Anemia - a disease state characterized by decrease in red cell massOften in conjunction with a decrease in the number of red blood cells per unit volume of blood (mcv). The most typical of iron deficiency anemia. It is characterized by the depletion of iron stores in the body.
Causes
The following causes of iron deficiency are:
- Inadequate iron stores at birth. Premature babies as well as children of mothers who suffered during pregnancy, iron deficiency anemia, are at risk. Status of the placenta is also of great importance, since the positive balance of iron in the fetus due to placental perfect transport mechanisms.
- Insufficient intake of iron from food and malabsorption in the gastrointestinal tract. What matters is not ctolko iron content in the product, as the effectiveness of its absorption and assimilation. Iron is absorbed in the duodenum and jejunum, so in various diseases of the digestive tract (chronic enteritis, Impaired intestinal absorption) may also develop iron deficiency due to a violation of its absorption.
- Increased iron requirement in relation to growth, maturation of various organ systems, an increase of circulating blood volume. Especially high demand for iron during stretching, adolescence and during the formation of menstrual function in adolescent girls.
- Excessive loss of body iron. This is primarily hemorrhage: bleeding of various localization (for diseases of the digestive tract - ulcerous processes, polyps, vascular abnormalities, nosebleeds), Worms, heavy menstruation. Excess iron loss can be expressed with allergic manifestations of the skin due to loss of the micronutrient with exfoliated epithelium with frequent SARSAs viruses and bacteria use the iron for their activity.
Symptoms of iron deficiency anemia
The severity of symptoms of iron deficiency anemia depends on the rate of development of anemia (for slow development, characteristic of iron deficiency, the time for the full development of compensatory mechanisms is sufficient) and its duration. Even moderate anemia often occurs without symptoms.
- The patient may be concerned about fatigue, shortness of breath and palpitations, especially after exercise, often - dizziness and headaches, tinnitus, even fainting possible. The person becomes irritable, disturbed sleep, decreased concentration. Since the blood flow in the skin is reduced, may develop increased sensitivity to cold. Occurs and symptoms of gastro-intestinal tract - a sharp decrease in appetite, dyspepsia (nausea, change in the nature and frequency of stool).
- In teenage girls disrupted menstrual cycle, which is manifested in the form of a lean or heavy bleeding.
- The main symptom of iron deficiency anemia - pale skin. However, its information value is limited by other factors that determine skin color. Therefore, the most informative indication of anemia is visible mucous pallor - oral mucosa, conjunctiva and nail bed eyelids.
- Prolonged iron deficiency appear pica (eating chalk, dirt, paint, ice), smell (like pungent smells of gasoline, paints, varnishes), developed inflammation and cracked tongue, lips, corners, thinned, streaked, brittle nails. People with iron deficiency often suffer from SARS, which in turn exacerbates the existing iron deficiency.
The diagnosis is confirmed by laboratory data. To do this, measure the level of blood serum iron.
Treatment of iron deficiency anemia
Treatment of iron deficiency anemia should be carried out with iron preparations. The goal of treatment with iron preparations - the elimination of iron deficiency in the body, not just the normalization of hemoglobin levels, so a long term treatment (at least 3 months).
It is important to focus not on the content of iron in food, and its shape. It is a form of iron determines the percentage of its absorption and assimilation and, therefore, the effectiveness of therapy.
Of the various forms of iron is most easily absorbed heme iron - complex organic compound, wherein iron is in the composition of hemoglobin. Iron from cereals, vegetables, fruits absorbed significantly worse due to the presence of inhibitors such as oxalates, phosphates, tannin and others. Compare: iron digestibility coefficient of beef (heme iron) amounts to 17-22%, fruit - not more than 3%. Thus, food intake must be as rich products in which iron is contained in the form of heme (beef tongue, rabbit meat, beef). It should also be noted that meat, liver and fish improves the absorption of iron from fruits and vegetables while their use.
Absorption of iron from cereals, legumes, tubers, vegetables and fruits is significantly lower. Vegetable enhance absorption of iron, ascorbic acid, meat products, poultry, fish, as well as substances that lower the acidity of food (e.g., lactic acid). Reduce the absorption of iron soy protein, tea, coffee, nuts and legumes.
It should be borne in mind that iron absorption can be reduced, while the application of a number of medications (tetracyclines Almagelum, magnesium salts). For better tolerability iron supplements should be taken with food. For children the drugs of choice are liquid forms of iron preparations (Aktiferrin, Maltofer).
Daily therapeutic dose of iron preparations should be sufficient to normalize the hemoglobin level and replenishment iron stores in the bone marrow, which is to iron salt preparations 3-6 mg / kg / day elemental iron in two or three reception. Considering that the development of iron deficiency anemia of iron absorption is increased in comparison with the norm and is 25-30% (under normal iron reserves - 3-7%) it is necessary to apply from 100 to 300 mg iron in the ferrous day. The use of higher doses has no meaning because the absorption of iron is not increased. Thus, the minimum effective dose is 100 mg, and the maximum - 300 mg ferrous iron per day.
