What are the common symptoms of iron deficiency anemia. How can you identify if you’re at risk for IDA. What steps should you take to get diagnosed and treated for iron deficiency.

The Importance of Iron in Your Body

Iron plays a crucial role in our bodies, far beyond its familiar presence in the periodic table. This essential mineral is fundamental to the production of hemoglobin, a vital molecule in red blood cells responsible for transporting oxygen throughout our body. When iron levels are insufficient, it can lead to a range of uncomfortable and potentially serious symptoms.

Dr. Robert Eisner, a hematologist at Northwestern Medicine in Chicago, emphasizes, “Iron deficiency is a major public health concern across the world.” Despite its prevalence, many people remain unaware of the risks and symptoms associated with iron deficiency anemia (IDA).

Recognizing Iron Deficiency Anemia: Key Symptoms to Watch For

Iron deficiency anemia occurs when the body lacks adequate iron levels in the bloodstream, resulting in insufficient oxygen delivery throughout the body. This deficiency can manifest in various ways, impacting overall health and well-being.

Common Symptoms of IDA:

• Fatigue and decreased energy levels
• Weak or brittle hair and nails
• Headaches
• Muscle weakness
• Pounding in the ears
• Unusual cravings for non-food items (pica)

Is it possible to have IDA without noticeable symptoms? Yes, IDA can develop gradually and often goes unnoticed until it becomes severe. Dr. Stephanie Martin, an OB/GYN and medical director at Clinical Concepts in Obstetrics, notes that it’s common for IDA to be asymptomatic while still subtly affecting daily life.

Identifying Risk Factors for Iron Deficiency Anemia

Understanding who is at higher risk for developing IDA is crucial for early detection and prevention. Several factors can increase an individual’s susceptibility to iron deficiency.

High-Risk Groups for IDA:

1. Women, especially those with heavy menstrual cycles
2. Pregnant women
3. People with inflammatory bowel disease
4. Individuals with a history of gastric bypass surgery
5. Those who have experienced major physical trauma
6. People with peptic ulcer disease
7. Endurance athletes
8. Vegetarians and vegans

Why are women more susceptible to IDA? Dr. Eisner explains, “People at the highest risk include young women due to chronic blood loss in the menstrual cycles and from childbearing.” Heavy periods, lasting more than seven days or requiring frequent pad or tampon changes, can be a significant contributor to iron deficiency.

The Impact of Diet on Iron Levels

Diet plays a significant role in maintaining healthy iron levels. Certain dietary choices can increase the risk of developing iron deficiency anemia.

Are vegetarians and vegans at higher risk for IDA? Yes, plant-based diets can potentially lead to lower iron intake. Dr. Martin explains, “The iron that’s in vegetables is called non-heme iron, and it’s not as well absorbed as it is from a meat source. That doesn’t mean that it’s not valuable, but it does mean you’re less likely to get enough iron in your diet.”

For those following vegetarian or vegan diets, it’s especially important to pay attention to potential IDA symptoms and ensure adequate iron intake through carefully planned meals or supplements.

Diagnosing Iron Deficiency Anemia: When to Seek Medical Attention

Recognizing when to consult a healthcare provider about potential iron deficiency anemia is crucial for timely diagnosis and treatment.

How can you determine if you need to get checked for IDA? Dr. Sandeep Basu, a hematologist and oncologist at Mayo Clinic Health System, advises, “If symptoms persist, it should prompt a visit to a medical provider for additional testing and evaluation.”

The most reliable method for diagnosing IDA is through a blood test that specifically checks iron levels. It’s important to note that iron panel testing is not always included in routine blood work, so be sure to request it specifically when discussing your concerns with your healthcare provider.

The Importance of Early Detection and Treatment

Early detection of iron deficiency anemia can prevent the condition from progressing and minimize its impact on overall health. Regular check-ups and awareness of potential symptoms are key to managing IDA effectively.

Dr. Eisner recommends, “Having a blood count done with an annual physical exam can find iron deficiency before it becomes very severe.” This proactive approach allows for timely intervention and treatment, potentially averting more serious health complications.

Treatment Options for Iron Deficiency Anemia

Once diagnosed, there are several approaches to treating iron deficiency anemia. The most appropriate treatment plan will depend on the severity of the condition and the underlying cause.

