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What happens if you dont get enough iron: Iron deficiency anemia – Symptoms and causes


Iron deficiency anemia – Symptoms and causes


Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body’s tissues.

As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin). As a result, iron deficiency anemia may leave you tired and short of breath.

You can usually correct iron deficiency anemia with iron supplementation. Sometimes additional tests or treatments for iron deficiency anemia are necessary, especially if your doctor suspects that you’re bleeding internally.

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Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify.

Iron deficiency anemia signs and symptoms may include:

  • Extreme fatigue
  • Weakness
  • Pale skin
  • Chest pain, fast heartbeat or shortness of breath
  • Headache, dizziness or lightheadedness
  • Cold hands and feet
  • Inflammation or soreness of your tongue
  • Brittle nails
  • Unusual cravings for non-nutritive substances, such as ice, dirt or starch
  • Poor appetite, especially in infants and children with iron deficiency anemia

When to see a doctor

If you or your child develops signs and symptoms that suggest iron deficiency anemia, see your doctor. Iron deficiency anemia isn’t something to self-diagnose or treat. So see your doctor for a diagnosis rather than taking iron supplements on your own. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications.


Iron deficiency anemia occurs when your body doesn’t have enough iron to produce hemoglobin. Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout your body.

If you aren’t consuming enough iron, or if you’re losing too much iron, your body can’t produce enough hemoglobin, and iron deficiency anemia will eventually develop.

Causes of iron deficiency anemia include:

  • Blood loss. Blood contains iron within red blood cells. So if you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin.
  • A lack of iron in your diet. Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. For proper growth and development, infants and children need iron from their diets, too.
  • An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine’s ability to absorb nutrients from digested food, can lead to iron deficiency anemia. If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients.
  • Pregnancy. Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of hemoglobin for the growing fetus.

Risk factors

These groups of people may have an increased risk of iron deficiency anemia:

  • Women. Because women lose blood during menstruation, women in general are at greater risk of iron deficiency anemia.
  • Infants and children. Infants, especially those who were low birth weight or born prematurely, who don’t get enough iron from breast milk or formula may be at risk of iron deficiency. Children need extra iron during growth spurts. If your child isn’t eating a healthy, varied diet, he or she may be at risk of anemia.
  • Vegetarians. People who don’t eat meat may have a greater risk of iron deficiency anemia if they don’t eat other iron-rich foods.
  • Frequent blood donors. People who routinely donate blood may have an increased risk of iron deficiency anemia since blood donation can deplete iron stores. Low hemoglobin related to blood donation may be a temporary problem remedied by eating more iron-rich foods. If you’re told that you can’t donate blood because of low hemoglobin, ask your doctor whether you should be concerned.


Mild iron deficiency anemia usually doesn’t cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following:

  • Heart problems. Iron deficiency anemia 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 when you’re anemic. This 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. But 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 anemia is associated with an increased susceptibility to infections.


You can reduce your risk of iron deficiency anemia by choosing iron-rich foods.

Choose iron-rich foods

Foods rich in iron include:

  • Red meat, pork and poultry
  • Seafood
  • Beans
  • Dark green leafy vegetables, such as spinach
  • Dried fruit, such as raisins and apricots
  • Iron-fortified cereals, breads and pastas
  • Peas

Your body absorbs more iron from meat than it does from other sources. If you choose to not eat meat, you may need to increase your intake of iron-rich, plant-based foods to absorb the same amount of iron as does someone who eats meat.

Choose foods containing vitamin C to enhance iron absorption

You can enhance your body’s absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Vitamin C in citrus juices, like orange juice, helps your body to better absorb dietary iron.

Vitamin C is also found in:

  • Broccoli
  • Grapefruit
  • Kiwi
  • Leafy greens
  • Melons
  • Oranges
  • Peppers
  • Strawberries
  • Tangerines
  • Tomatoes

Preventing iron deficiency anemia in infants

To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow’s milk isn’t a good source of iron for babies and isn’t recommended for infants under 1 year. After age 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children don’t drink more than 20 ounces (591 milliliters) of milk a day. Too much milk often takes the place of other foods, including those that are rich in iron.