Table: the iron content of staple foods
| animal products | Herbal Products | ||
| Name | Content (Mg / 100g) |
Name | Content (Mg / 100g) |
| Cheese obezzh.moloka | 37 | beans | 72 |
| pig liver | 29,7 | Nuts | 51 |
| Cheese Swiss francs. | 19 | Halva tahina | 50,1 |
| Brewer's yeast | 18 | Cereals | 45 |
| beef liver | 9 | fresh mushrooms | 35 |
| kidneys beef | 7 | sunflower Halva | 33,2 |
| Heart | 6,3 | millet | 31 |
| Yolk | 6 | Poppy | 24 |
| beef tongue | 5 | Peas | 20 |
| Rabbit (meat) | 4,5 | sea kale | 16 |
| turkey meat | 4 | dried apples | 15 |
| Mutton | 3,1 | dried pears | 13 |
| Veal | 2,9 | prunes | 13 |
| Beef | 2,8 | Dried apricots | 12 |
| meat of chickens | 2,5 | Cocoa | 11 |
| Mackerel | 2,5 | Dried apricots | 11 |
| Chicken egg | 2,5 | briar | 11 |
| Carp | 2,2 | Buckwheat | 8 |
| frankfurters | 1,9 | bilberry | 8 |
| caviar Kets | 1,8 | Oatmeal | 6 |
| Sausage | 1,7 | dried mushrooms | 5,5 |
| Chicken | 1,6 | Almond | 5 |
| Pork | 1,6 | oat groats | 4,3 |
| Burbot | 1,4 | Dogwood | 4,1 |
| Pasta | 1,2 | Peach | 4,1 |
| Saltwater fish | 1,2 | apricots | 4 |
| Honey | 1,1 | Nectarine | 4 |
| Herring Atlanta. | 1 | groats wheaten | 3,9 |
| Breast milk | 0,7 | Wheat flour | 3,3 |
| Cod | 0,6 | Spinach | 3,3 |
| Cottage cheese | 0,4 | buckwheat flour | 3,2 |
| egg white | 0,2 | Raisins | 3 |
| Cow's milk | 0,1 | Cushenye apricots | 2,6 |
| Cream | 0,1 | Apples with red skin | 2,5 |
| Butter | 0,1 | Pear | 2,3 |
| Plum | 2,3 | ||
| prunes | 2,1 | ||
| Blackcurrant | 2,1 | ||
| Fresh apples. | 2 | ||
| cherry-plum | 1,9 | ||
| Raspberry | 1,8 | ||
| parsley | 1,8 | ||
| Sweet cherry | 1,8 | ||
| Semolina | 1,6 | ||
| Gooseberry | 1,6 | ||
| Raspberry | 1,6 | ||
| White bread | 1,5 | ||
| Cauliflower | 1,5 | ||
| Cherry | 1,4 | ||
| Beet | 1,4 | ||
| rice | 1,3 | ||
| Cabbage | 1,2 | ||
| Fried potato | 1,2 | ||
| Carrot | 1,1 | ||
| Melon | 1 | ||
| Corn | 1 | ||
| cucumbers | 0,9 | ||
| grenades | 0,8 | ||
| boiled potatoes | 0,8 | ||
| Carrot | 0,8 | ||
| Pumpkin | 0,8 | ||
| Strawberry | 0,7 | ||
| Banana | 0,6 | ||
| grapes | 0,6 | ||
| Cranberry | 0,6 | ||
| Lemon | 0,6 | ||
| tomatoes | 0,6 | ||
| Rhubarb | 0,6 | ||
| Salad | 0,6 | ||
| Orange | 0,4 | ||
| cowberry | 0,4 | ||
| courgettes | 0,4 | ||
| Mandarin | 0,4 | ||
| A pineapple | 0,3 |
For more information on nutrition in iron deficiency anemia can be found in our a separate article.
Individual variations in the necessary amount of iron due to the degree of iron deficiency body depletion, the speed of blood, absorbability, tolerance and some other factors. With this in mind when choosing a drug should focus not only on the content of total, but mainly on the amount of divalent iron which is absorbed only in gut. For example, when administering the drug with a low content of ferrous iron (ferropleks) number of tablets must be at least 8-10 day, whereas formulations with a high content of divalent iron (ferrogradument, Sorbifer durules et al.) may be administered in an amount of 1-2 tablets day.
side effects
Most often in the treatment of iron preparations observed following side effects: metallic taste, darkening of tooth enamel, allergic skin rashes, digestive disorders as a result of irritation to the mucous membrane of the digestive tract, particularly the intestine (diarrhea, nausea, vomiting). Therefore, the initial dose of drug must be 1 / 3-1 / 2, followed by treatment to increase their total dose over several days in order to avoid pronounced side effects.
Intramuscular administration of iron preparations is carried out only on strict because of pronounced local and systemic side effects. Indications for intramuscular administration of iron preparations are: digestive diseases (impaired intestinal absorption syndrome, nonspecific ulcerative colitis, Chronic enterocolitis, gastro-intestinal bleeding) and iron preparations intolerance when receiving through the mouth.
Contraindications to anemia iron preparations are not due to iron deficiency (hemolytic, aplastic), Hemosiderosis, hemochromatosis.
Inefficiency therapy in patients receiving iron supplementation during their good tolerance may be due to the following factors:
- wrong diagnosis;
- ongoing blood loss;
- comorbidities (SARS, exacerbation of chronic infection foci).
Forecast
The prognosis of iron deficiency anemia, is generally favorable.