Common Treatment Strategies:

• Dietary changes to increase iron intake
• Iron supplements (oral or intravenous)
• Addressing underlying health conditions contributing to iron deficiency
• In severe cases, blood transfusions may be necessary

How long does it take to recover from IDA? The recovery time can vary depending on the severity of the deficiency and the chosen treatment method. Some individuals may notice improvements in symptoms within a few weeks of starting treatment, while others may require several months to fully replenish their iron stores.

Preventing Iron Deficiency Anemia: Lifestyle and Dietary Considerations

Taking proactive steps to prevent iron deficiency anemia can significantly improve overall health and well-being. Incorporating iron-rich foods into your diet and being aware of factors that may increase your risk are essential preventive measures.

Tips for Maintaining Healthy Iron Levels:

1. Consume a balanced diet rich in iron-containing foods
2. Consider iron supplements if you’re in a high-risk group
3. Pair iron-rich foods with vitamin C to enhance absorption
4. Be aware of medications or supplements that may interfere with iron absorption
5. Address any underlying health conditions that may contribute to iron deficiency

Can certain foods enhance iron absorption? Yes, consuming vitamin C-rich foods alongside iron sources can significantly improve iron absorption. For instance, pairing leafy greens with citrus fruits or bell peppers can boost the body’s ability to utilize dietary iron.

Understanding the importance of iron in our bodies and recognizing the signs of deficiency are crucial steps in maintaining optimal health. By staying informed about risk factors, symptoms, and treatment options for iron deficiency anemia, individuals can take proactive measures to ensure their iron levels remain within a healthy range. Regular check-ups, a balanced diet, and awareness of potential symptoms are key components in managing and preventing this common but often overlooked condition.

Symptoms, Risk Factors, & Treatment

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Iron. You know it as a metal—perhaps you first learned about it while memorizing the periodic table in high school chemistry class—but did you know it is also an essential mineral your body needs to function? Iron is used to make hemoglobin, a molecule in red blood cells that transports oxygen to your organs and muscles. And when you’re not getting enough iron in your system, it can result in some pretty crummy symptoms, from fatigue and muscle weakness to headaches and shortness of breath.

“Iron deficiency is a major public health concern across the world,” says, Robert Eisner, D.O., a hematologist at Northwestern Medicine in Chicago. Despite this fact, a new survey from the Get Iron Informed shows how little many of us know about the condition—of 1,000 women, 42% could not identify common risk factors for iron deficiency anemia (IDA), and 62% reported that they’ll only visit a healthcare provider if they have severe bodily symptoms (often brushing off milder ones like headaches and stomach pain).

Experts say this illustrates the need for better education about the condition. “The big thing that I witness in my practice, and that this survey really confirmed, is that women don’t recognize that they could be at risk” for iron deficiency anemia, says Stephanie Martin, D.O., OB/GYN, medical director at Clinical Concepts in Obstetrics in Brentwood, TN (who is affiliated with the campaign). “And even if they have symptoms that are pretty classic for IDA, they don’t recognize that that’s what it could be.”

What Is Iron Deficiency Anemia?

What Is Iron Deficiency Anemia?

Iron deficiency anemia is the technical term for what happens when you have inadequate levels of iron in your bloodstream. This results in a lack of oxygen delivery throughout the body, which can have wide-ranging effects on your health. IDA causes a decline in energy levels, weak or brittle hair and nails, headaches, muscle weakness, a pounding in the ears, and cravings for non-food items like ice or dirt.

But the condition is slow to develop, so many people don’t recognize symptoms until the anemia is very severe. “Because of the insidious onset of iron deficiency anemia, patients do not always realize that they have been having symptoms until we replete the iron stores and they start feeling better again,” Eisner says. Martin echoes this, saying it’s quite common for IDA to be asymptomatic and still wreak subtle havoc on your daily life. Even when someone does have symptoms, it’s easy to mistake them for other things like stress or lack of sleep. “These symptoms can be due to a whole bunch of things,” Martin says. “People don’t consider that it could be iron deficiency anemia that is causing all these problems.”

Who Is at Risk?

Who Is at Risk for IDA?

Women are more likely than men to develop IDA. “People at the highest risk include young women due to chronic blood loss in the menstrual cycles and from childbearing,” Eisner explains. If your periods are heavy (lasting more than seven days or requiring you to change your pad or tampon after less than two hours), that’s worth getting checked out—you could be dealing with fibroids, polyps, hormone-related problems, or even uterine cancer.