Oct. 18, 2019

7 Unusual Signs of Iron Deficiency

1. Extreme fatigue and exhaustion “Fatigue is one of the most common signs of iron deficiency because it means your body is having trouble carrying the oxygen to your cells so it’s affecting your energy levels,” Thayer says.

People lacking enough iron in their blood often feel sluggish, weak, and unable to focus. Though fatigue can be the sign of numerous conditions, if it does not go away with adequate rest, consider having your iron levels checked.

2. Frequent infections Iron plays a key role in a healthy immune system, so lower levels of the mineral can make someone more susceptible to infections. “Red blood cells help to transport oxygen to the spleen, which is one place where infections can be fought off,” Dr. Murr says.

Red blood cells also carry oxygen to the lymph nodes, which house infection-fighting white blood cells. “When someone has an iron deficiency, the white blood cells aren’t being produced as well, and they’re not as strong because they’re not getting enough oxygen, making that person more susceptible to infections,” she says.

3. Pale skin Hemoglobin gives skin its rosy color, so low levels cause the skin to become lighter.

“When red blood cells become low in iron, they become smaller and paler in the center so skin also becomes paler,” Murr says. This may be easier to detect in people with lighter complexions, but no matter what your skin tone, if the area inside your bottom eyelid is lighter than normal, this may be a sign of iron deficiency.

4. Swollen tongue Changes to your tongue, including soreness or swelling, can be a sign of iron deficiency. Cracks on the side of the mouth are also common among people with iron deficiency.

5. Restless Legs Syndrome Some people who have iron deficiency develop restless legs syndrome, a disorder that causes you to have a strong urge to move your legs. The urge often comes with an unpleasant, crawling sensation in the legs that can make it hard to sleep.

6. Pica People with iron deficiency may develop cravings for non-food substances, such as clay, dirt, or chalk, a condition known as pica.

However, submitting to your cravings and eating these substances could be harmful, as it may lead to the ingestion of harmful toxins and substances. “Eating clay, chalk, and dirt can actually interfere with absorption of iron,” says Murr.

7. Hair loss Iron deficiency, especially when it develops into anemia, can cause hair loss. “When hair follicles don’t get enough oxygen, they go into a resting stage, and hair falls out and doesn’t grow back until anemia is improved,” Murr says. It is normal to lose about 100 strands of hair per day. However, if you notice your hair loss is excessive and it is not growing back, this may be a sign of iron deficiency.

If you’re experiencing these symptoms and think you may be iron deficient, speak to your doctor. He or she can help you get to the root cause of your iron deficiency, find ways to include more iron-rich foods in your diet, and determine whether you need to take supplemental iron.

Signs and causes iron-deficiency anemia

  • Iron-deficiency anemia affects more women than men.
  • Causes of iron-deficiency anemia and how it’s diagnosed.
  • How to build up iron on a plant-based diet.


If you’re a woman of child-bearing age and you’re dealing with fatigue, dizziness, headaches and strange cravings for ice, your body is trying to tell you something. You may have iron-deficiency anemia.

Your body needs iron to make hemoglobin, which carries oxygen to all the cells in the body. When you don’t have enough iron, it can make you sluggish, irritable and unfocused. This lack of iron causes anemia, otherwise known as iron-deficiency anemia.

Just as with migraines, iron-deficiency anemia affects more women than men. Women who are pregnant or have heavy periods have the highest risk of iron-deficiency anemia.

Symptoms of iron-deficiency anemia and how it’s diagnosed

Iron-deficiency anemia develops slowly — your symptoms could be mild, or you may not even have any. But when the anemia gets worse, fatigue and weakness may appear. These are the most common symptoms. One or more of these other signs may also appear:  

  • Dizziness
  • Headaches
  • Low body temperature
  • Pale or sallow (yellowish) skin
  • Rapid or irregular heartbeat
  • Shortness of breath or chest pain, especially when you’re physically active
  • Brittle nails
  • Pica, which is unusual cravings for ice or icy drinks, or nonfood items like paper 

If you’re concerned, talk with your doctor. He or she may take these steps to diagnose the problem:

Check your health history. Your doctor might ask you about:

  • Your periods and how regular or heavy they are
  • Any digestive problems you may have, such as blood in your stool
  • What foods you’re eating
  • What medicines you’re taking
  • Your family health history

Give you a physical exam.

