A recent study found that a surprisingly large number of adults in the United States – nearly 1 in 3 – may have iron deficiency, even if they don’t have a health condition like anemia, heart failure or chronic kidney disease that would trigger screening for the condition.
The study, published in the medical journal JAMA Network Open in September, warns that iron deficiency may be a “widespread” and “underrecognized” public health problem in the United States.
Dr. Ashish Dalal, who practices medical oncology, hematology, and hematology oncology at Health First Cancer Institute, agrees with the findings of the study.
“I’m a blood and cancer doctor,” he says. “In my practice, between 35-to-40 percent of those I see have anemia and 75 percent of those have iron deficiency.”
The terms anemia and iron deficiency are frequently used interchangeably but have different meanings.
Anemia is a medical condition characterized by a low red blood cell count. These cells are responsible for transporting oxygen to various parts of the body. A lack of them can cause fatigue, weakness and shortness of breath.
Anemia can be caused by low iron, a nutritional deficiency. Iron is a mineral the body requires to produce hemoglobin, the protein in red blood cells that transports oxygen. When a person lacks iron, their body is unable to produce enough hemoglobin, and they may develop anemia.
Dr. Dalal explains that 80 percent to 90 percent of his patients who are suffering from iron deficiency are bleeding somewhere. “Usually, the bleeding is in the gut. However, if the patient is a young woman, the iron deficiency is usually the result of heavy periods.
“It can also be caused by low dietary iron intake, although this is rare in the United States.
“Gastric bypass surgery can significantly increase the risk of iron deficiency due to the surgical alteration of the digestive tract, bypassing the duodenum, which is the primary site of iron absorption,” says Dr. Dalal. “The body struggles to absorb enough iron from food after the procedure, which can lead to anemia if not properly managed with dietary adjustments and iron supplements.
“Even iron pills are bypassed, so these patients who require treatment should receive iron intravenously.
“Iron used to be delivered by deep injection,” adds Dr. Dalal. “But many people had a severe reaction to it. There are far fewer side effects from the IV procedure.”
Cleveland Clinic outlines possible side effects, which usually are described minimal:
- Bloating or swelling of your face, arms, hands, lower legs or feet.
- Dizziness, faintness or lightheadedness when getting up suddenly from a lying or sitting position.
- Gastrointestinal pains, including nausea, cramps or diarrhea.
- Problems with breathing.
Discussing the symptoms of iron deficiency, Dr. Dalal says, “people crave ice and eat it voraciously.” WebMD expands on this urge, called pagophagia, stating that chewing on ice helps people with iron deficiency feel more alert and mentally sharp.
“Brittle nails and leg cramps are two other symptoms,” continues Dr. Dalal. They all respond to treatment, although results can take four weeks to occur.
Mayo Clinic says that mild iron deficiency usually doesn’t cause complications. However, left untreated, it can become severe and lead to health problems, including the following:
- Heart problems. Iron deficiency may lead to a rapid or irregular heartbeat. Your heart must pump more blood to compensate for the lack of oxygen carried in your blood, which can lead to an enlarged heart or heart failure.
- Problems during pregnancy. In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies. The condition is preventable in pregnant women who receive iron supplements as part of their prenatal care.
- Growth problems. In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development. Additionally, iron deficiency is associated with an increased susceptibility to infections.
There are many ways to minimize or cure iron deficiency, according to Dr. Dalal. “If you’re a woman whose heavy periods are causing this condition, your OB/GYN can help.
“If fibroids are to blame, have them removed. Because it can be a predictor of colon cancer, it’s important to find what’s causing your iron deficiency as soon as possible.”
Many people take an iron supplement to treat their iron deficiency, and that can be effective, too, depending on the underlying cause.
“Take vitamin C or orange juice with the supplement to help ensure you’re absorbing the iron properly,” advises Dr. Dalal. “Avoid time-release products. You should also take your iron supplement separately from meals since some foods interfere with absorption.
“Start with one pill a day and each week add one pill a day until you’re meeting your recommended dose. There are also liquid forms available.”
Dr. Ashish Dalal graduated from the M.S. University Medical College of Baroda in India, where he also completed a rotating internship. He was a clinical research associate in the Oncology Department at Montefiore Medical Center in New York and completed a residency in Internal Medicine and fellowship in Hematology and Oncology at Beth Israel Medical Center in New York.
Dr. Dalal is board-certified in Hematology and Medical Oncology. He works at Health First Cancer Institute in Melbourne. Call 321-253-4673 for more information or an appointment.