People with inflammatory bowel disease are also considered higher risk for IDA because of the possibility of gastrointestinal bleeding. Same goes for anyone with a history of gastric bypass surgery, major physical trauma, or peptic ulcer disease. Research also suggests that iron deficiency is widespread among endurance athletes due to increased sweat, blood loss, and exertion associated with intense athletic training.

Diet can also contribute to IDA risk. Vegetarians and vegans tend to eat fewer iron-rich foods (since meat is a big source of iron in the human diet). “The iron that’s in vegetables is called non-heme iron, and it’s not as well absorbed as it is from a meat source,” Martin says. “That doesn’t mean that it’s not valuable, but it does mean you’re less likely to get enough iron in your diet.” Herbivores should pay extra close attention to whether they experience symptoms consistent with IDA.

How to Get Checked for IDA

How to Get Checked for IDA

The best and most reliable way to figure out if you have IDA is to get your iron levels checked through a blood test. “We all have days where we might feel a little more tired or under the weather,” says Sandeep Basu, M.D., a hematologist and oncologist at Mayo Clinic Health System in Eau Claire, WI. “If, however, these symptoms persist, it should prompt a visit to a medical provider for additional testing and evaluation.”

Iron panel testing is not always part of a routine blood draw—make sure you ask for it specifically. “Having a blood count done with an annual physical exam can find iron deficiency before it becomes very severe,” Eisner says. If you’re already experiencing symptoms, that means your IDA has progressed enough that you’ll need treatment. Your doctor may prescribe iron pills or an IV to replenish your iron levels. Then, Dr. Basu explains, comes the crucial step of “evaluating and treating the underlying condition and source for blood loss, such as a tumor or ulcer.” This will prevent you from developing IDA again several months or years later. If your iron deficiency was diet-induced, talk to your doctor about how to get better sources of iron in your diet, whether that means taking a supplement or strategically incorporating meat and fish.

You may not even realize how much IDA is affecting your life until you see what it feels like to have normal iron levels again. (Where did all this energy come from??) “It’s important for women to recognize that they could be at risk, and they don’t have to have severe symptoms to have a significant problem,” Martin says. “We are often afraid to bring it up because we don’t think it’s ‘bad enough.’”

Case in point: The women from the Get Iron Informed survey waited an average of 3.9 years from the start of their symptoms to their official IDA diagnosis. That’s a long time not to feel like yourself. All it takes is a test and a talk with your doctor to be on the road to feeling better.

Notes: This article was originally published March 10, 2021 and most recently updated March 25, 2021.

• Iron: National Institutes of Health. (n.d.) “Iron: Fact Sheet for Consumers.” ods.od.nih.gov/factsheets/Iron-Consumer/
• IDA Survey: Get Iron Informed. (2021.) “Iron Deficiency Anemia.” getironinformed.com/
• IDA Symptoms: American Society of Hematology. (n.d.) “Iron-Deficiency Anemia.” hematology.org/education/patients/anemia/iron-deficiency
• Heavy Menstruation: Centers for Disease Control and Prevention. (n.d.) “Heavy Menstrual Bleeding.” cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html
• Athletes & Iron Deficiency: Medicine & Science in Sports & Exercise. (2019.) “The Impact of Morning versus Afternoon Exercise on Iron Absorption in Athletes.” journals.lww.com/acsm-msse/Fulltext/2019/10000/The_Impact_of_Morning_versus_Afternoon_Exercise_on.20.aspx

Our Review Process

Iron and Menopause: Does Increased Iron Affect the Health of Postmenopausal Women?

Antioxid Redox Signal. 2009 Dec; 11(12): 2939–2943.

doi: 10.1089/ars.2009.2576

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Author information Article notes Copyright and License information Disclaimer

Estrogen deficiency has been regarded as the main causative factor in menopausal symptoms and diseases. Here, we show that although estrogen decreases by 90%, a concurrent but inverse change occurs in iron levels during menopausal transition. For example, levels of serum ferritin are increased by two- to threefold from before menopause to after menopause. This observation has led us to hypothesize that, in addition to estrogen deficiency, increased iron as a result of menopause could be a risk factor affecting the health of postmenopausal women. Further studies on iron and menopause are clinically relevant and may provide novel therapeutic treatments. Antioxid. Redox Signal. 11, 2939–2943.

