the iron deficiency can also be remedied. The earlier iron deficiency anemia is detected, the better and less complicated it is to treat. If an iron deficiency has already been diagnosed, regular checks of the iron levels are carried out by the doctor. With the introduction of appropriate therapeutic measures (e.g. taking iron supplements), the deficiency can be corrected quite quickly. However, since the prognosis of iron deficiency anemia is directly related to the cause of the deficiency symptom, a detailed examination for serious underlying diseases should be performed. A basic deficiency of iron in the body can be easily eliminated, and iron deficiency anemia can be cured. However, if the anemia is caused by a more serious underlying disease (e.g. tumors, chronic gastrointestinal diseases), the underlying disease must be treated first. Iron deficiency anemia is also easily treatable if it is caused by poor nutrition, bleeding after surgery or pregnancy. In most cases, an improvement can be observed about three to six weeks after the start of therapy, but in order to completely replenish the iron stores, it is recommended to continue taking iron supplements for six months after this time.
Follow-up
Anemia brings the need for follow-up only in cases where the typical symptoms or causes are permanent. Complication should be prevented by this. On the other hand, if infections or tumors as triggers have been successfully treated, anemia usually does not develop. Even in the case of anemia after an accident, there is usually no need for follow-up care. The aim of follow-up care is, among other things, to prevent serious complications. Patients suffering from hereditary hemolytic and renal anemia are particularly affected. Here, continuous blood testing is indicated. In everyday life, patients often have to take dietary iron supplements. In megaloblastic anemia, vitamin absorption in the stomach and intestines is impaired. The patient must counteract this deficiency in everyday life. Sometimes vitamins even have to be injected. Anemia can be tied to specific life circumstances. Endurance athletes and pregnant women are not infrequently affected. They sometimes do not consume enough iron. To prevent damage to the unborn child, further monitoring during the course of pregnancy is advisable after the initial diagnosis. Strength athletes should also have their blood tested regularly because of the increased iron requirement. This is because an average diet is usually not sufficient to cover nutrients.
What you can do yourself
A faulty diet can cause the development of iron deficiency anemia. Therefore, various self-help measures start with the eating behavior. Foods that are high in iron include offal from animals and various other types of meat, millet, oats and legumes. Vitamin C enhances the absorption of iron, even if the iron content of the diet remains the same. Therefore, to improve iron absorption, anemics can eat a food rich in vitamin C with a meal – 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 symptoms. If symptoms are severe, it is appropriate to temporarily avoid excessive physical activity. Anemics should sit down or lie down if they experience dizziness, see black spots, get weak knees, or notice similar symptoms. This is especially true for patients suffering from heart failure, for example. Anemics should also consider possible other secondary diseases and complications in their daily lives. Taking prescribed medications correctly plays an important role in treatment. Doctors often advise patients who do not tolerate iron tablets well to take the tablet in the evening rather than in the morning. An interval of at least two hours from the last meal is often recommended. The iron tablet can also be combined with a glass of orange juice or similar.
