Anemia Who?

Guest post from NP Student Anna Papkee, RN, BSN

Anemia who?

Anemia is defined as a blood condition where the blood is lacking healthy red blood cells (RBCs). Red blood cells are essential to proper body function as RBC carry oxygen to body’s tissues.

What does it mean to have iron deficiency anemia?

Iron deficiency anemia (IDA) is the most common type of anemia. When an individual has IDA, an adequate amount of iron is not available in the body, resulting in a decreased amount of hemoglobin. Hemoglobin is the molecule that transports oxygen to different parts of the body. Without sufficient about of hemoglobin, oxygen is not carried to different parts of the body that need it and systemic symptoms exist.

Three different stages of IDA exist. Initially, iron stores begin to decrease as during IDA, iron is being used faster than it can be replaced. When iron is no longer available to make RBCs, the body begins to make RBCs without enough hemoglobin. The result of lack of adequate hemoglobin in RBCs is smaller than usual RBCs. The last stage of IDA is when a drop in hemoglobin is seen.

What would I be feeling if I had iron deficiency anemia?

One of the most common symptoms seen with iron deficiency anemia is fatigue. Often if patients are fatigued, an iron deficiency anemia work up is provided. Other symptoms include cold hands/feet, pallor, brittle nails, thinning of hair, fast heart rate, shortness of breath. Other tell-tale signs that an individual should be worked up for iron deficiency anemia is possessing behavior of pica. Pica is a mental eating disorder that is characterized by patients eating non-food items. Common non-food item seen in individuals with pica are dirt, metal, and ice.

How is it determined if IDA is causing my symptoms?

There are a few different ways diagnostically to determine if an IDA diagnosis is present. A complete blood count (CBC) and iron panel are the two primary blood lab draws that are ordered. Iron panel includes serum ferritin, serum iron, total iron binding capacity (TIBC), and transferrin saturation (TSAT). Typically, in IDA, a low hemoglobin, low ferritin, low mean corpuscular volume (MCV), and high TIBC is seen.

Am I at risk for developing IDA?

There are a few different reasons why individuals develop IDA. Individuals who are pregnant, vegetarian, vegan, advanced runners, menstruating individuals. In addition, people with GI conditions that affect iron absorption, including inflammatory bowel disease, IBS, and celiac disease, are also at increased risk for IDA.

A typical diet allows us to consume between 10-20 mg of iron daily. The amount of iron absorbed is 1-2% and this is an adequate amount of iron for the human body. Iron is typically consumed the food we eat, primarily through meat and certain vegetables. Certain foods and drinks decrease iron absorption by binding to the minerals in your gut. Major inhibitors include calcium (dairy products) and polyphenols and tannins (coffee and black tea). Conversely, vitamin C strongly enhances absorption.

If I do have IDA, how do I treat it?

The first line of treatment for IDA would be to replace iron orally. Typically Iron 65 mg orally every other day is prescribed. Repeat blood test are drawn in twelve weeks to assess iron level improvements. In some cases, individuals do not

respond to oral iron. Reasons individuals may not respond to oral iron include intolerance of medication. Oral iron can cause nausea and constipation, and at times these symptoms are not tolerable. Trouble absorbing medications can lead to the need for IV iron. Common malabsorption conditions include inflammatory bowel diseases, celiac disease, irritable bowel disease, or history of bariatric surgery. Treatment with iron is not recommended if you do not have an iron deficiency, so be sure to check-in with your healthcare provider.

Do I have to have regular follow ups with my doctor regarding IDA?

Lab checks are dependent on treatment plan. If oral supplementation of ferrous sulfate was indicated, every 3–6-month labs would be preferred. If an iron infusion was indicated for IDA, an iron study and CBC blood check would be completed around 8 weeks after final iron infusion. Checking labs too early will give a false value and is not enough time to fully predict how iron replacement has been working. It's important to make sure your lab values and symptoms are improving over time. If not, then an additional workup may be needed.

When should you schedule a consultation at MainelyNP?

If you have been feeling persistently tired, experiencing unexplained headaches, or noticing that your physical performance has dipped, it is time to seek professional advice. You don't have to wait until you are completely depleted to take action. Early intervention can prevent the more severe symptoms and complications of anemia. At MainelyNP Primary Care, we provide the comprehensive testing and personalized attention needed to get to the bottom of your symptoms. Whether you are in Portland or Midcoast Maine, we are here to support your journey back to full health. 

Reach out today to learn more!

Educational content only. Individual evaluation and treatment should be discussed with your healthcare provider.

References

Dunphy, L., Winland-Brown, J., Porter, B.L. & Thomas, D. (2023). Primary care: The art and science of advanced practice nursing (6th ed.). Philadelphia, PA: F.A. Davis. ISBN: 978-1-71964-465-5.

Hollier, A. (2022). Clinical guidelines in primary care (5th ed.). Scott, LA: Advanced Practice Education Associates. ISBN 978-1-56533-273-7