In recent years, interest in the improvement of women’s health has received great worldwide attention (30). The commitment of the National Institutes of Health (NIH) and its Office of Research on Women’s Health exemplifies the effort taken by the U.S. government and highlights the need for surveillance and screening programs that carefully monitor adverse effects in women. The health of girls and women is affected by developmental, physiological, and psychological age. Women’s lives are marked by a continuum from intrauterine life to the elderly years: infancy, childhood and adolescence, menarche, reproductive life, the menopausal transition, postmenopausal years, the elderly and frail elderly. Across the life span of a woman, menopause probably has the greatest impact on health (15). Menopause is a natural aging process during which a woman passes from the reproductive to the nonreproductive years. Despite this natural process, many women still experience menopausal symptoms such as vasomotor episodes or “hot flashes,” as well as pathophysiologic conditions such as loss of bone mineral density and thinning and drying of skin (27).

One of the first observable physiological changes for menopause is the cessation of menstrual periods. Because of the reduction in ovarian functions, estrogen deficiency has been the main focus of menopausal research, interventions, and treatments. Yet, results of a meta-analysis of high-quality randomized controlled trials showed that estrogen-only or a combination with progestin hormone-replacement therapy (HRT) reduced hot flashes in 90% of perimenopausal women, but in just 65% of postmenopausal women (15). Moreover, overall bone turnover is significantly increased in peri- and postmenopausal women but in an imbalanced fashion. Bone resorption increases, at 90%, and bone formation increases at only 45%, resulting in a net loss of bone mineral density (11). The exact mechanism through which bone formation after menopause cannot keep up with bone resorption remains unknown. HRT is partially effective in slowing bone loss in postmenopausal women (33). The benefits and drawbacks of HRT remain controversial, and a substantial number of women have discontinued its use because of concerns about side effects (15). Taking into consideration the partial alleviation and potential risk of HRT, we searched risk factors other than estrogen deficiency in menopausal symptoms and diseases.

Menstruation is a unique physiological phenomenon in young women, characterized by the periodic high levels of estrogen and the shedding of the endometrium. Because of this monthly blood loss, iron deficiency is prevalent in premenopausal women (46). During perimenopause, fewer eggs exist for the ovaries to stimulate, and menstrual periods become irregular. This period of fluctuation can last up to 10 years. Cessation of menstruation marks the later stage of perimenopause. Because iron is no longer lost through menstruation, it accumulates in the body.

Estrogen and iron are two of the most important growth nutrients in a woman’s body development. Estrogen affects the growth, differentiation, and function of tissues such as breasts, skin, and bone (36). Iron is essential for oxygen transport, DNA synthesis, as well as energy production (22). Although estrogen variation over the life span of a woman is considered within normal range, a long duration of exposure to estrogen, including early age at menarche, nulliparity, late first full-time pregnancy, and late menopause, is a well established risk factor for breast cancer (6). Conversely, estrogen deficiency has been considered the major cause of menopausal symptoms and diseases. With the iron data obtained from the Third National Health and Nutrition Examination Survey (NHANES III) (45), shows that concurrent but inverse changes occur between iron and estrogen levels in healthy women during menopausal transition. Whereas estrogen decreases because of the cessation of ovarian functions, iron increases as a result of decreasing menstrual periods (25, 45). For example, level of serum ferritin is increased by two- to threefold during this period (25). It has been estimated that 1 μg/L serum ferritin corresponds to 120 μg storage iron per kg bodyweight (10). This produces an increase in body iron storage from 4.8 mg/kg bodyweight at the beginning of perimenopause at age 45 years to 12 mg/kg bodyweight after menopause at age 60 years. As shown in , iron deficiency in young women is a relevant health issue that has received great attention from medical professionals. It affects 20% of nonpregnant women aged between 16 and 49 years in industrialized countries and >40% of all women in developing countries (46). Loss of iron in menstrual blood was proposed as a uterine function responsible for the low heart-disease risk of young women (37, 38).

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Concurrent but inverse changes of ferritin versus estrogen during menopausal transition. Serum levels of 17β-estradiol (E2) were converted to percentage of peak value at 500 pg/ml serum at age 25 years. Levels of ferritin were expressed as nanograms per milliliter serum. E2 data as a function of age were obtained from the website http://www.drlam.com/A3R_brief_in_doc_format/Estrogen Dominance.cfm. Ferritin data were obtained from ref. 45. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article at www.liebertonline.com/ars).