Do blood tests. You’ll have a complete blood count (CBC), which measures many parts of your blood. If the test shows that you have anemia, you’ll likely have another blood test. This one will measure the iron levels in your blood to make sure you have iron-deficiency anemia.  

If you’re diagnosed with iron-deficiency anemia, your doctor may do other tests to find out what’s causing it.

If you’re diagnosed with iron-deficiency anemia, your doctor may do other tests to find out what’s causing it.

Causes of iron-deficiency anemia 

You might have low iron levels for several reasons, including:

  • Bleeding. It can cause you to lose more blood cells and iron than your body can replace. You may bleed because of:
  • Digestive problems
    • Long-term use of aspirin
    • Donating blood too often 
    • Heavy or lengthy periods
    • Uterine fibroids
  • Pregnancy. When you’re pregnant, your body needs more iron than usual to support your growing baby.
  • Problems absorbing iron. With certain health problems such as celiac disease or Crohn’s disease, it may be harder for your body to absorb iron from food. Gastric bypass surgery for weight loss is another reason your body may struggle to absorb iron from food. 

The top cause for low iron is not having enough iron in your diet. Since your body doesn’t produce iron on its own, you have to get what you need from what you eat. That means iron-rich foods need to be on the menu regularly. 

Why diet is so vital for avoiding iron-deficiency anemia

Someone once said, “Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon.” While that’s a humorous take on why some people are lifelong carnivores, it doesn’t speak for the vegetarians who choose not to eat meat. 

Your body absorbs the iron in animal-based foods, such as meat, chicken, and fish, much better than the iron in plant-based foods — two to three times better. 

So, when it comes to iron intake, what’s a vegetarian (or vegan) to do to?

Variety is one of the answers to that question. Vegetarians should eat a range of iron sources to meet the daily requirements and avoid iron-deficiency anemia. According to the Academy of Nutrition and Dietetics, those sources include:

  • Iron-fortified breakfast cereals
  • Soybeans
  • Some dark leafy greens including spinach and chard
  • Lentils
  • Beans
  • Eggs

You’ll be doing yourself a big favor by eating a good source of vitamin C while you’re eating the rest of your meal. The vitamin helps your body absorb iron. It’s found in citrus fruits, tomatoes and peppers. 

Try these suggestions for a day’s worth of healthy vegetarian meals that include iron and Vitamin C.

  • Breakfast: Try a parfait of low-fat yogurt with layers of strawberries (high in vitamin C) and crunchy, iron-fortified cereal. 
  • Lunch: Enjoy a lentil burger with sautéed mushrooms and tomato on a whole-grain bun.
  • Dinner: Stir fry tofu and vegetables with brown rice.

Along with the iron-rich foods you eat, your doctor may suggest that you take a multivitamin for women that includes iron. Or you may need to take an iron-only supplement. The important thing is to do this under a doctor’s care. If you take too much iron, it could lead to an iron overload that can damage organs.

More iron (in the right amounts) can mean more energy 

In just a few months, you should be getting your iron levels back to normal, which should cut down or eliminate any symptoms you were having. When your energy is back, you’ll feel more like your old self.

Find a doctor

If you have symptoms of iron-deficiency anemia, find a Providence doctor to help diagnose your condition. Search in our provider directory for a primary care doctor.






Are you a vegetarian? How do you add iron to your diet to prevent iron-deficiency anemia? Share it @Providence. #anemia

Related resources

Being an iron woman could lead to iron deficiency

Keep your digestive tract happy with a colon-friendly diet

MedlinePlus: Celiac Disease

How to go vegan without sacrificing your nutritional health

Academy of Nutrition and Dietetics

Deliciously simple vegetarian recipes

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

There’s One Mineral Your Body Can’t Function Without

Health Tips

If simple physical tasks, like walking up two flights of stairs, have you feeling exhausted and breathless, you might consider getting checked for iron-deficiency anemia.

