Iron deficiency is a common problem for women. Here’s how to recognise it and what you can do
If I had $1 for every time I’ve been asked if I’m anaemic, I could be retired by now and living on a Caribbean island. I’m not anaemic, I just have very pale skin inherited from my English parents. But constantly being asked if I do has made me very aware of my iron levels so I do get them tested every now and then.
But there are lots of women who don’t realise that anaemia is the reason why they feel so tired or look washed out. of course there are lots of reasons why you might be lethargic or pale, but it’s worth having a blood test to rule out anaemia.
What is anaemia? It’s a disorder of the red cells in your blood. They contain a substance called haemoglobin which collects oxygen from your lungs and distributes it to your tissues, where it’s needed to provide energy. Being anaemic means you don’t have enough red blood cells so your tissues aren’t getting enough oxygen.
What causes it? Anaemia is usually a symptom of something else that is wrong in your body, and there can be a variety of causes. These include:
A lack of iron or vitamins, so your bone marrow can’t make enough red blood cells.
A disease which affects the ability of your bone marrow to produce cells at a fast enough rate.
Blood cells that don’t last long enough.
Who gets anaemia? Anaemia caused by iron deficiency affects around 4% of women (this increases to around 8% of women aged 30 to 49). That’s because we lose blood through periods – around 40mg every month. If you have heavy periods you will lose even more.
Women and men both lose around 1mg of iron a day through sweating or shedding cells from the skin. But that increases to 2.5mg a day when you’re pregnant and 2mg when you’re breast-feeding, because you’re giving your iron stores to your baby.
Vegetarians and vegans can be prone to anaemia if they are not getting enough iron and B vitamins in their diet.
Athletes, and in particular runners, are also more likely to have low iron levels.
Anaemia may also develop if you have ongoing bleeding from a problem like piles or a stomach ulcer.
How do I know I’ve got it? The signs of anaemia include:
Tiredness: This is the most common symptom and can be a sign of many other illnesses, or simply due to lack of sleep. But if you feel much more tired than you should do, it’s worth getting tested. You may also have difficulty concentrating and get upset easily.
Breathlessness: If you’re anaemic your lungs are having to work harder to make up for the reduced number of blood cells needed to supply your body with oxygen. You can end up feeling short of breath.
Pain in your legs and heart: You may notice sore leg muscles when you walk, or angina-like heart pain. Pallor: If you are paler than usual and it makes you look unhealthy, anaemia may be to blame. Also, check the inside of the skin just below your eyeball. It should be a rosy pink colour, not washed-out looking.
Dizziness: Lack of oxygen to the brain can make you prone to fainting.
Change in nail shape: If your fingernails become spoon-shaped it could be caused by anaemia.
A sore tongue and cracks in the corner of your mouth: This is a less common symptom that appears in cases of chronic iron deficiency.
If you have some of these symptoms, see your doctor. They will order a blood test to reveal how many red blood cells you have and if you’re anaemic.
Can anaemia be dangerous? It’s important that the reason for your anaemia is diagnosed so it can be treated. If it is due to blood loss it can lead to a fall in blood pressure and a lack of oxygen, which can even be life-threatening. If your iron deficiency is caused by a problem like a bleeding ulcer, this will need to be sorted out.
What’s the treatment? That depends on the cause of your anaemia.
Usually all that is needed is to take a course of iron tablets. You may need to take them for several months. Sometimes iron tablets can cause symptoms like stomach cramps and nausea. Constipation and flatulence can also be uncomfortable and annoying side effects. If you can’t tolerate pills, you can have iron injections or take a tonic.
If a vitamin deficiency is causing the anaemia you may need folate tablets or injections of vitamin B12. These injections may also be needed if you have a type of anaemia called pernicious anaemia, in which your body can’t absorb B12 properly.
Your anaemia will be included in your overall treatment if it is the result of bone marrow problems caused by a serious illness like leukaemia, or medical treatment such as radiotherapy.
Can it be prevented? You can reduce your risk of getting iron-deficiency anaemia by eating a balanced diet that provides all the nutrients needed to make healthy blood.
Iron-rich foods include:
Liver and red meat (high-iron content).
Chicken, fish, beans and peas (moderate).
Fruit and vegetables (low-iron content).
The iron in meat, called haem iron, is more easily absorbed by the body than the non-haem iron in veges. However, eating foods containing vitamin C at the same time as non-haem iron will help your body to absorb it better.
If you have a history of iron deficiency or are pregnant, your doctor may suggest an iron tonic. However, you should never take a product containing lots of extra iron unless you know you are deficient. Too much iron can cause haemochromatosis, or iron overload, which can lead to serious health problems.
Did you know …? Popeye got it wrong. Yes, spinach does contain a lot of iron but it’s the kind that is hard to absorb.