Although increased iron as a result of menopause is considered within normal physiologic range, potential health problems in women, as well as in men or neonates, could be linked to increased iron storage, which is normal but not necessarily healthy (39, 40). For example, a role for iron has been proposed in the pathogenesis of many diseases, such as ischemic heart disease, cancer, diabetes, infections, and neurodegenerative disorders (reviewed in ref. 40). Although healthy levels of iron in human body have not yet been established, it is conceivable that iron imbalance (deficiency or overload) could cause adverse health effects. It has been postulated that iron deficiency in young women plays a role in a high breast cancer recurrence in young patients, and increased iron contributes to a high breast cancer incidence in postmenopausal women (17).

We hypothesize that, in addition to breast cancer and heart disease (17, 38), increased iron could affect other aspects of women’s health after menopause. Because the role of iron in menopause has not yet been fully investigated, we used iron studies to show evidence of the role of increased iron in hot flashes, osteoporosis, and skin aging, three common ailments associated with menopause.

Iron and hot flashes

A hot flash indicates the sensation of heat and varies in frequencies among women of different ethnic backgrounds, as well as in durations, recurrence rates, and severities (27). In the Study of Women across the Nation (SWAN), African-American women reported more frequent hot flashes than did white women, who in turn reported more than did Hispanic women (12). Estrogen deficiency plays an important role in this symptom, at least at the beginning of the menopausal transition, as shown by the effectiveness of HRT in 90% of perimenopausal women. Does increased iron contribute to this symptom, particularly in older postmenopausal women in whom HRT is less effective? A literature search found no studies attempting to link iron overload to hot flashes. However, poor temperature regulation leading to cold intolerance has been reported in individuals with iron-deficiency anemia (5). Heat production is impaired by iron deficiency, and heat-loss rate is increased by the demand for tissue oxygenation when decreased blood flow is needed to minimize heat losses to the environment. By examining ferritin data from the NHANES III study (45), we found that serum ferritin levels are parallel with the reported prevalence of hot flashes among African-American, white, and Hispanic women. This observation suggests that, in contrast to iron deficiency leading to cold intolerance, an increase in iron might play a role in postmenopausal hot flashes.

Iron and osteoporosis

Osteoporosis is a common disease characterized by low bone mineral density, resulting in a high incidence of bone fractures, and occurs in ∼50% of women but only in 12% of men older than 50 years (20, 28). By searching for factor(s) other than estrogen deficiency in osteoporosis, we found that both dietary iron deficiency and overload affect bone in animal studies (8, 18, 19, 21, 23, 29). One recent report showed that osteoporosis patients are slightly iron deficient, having lower serum iron and higher transferrin as compared with the control group (7).

However, hemochromatosis patients, who carry a hemochromatosis Fe (HFE) gene mutation and have an iron-overload condition, are at much higher risks of developing osteoporosis (14, 41). Osteopenia with a T score of 1 SD or less and osteoporosis with a T score of 2. 5 SD or less were in 78.9% and 34.5% of iron-overload patients, respectively (14), although vitamin D and parathyroid hormone levels appeared normal in these patients. It is interesting to note that osteoporosis is highly prevalent in middle-aged men with HFE gene mutation (14). These results suggest that early occurrence of iron overload in men carries a risk for osteoporosis. A 20-year delay in iron accumulation because of menstrual periods in women who have the same HFE gene mutation may be protective.

Sickle cell disease, an inherited disorder accompanied by anemia and iron overload because of defective hemoglobin, often leads to osteoporosis and osteopenia (2, 35). Analyses of sickle cell disease patients showed that low bone mineral density was significantly associated with lower body mass index, lower hemoglobin, and higher ferritin levels (35). If these studies are correlative, one case report showed that normalization of serum ferritin by frequent phlebotomies increased bone mineral density of the lumbar spine (3). These studies implicate the role of increased iron in the etiology of postmenopausal osteoporosis (42).

Iron and skin aging

During menopausal transition, the skin becomes thin, dry, and wrinkled, which is due to changes in collagen and elastin content, as well as its ability to retain fluids (9). The human body has a limited capacity to remove excess iron; body iron is normally eliminated through the stool, urine, and exfoliation of epidermal cells. About 20% of the 1-mg iron daily from the diet is excreted through the skin (13). In patients with erythrodermic psoriasis, desquamated skin cells account for up to 38% of total body iron loss (34). When body iron storage increases, the skin is exposed to higher levels of iron, which may cause oxidative damage and skin aging during this process. Moreover, the increased stress may make skin more susceptible to UV damage.