What is Iron-Deficiency Anemia?

Iron is an important mineral for our health because its primary function is to carry oxygen in the blood to every cell in our body via hemoglobin. If your body doesn’t have enough iron, it can’t produce enough healthy oxygen-carrying red blood cells – which can lead to anemia. Anemia is a condition in which the body is not producing enough hemoglobin.

With anemia, your cells aren’t getting enough oxygen.

Needless to say, oxygen is vital. Oxygen is what our tissues need to heal and function, so the main issue with this anemia from iron deficiency is that it complicates every other diagnosis, like heart failure, diabetes or infections. You can’t take care of these other things if you don’t have enough oxygen in your system.

Signs of Iron-Deficiency Anemia

If you do show signs of iron-deficiency anemia, symptoms are mild at first and develop slowly. They include:

  • Exercise intolerance: feeling exhausted after a brisk walk could mean that your body is asking for iron.
  • Feeling weak or tired: lacking oxygen in your blood can make you feel sluggish, weak, and have trouble focusing.
  • More frequent infections: iron plays a key role in a healthy immune system, so lower levels can make you more susceptible to infections.

I Think I Have Iron-Deficiency Anemia: What Should I Do?

If you’re experiencing any of these symptoms and think you may have iron-deficiency anemia, schedule an appointment with your primary care doctor. He or she will order a blood test, and talk to you about ways to incorporate more iron-rich foods in to your diet.

If your doctor confirms you’re iron deficient, your treatment plan will likely include taking iron as well as folic acid and vitamin C supplements, which aid in iron absorption.

 Other ways to naturally increase your iron levels include:

  • Eating iron-rich foods (green leafy vegetables, and nuts)
  • Avoiding stress
  • Exercising consistently

Last Updated:
May 05, 2017

How Iron Deficiency Can Affect Your Life (And What To Do About It)

Iron is a mineral that’s part of hemoglobin, the protein in red blood cells that transports oxygen from the lungs and throughout the body. If your body doesn’t have enough iron, it won’t get enough oxygen, and your cells (which are powered by oxygen) won’t be able to function efficiently.

“If you’re mildly low on iron, or slightly anemic, you can experience frequent fatigue, weakness and take longer to complete tasks,” says Mary Ann Skoures, M.D., a family medicine physician with Henry Ford Health System. If you’re chronically or severely low on iron, it can lead to several side effects:

  • a pale complexion
  • shortness of breath
  • headaches
  • dizziness
  • brittle fingernails
  • cold hands and feet
  • frequent illness
  • restless legs syndrome
  • cravings to eat ice, clay, dirt, chalk, or paper (a condition called pica)
  • an irregular heartbeat and heart palpitations

Here, Dr. Skoures shares reasons why you could be iron deficient and what to do about it. 

Why You Could Be Iron Deficient

To get tested for iron deficiency, your doctor will draw blood to measure your hemoglobin levels. The normal hemoglobin range for women is about 12 to 15 grams per deciliter. For men, it’s 13.5 to 17.5 grams per deciliter. If you test below the normal range, your doctor may order an ultrasound, endoscopy, or colonoscopy to check for internal bleeding. If that’s not the cause, there are additional reasons you could be iron deficient:

  1. Underlying digestive issues. If you have untreated Crohn’s disease, irritable bowel syndrome, or other digestive issues, your body may not be properly absorbing nutrients, says Dr. Skoures. Crohn’s can also cause bleeding in the digestive tract, leading to a loss of iron. If you experience frequent constipation, bloating, stomach pains or loose stools, head to your doctor.
  2. You’re pregnant. “Your body needs twice the amount of iron to support a growing baby, so if you’re not getting enough iron, you could become deficient,” says Dr. Skoures. Pregnant women are often recommended iron supplements. If you’re pregnant, heed the advice of your doctor or midwife.
  3. You’re menstruating. Women who menstruate lose blood every month, so it’s not uncommon for them to be slightly anemic, especially those who have heavier menstrual periods, says Dr. Skoures.
  4. You’re not eating the rights foods. If you’re on a meat-free diet, your body may not be getting enough iron. “Although plant sources of iron are abundant (like spinach and legumes) this type of iron, called non-heme iron, is not as easily absorbed by the body as iron from meat and fish sources, which is called heme iron,” says Dr. Skoures.
  5. You have a genetic form of anemia. Some types of anemia are hereditary, like sickle-cell anemia and thalassemia. Genetic forms of anemia may require long-term management under a doctor’s supervision.

