Iron Deficiency Anemia – Diagnosis and Treatment
Diagnosis
Doctors use several ways to find out if a person has iron deficiency anemia. They start by checking the patient’s medical history and asking about symptoms like tiredness, weakness, pale skin, and shortness of breath.
They also look for physical signs such as a fast heartbeat, brittle nails, pica (craving non-food items), and cold hands and feet.
Blood tests help confirm the diagnosis. Some main tests include:
| Test Name | What It Checks | Normal Range (adults) |
|---|---|---|
| Hemoglobin | Amount of hemoglobin in blood | 13.2–16.6 g/dL (men), 11.6–15 g/dL (women) |
| Hematocrit | Percentage of blood made up of red blood cells | 38.3–48.6% (men), 35.5–44.9% (women) |
| Ferritin | Level of stored iron | Varies (low value means low iron stores) |
| Mean Corpuscular Volume | Size of red blood cells | 80–96 fL (smaller in iron deficiency) |
| Serum Iron | Amount of iron in the blood | 60–170 mcg/dL (may be lower in IDA) |
| Transferrin Saturation | Iron bound to transport protein | Low in iron deficiency anemia |
A complete blood count (CBC) checks the number and appearance of red blood cells. People with iron deficiency anemia often have red blood cells that are smaller and paler than normal.
Other Tests to Find the Cause
If tests show iron deficiency anemia, doctors look for the reason behind low iron. They may use extra tests such as:
- Endoscopy: Doctors use a camera to look inside the stomach and check for bleeding or ulcers.
- Colonoscopy: They check the colon and rectum for bleeding, especially if blood loss from the lower digestive tract is suspected.
- Pelvic Ultrasound: Doctors may use this for women with heavy periods to check for causes like uterine fibroids.
Doctors often order these tests if iron supplements do not improve iron levels.
Treatment
Using Iron Supplements
Doctors usually suggest iron supplements to boost iron levels. Most people take tablets, but some infants and children may need a liquid form.
The amount and type depend on age and health needs.
Tips for Taking Iron Supplements:
| Tip | Reason |
|---|---|
| Take on an empty stomach | Improves absorption |
| Use with vitamin C | Increases how much iron your body takes in |
| Separate from antacids | Prevents reduced iron absorption |
| Continue after symptoms | Fully restores iron reserves |
- Take iron on an empty stomach if possible. If this causes stomach pain, it is okay to take it with food.
- Avoid taking iron with antacids because antacids lower iron absorption. Wait at least two hours after taking antacids before using iron.
- Take iron with vitamin C, like orange juice or a vitamin C tablet, to help your body absorb more iron.
Some people may notice constipation or dark stools when taking iron supplements. Doctors may suggest a stool softener if constipation happens.
Iron therapy may take several months to restore iron stores. Even after symptoms improve, you may need to keep taking iron for several more months or up to a year, depending on follow-up blood tests.
Fixing Health Issues That Cause Low Iron
If iron supplements do not work, another problem may need treatment. Ongoing blood loss, trouble absorbing iron, or health conditions like celiac disease can cause low iron.
Doctors may recommend:
- Medicine to reduce heavy menstrual periods, such as certain birth control pills.
- Treatment for stomach ulcers with antibiotics or other medications.
- Surgery to remove bleeding polyps or growths.
- Eating an iron-rich diet with foods like poultry, fish, beans, tofu, raisins, and iron-fortified cereals.
- Eating foods high in vitamin C, such as strawberries or bell peppers, with iron-rich meals.
- Limiting cow’s milk in young children because it can block iron absorption.
In rare cases, doctors use intravenous iron (iron infusions) or blood transfusions to quickly raise iron and hemoglobin levels. They use these options if other treatments do not work or if the body cannot absorb iron from food and supplements.
Getting Ready for Your Visit
Steps You Can Take Before Seeing Your Doctor
Preparing for your medical visit helps you and your doctor make the most of your time. Try these steps:
- List all symptoms. Write down changes in your body, such as tiredness, shortness of breath, pale skin, or unusual bruising.
- Write down important personal details. Include big life events, recent stress, or sudden changes that could affect your health.
- Make a complete list of your medications. List prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
- Prepare your questions. Bring a set of questions so you do not forget anything important.
Here are some useful questions to ask:
| Question | Purpose |
|---|---|
| What is causing my symptoms? | To understand the main issues |
| Are there other possible reasons for my symptoms? | To explore different causes |
| Will this problem last a long time? | To know the outlook |
| What treatments do you suggest? | To review your options |
| Are there alternative therapies? | To consider other approaches |
| How do I manage other health issues with this condition? | For managing multiple conditions |
| Should I follow any special diet? | To plan your nutrition |
Ask any new questions that come up during your appointment.
Questions Your Doctor May Ask You
Your healthcare provider will likely ask several questions to better understand your case and notice any changes in your body.
- When did your symptoms start?
- How intense are your symptoms?
- What helps your symptoms feel better?
- Is there anything that makes your symptoms worse?
Your doctor may also ask if you have had any unusual bleeding, such as heavy periods, bleeding from hemorrhoids, or nosebleeds.
They might want to know if you avoid eating meat or follow a vegetarian diet. Your doctor may ask if you have given blood more than once in the past few months.