It has been shown that without UV exposure, iron overload alone did not induce skin histologic changes in iron-overloaded transgenic HFE^−/− mice. This also was true for mice fed a high-iron diet or for mice injected with iron (1). However, human skin fibroblasts were exposed to UVA; the detrimental effects of iron were observed by a significant increase in matrix metalloproteinase-1 (MMP-1) (31). Preincubation with iron chelators reduced UVA-dependent MMP-1 upregulation, suggesting that iron is involved in UVA-mediated collagen degradation (31). Prolonged UVB exposure also resulted in an accumulation of larger amounts of non-heme iron in sun-exposed skin when compared with nonexposed skin, and treatment with iron chelators significantly decreased UVB-induced skin damage (4). These results indicate that increased iron in the skin enhances oxidative stress when exposed to UV and affects downstream genes, which further promote skin photoaging.

As compared with estrogen deficiency, increased iron is an unexplored risk factor in menopausal symptoms and diseases associated with menopause. Appropriate rodent animal models mimicking menopausal conditions of estrogen and iron levels are absent. Previous animal studies used a mouse model with surgical induction of menopause by ovariectomy (32). In ovariectomized mice, serum estradiol baseline levels are significantly decreased, simulating one of the major postmenopausal aspects. From our point of view, another important aspect that has not been taken into account in previous animal studies is the significant increase in iron levels after menopause. Therefore, testing the hypothesis in a research laboratory is difficult because it requires the development of a new model simultaneously simulating iron and estrogen changes. Conversely, epidemiologists could first examine whether iron levels are higher in women who experience more frequent hot flashes or hip fractures than in women without. Because both increased iron and decreased estrogen could affect women’s health during and after menopause, a study design to examine two variables and one disease outcome is needed. Information gained may be used by clinicians and basic scientists to see whether the cause–effect relation exists between increased iron and menopausal symptoms and diseases.

Today, although considerable scientific data are available on the natural biologic and pathologic processes that could affect women’s health, substantial gaps in knowledge remain. Efforts have been made to understand the effects of female sex hormones on cellular and organ systems in relation to women’s health and disease. As illustrated in , the natural biologic system in young women is high estrogen and low iron. The reverse is true in older women: low estrogen and high iron. Could an increase in iron levels as a result of menopause be a risk factor that affects women’s health? Increased iron could lead to oxidative stress and sensitize the skin to UV exposure. Urinary levels of 8-oxo-2′-deoxyguanosine, a marker of oxidative DNA adducts, has been shown to increase with serum ferritin levels in men and women (26). Because iron is a growth nutrient, increased iron could also increase proliferation of osteoblast progenitors without differentiation to mature osteoblasts and thus, slow bone formation.

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Proposed mechanisms of increased iron as a result of menopause on osteoporosis and skin aging. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article at www.liebertonline.com/ars).

An increase in iron is observed in men during their adolescent years (age 18–30 years) (45), and men do not seem to be immune to the pathologic effects of iron increase (16, 43, 44). The greater incidence of heart disease in men, as well as in postmenopausal women, when compared with the incidence in premenopausal women, has been attributed to higher levels of stored iron in these two groups (38).

Yet important differences exist between men and postmenopausal women in terms of timing and patterns of changes in hormone and iron levels. First, iron increase in men happens in conjunction with the increase of male sex hormones (24, 45), which could provide protection against the harmful effects of the increased iron. Nevertheless, iron increase in women occurs during their midlife (age 42–51 years) at the same time as female sex hormones are decreased. Therefore, the combined effects of increased iron and estrogen deficiency could greatly affect on women’s health. Second, it is important to recognize that men and women inherit differently, and thus it is difficult to compare them from the start. Therefore, the observation of increased iron at early age in men accompanied by a lower incidence of osteoporosis should not hinder us from investigating the role of increased iron in menopause. Considering that current menopausal research and treatments focus mainly on ovarian hormones and their receptors, indicting increased iron as a risk factor in menopause-related diseases is more complex, yet more realistic, and worth further investigation.