What You Can Do To Absorb More Iron

If you’re experiencing worrisome symptoms, it’s always best to see your doctor first, whether for an in-person or virtual visit. Here are other ways to help increase your iron:

  1. Don’t eat polyphenols with iron-rich meals. Polyphenols are naturally occurring compounds found in a variety of foods like dark chocolate, red wine, berries, coffee, green tea, turmeric and more. They’re very healthy—they contain tons of antioxidants, and you should load up on them—but research suggests that if you consume polyphenols with non-heme (plant-sourced) iron, they can bind to hemoglobin and inhibit iron absorption. If you aren’t iron deficient, you don’t need to worry about this, but if you are, try having your iron-packed meals two hours after eating or drinking polyphenols.
  2. Eat vitamin C with iron. Conversely, vitamin C-rich foods like oranges and lemons can help increase iron absorption, which is why doctors often recommend gulping down iron supplements with a glass of orange juice, says Dr. Skoures.
  3. Take a supplement. While iron supplements shouldn’t replace iron-rich foods, you can try taking a supplement in addition to eating a healthy diet.
  4. If you’re vegan, up the amount of iron-rich plant food that you eat. Look for foods enriched with iron, and try to increase the amount of iron you get from plant sources, like spinach, lentils, chickpeas, pumpkin seeds, and fortified cereals.

To find a doctor or registered dietitian at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936). 

Want more advice from our wellness experts? Subscribe today to receive weekly emails of our latest tips. 

Mary Ann Skoures, M.D., is a family medicine physician with Henry Ford Health System. She sees patients at Henry Ford Wyandotte Family Medicine in Allen Park.


Tags: Nutrition, Primary Care

A healthy diet is the key to getting the iron you need – Harvard Health Blog

ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. 

An article in this week’s Journal of the American Medical Association (JAMA) focuses on what happens to iron stores in the body after donating blood. As many as one-third of regular blood donors have too little iron in their bloodstreams. According to the article, it can take up to six months to replenish the body’s iron after donating a unit of blood—significantly longer than the recommended 8-week waiting period between deposits at the blood bank.

The article made me wonder about the basics of iron health. How much of this stuff do we need? How do we get it? If you always feel pooped, how likely is “iron poor blood” to blame?

Iron stores

One-quarter of the world’s population is anemic, meaning they don’t get enough iron to produce the red blood cells and oxygen-carrying hemoglobin needed to nourish their myriad cells.

In developed nations like the United States, iron-poor blood is uncommon. Anemia attributable to iron deficiency affects perhaps 1% to 2% of American adults. “Because our country usually has a problem of eating too much, most adults meet the minimum requirements for iron intake,” says nutrition researcher Howard Sesso, an associate professor of epidemiology at Harvard Medical School.

In the United States, blood loss is the main cause of iron deficiency and anemia. Among women, heavy menstrual periods and childbirth account for this. Among those age 65 and older, the causes of iron deficiency and anemia are likely to be internal bleeding, difficulty absorbing iron and other nutrients, and eating a less varied diet.

The average American man harbors about 3.5 grams (one-eighth of an ounce) of iron in his body. The average woman has about 2.5 grams.

Where do we keep this iron? Roughly 60% of it is held by the oxygen-carrying hemoglobin protein in red blood cells. The next largest storehouse is ferritin, a protein that latches onto iron and sequesters it in the liver, spleen, and bone marrow. When the body needs to draw on its iron account, it comes out of the ferritin bank.

Without enough stored iron, an individual can develop anemia. Symptoms include fatigue, loss of stamina, shortness of breath, weakness, dizziness, and a pale, unhealthy complexion. So precious is iron for your health that the body uses a protein called transferrin like a scrap metal collector to scrounge iron from old red blood cells before they are destroyed.