This work was funded by the National Institutes of Health (NIH CA132684) and in part by NIH grants ES 00260, CA34588, and CA 16087. We thank Daniel Yen from The College of New Jersey for editorial assistance.

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Iron deficiency anemia – Novokuznetsk Center for Public Health and Medical Prevention

Do you know that iron deficiency anemia is a global problem.

Iron is the only known mineral that cannot be met by food alone.

Thus, in the USA alone, iron-containing preparations are constantly used by more than 25 million people. Women are more susceptible to this disease.
In 10% of women under 45 iron deficiency is obvious, and in 30% it is hidden.

Iron deficiency in Europe and Russia affects 30–40% of the population, and up to 50–60% in the regions of the North and Siberia.

Check if you have the symptoms of iron deficiency described below.

1. Constant feeling of tiredness. The most common symptom of anemia. Women often do not pay attention to fatigue, as they consider it an integral part of their busy lives.
However, iron deficiency causes an insufficient supply of oxygen to the tissues and the body loses vitality. If your “normal” fatigue is accompanied by weakness, headaches, dizziness, irritability, inability to concentrate, check your blood iron levels. It is no coincidence that iron deficiency anemia is also called the “tired blood” disease.

2. Pale complexion. Hemoglobin gives blood its red color and gives your skin a pinkish undertone. But regardless of the color of your skin, if the color of the visible mucous membranes of your gums, lips and eyelids is pale, iron deficiency may be the cause.

3. Shortness of breath. If the body does not have enough oxygen, you will constantly lack air. If you start to feel short of breath while doing normal household chores or just climbing stairs, low iron levels in your blood may be to blame.

4. The slightest violation of the heart rhythm instantly makes itself felt. A strong heartbeat manifests itself in different ways: you feel painful tremors, someone’s heart beats and “pops out” of the chest, accompanied by weakness, sweating, a rush of blood to the face, increased pulsation in the temples. In this case, replenishment of iron deficiency in the body is vital. If you have heart disease, the accompanying anemia will only make your condition worse.

5. With prolonged iron deficiency, a “perverted appetite” appears: eating chalk, dirt, paints, ice. The sense of smell is disturbed: they begin to like the sharp smells of gasoline, paints, varnishes. Inflammation and cracks of the tongue, corners of the lips, thinned, striated, brittle nails develop.

6. Low immunity. People with iron deficiency are more likely to get SARS, which, in turn, exacerbates the existing iron deficiency.

7. Hair loss. With iron deficiency anemia, extensive alopecia can begin, and you will begin to lose hair quite quickly. American scientists believe that one of the main causes of hair loss is an insufficient amount of iron in the blood. Hair loss is an extreme measure of the body. This means that with a deficiency of nutrients, the body reduces the nutrition of all that is superfluous – hair and nails, which causes their fragility and loss. For example, if a person loses about 20% of the hair on his head, this will significantly reduce his need for oxygen. Doctors say that a year after the deficiency of vitamins and minerals in the body is restored, the hair will begin to grow back.

8. Iron deficiency reduces the function of the thyroid gland and blocks its ability to speed up metabolism. Hypothyroidism is often hidden – 6 out of 10 people are unaware of their disease. Therefore, if you have begun to gain weight, suffer from a lack of energy, your body temperature is below normal, consult a doctor.

Iron deficiency or “Iron status” in a woman’s life.

Iron is an indispensable trace element in the human body, which, as part of hemoglobin, ensures the delivery of oxygen to all organs and tissues. Iron is also part of many enzymes and proteins that provide metabolic processes in the body.

It is not surprising that iron deficiency in the body negatively affects not only the well-being of a person, but also his appearance. The skin becomes dry and pale, the hair becomes dull, weak and falls out, and the nails become brittle, with white patches. Non-healing sores appear in the corners of the lips, and painful cracks appear on the hands and feet.

Against the background of a long-term iron deficiency, people experience constant weakness, loss of strength, the slightest physical exertion causes shortness of breath, dizziness may appear, memory deteriorates.

The immune system also suffers: people become less resistant to infections, often suffer from colds and intestinal disorders.

According to the WHO, approximately 60% of the world’s population has a lack of iron in the body (latent iron deficiency), and 30% of the deficiency of this element is so great that we are already talking about iron deficiency anemia (IDA) – a condition in which the level of hemoglobin.

IDA is much more common in women than in men, which is not surprising. The hormonal characteristics of the body and monthly menstrual blood loss require more significant reserves of this trace element. So, the need for iron in men is about 10 mg / day, in women of reproductive age – 15 mg / day, in pregnant and lactating women – 20 or more. Potentially, any menstruating woman is at risk for iron deficiency and iron deficiency anemia, so WHO experts recommend prophylactic intake of oral iron preparations during menstruation.

Even with normal hemoglobin levels (more than 120 g/l in women and 130 g/l in men), but low ferritin levels (less than 30 µg/l, symptoms of iron deficiency may already be quite pronounced.

It should be remembered that ferritin performs two functions in the body: it is an iron donor in cells that need it (in iron deficiency), and it serves as a regulatory protein in the acute phase of inflammation.In case of inflammation of any cause, its concentration in the blood serum rises to 100 mcg/l and does not reflect iron deficiency.Therefore, if inflammation is suspected, the level of C-reactive protein or other markers should be measured simultaneously with ferritin.

Today, no one doubts the fact that a couple planning a pregnancy should be examined for anemia and iron deficiency, preferably a few months before conception, in order to compensate for these conditions in time and ensure the correct development of the fetus and the course of pregnancy. If the fetus does not receive the required amount of such an important trace element, it may lag behind in development, have a small weight and more serious disorders. In addition, IDA can threaten miscarriage and premature birth.

With the onset of menopause, monthly blood loss stops, which favorably affects the level of ferritin and iron stores in the body. However, concomitant diseases accumulated over the years of life, insufficient intake of iron from food and impaired absorption in the intestine can provoke iron deficiency not associated with blood loss.

It is not uncommon for iron deficiency to be missed in perimenopausal women when the symptoms of the menopausal syndrome mask the symptoms of iron deficiency. Significant fluctuations in hormone levels in premenopause can provoke a type 9 menstrual cycle disorder0041 acyclic uterine bleeding (AMB) when blood loss becomes frequent and profuse. This leads to the rapid depletion of iron stores and the development of IDA.

In women with IDA, there is a violation of temperature regulation, which leads to cold intolerance and more severe vegetative-vascular manifestations of the climacteric syndrome (fever, chills, hot flashes).

They can also suffer from iron deficiency: attention, memory and the ability to learn and reason deteriorate.

There is a direct link between low iron levels and anxiety/depression, sleep disturbances, mental disorders due to a decrease in dopamine production.

Deficiency of myoglobin, which provides an oxygen reserve in the muscles, is accompanied by severe muscle weakness, including weakening of the sphincters, the clinical manifestation of which is frequent urination and stress incontinence.

Both iron deficiency and excess affect bones. According to studies, patients with osteoporosis have a moderate iron deficiency and a lower serum iron content against the background of a higher transferrin content compared to the control group.

Predisposing factors for iron deficiency and anemia in European women:

• insufficient dietary iron intake, iron malabsorption
• thyroid disorder, autoimmune thyroiditis
• digestion disorder, vitamin B9 and B12 deficiency – vegetarianism
• low body mass index
• vitamin C deficiency
• malabsorption syndrome, infection with Helicobacter pylori
• excessive consumption of coffee, tea
• increased blood loss
• copper-containing intrauterine contraceptive
• profuse menstruation, uterine bleeding
• intestinal bleeding
• taking aspirin, NSAIDs, anticoagulants
• donation
• chronic inflammatory diseases, obesity
• increased need for iron on the background of physical activity and sports
• intolerance, excessive consumption of flour, gluten.

Unfortunately, the diet of a modern person does not always allow getting enough iron from food. On average, we consume about 10–20% of our daily iron intake. Only 4% of iron is absorbed from fruits in the body, only 3% from legumes, and as much as 22% from beef. Vegans and vegetarians, when signs of iron deficiency appear, should compensate for the lack of iron in food with the help of biologically active additives and vitamin complexes.

The main principle of therapy for latent iron deficiency is to eliminate its causes, but in most cases this is not possible to complete in full. The appointment of iron-containing drugs is the main treatment for IDA and latent iron deficiency.

Iron preparations vary in bioavailability, efficacy and incidence of adverse events. Good tolerability is a key factor that ensures adherence to therapy. You should not be overly fond of the use of dietary supplements, considering them safe and effective means. An excess of iron in the body is no less harmful than its deficiency.