Keeping the reservoir full

Most of us get the iron we need from food. Proponents of the Paleo or “cave man” diet should be cheered to know that red meat, poultry, and fish contain the most easily absorbed form of dietary iron—called heme iron. This is iron attached to the hemoglobin protein. The body absorbs heme iron more easily than the iron found in plants.

“In the typical American diet, the main sources of iron tend to be animal products,” Sesso says. “Typical meat consumption in the United States is usually more than adequate to meet one’s iron requirements.”

In plant foods, iron is not attached to such a protein. The body doesn’t absorb non-heme iron from fruits, vegetables, beans, and other plant foods as easily as it absorbs heme iron. That means those who eat little or no meat must take in more iron from leafy greens, legumes, whole grains, mushrooms, and other iron-rich plant foods. They also need to get enough vitamin C, which helps the body absorb iron from food.

The USDA recommends that women between the ages of 19 and 50 get 18 mg of iron a day, while women ages 51 and older and men 19 years and beyond need 8 mg a day. Moderate amounts of meat plus fruits and vegetables can provide that amount, helped along by the many foods fortified with iron and other vitamins and minerals, like milk, flour, and breakfast cereals. And half of all Americans get some iron from a daily multivitamin.

One caution about iron: If you don’ think you are getting enough iron, or feel pooped out and assume it’s your “tired blood,” you may be tempted to pop an iron supplement as insurance. But beware. The body does not excrete iron rapidly. That means it can build up over time and, in some people, becomes toxic. The genetic disorder hemochromatosis causes iron to build up in organs, causing heart failure and diabetes.

So don’t just prescribe yourself an iron supplement on a whim; ask your doctor if you need it.

Good sources of iron

Food Portion Iron content (milligrams)
Fortified cold breakfast cereal 3 ounces 30 to 60
Spirulina seaweed 3 ounces 28
Oysters 3 ounces 9
Soybeans, cooked 1 cup 9
Cream of Wheat 1 serving 9
Pumpkin seeds 3 ounces 8
Spinach, boiled and drained 1 cup 7
Lentils, cooked 1 cup 7
Soybeans, cooked 1 cup 5
Kidney beans, cooked 1 cup 4
Beef, ground 4 ounces 3
Turkey, ground 4 ounces 3
Source: USDA National Nutrient Database for Standard Reference


What happens when you are low in iron?

What do we use iron for?

It only seems fair to start by identifying what your body needs iron for. This essential nutrient is responsible for many different functions but I’ll start with what it’s most well-known for – haemoglobin. Haemoglobin is a key component of red blood cells and helps to transport oxygen from your lungs into your body tissues.

Your body needs iron to produce healthy red blood cells and iron is vital for carrying oxygen throughout your body, even helping your muscles to store oxygen so it can be used later.
Iron is also involved in converting blood glucose to energy and even helps to support the immune system and cognitive development in children! Your production of enzymes is dependent on iron too, which is particularly important as enzymes are essential for the production of hormones, amino acids and various neurotransmitters.

So, iron is pretty much invaluable when it comes to your overall health and wellbeing. Why then, is iron deficiency so common and what really happens to your body when your iron levels start to plummet?

How does low iron affect the body?

As I’ve covered, iron is an extremely important nutrient so when your levels of iron are low, it can have a number of repercussions, some of which you may already be familiar with as the symptoms are well documented.  Here I’ll go into a bit more detail about what is causing your symptoms.

First, let’s start with what happens to your red blood cells when you don’t receive enough iron. Since haemoglobin is a crucial component of these cells and iron is needed to produce haemoglobin, often your body will start to produce smaller, weaker red blood cells that are less able to carry oxygen efficiently around the body.

This is often where the most common symptom of iron deficiency, fatigue, comes into play. If certain areas of your body are deprived of oxygen you will start to feel drained, as though the energy is literally being sapped out of your body. Dizziness can often be the result of oxygen deprivation and it’s also not unheard of to experience heart palpitations as your heart will be working overtime, trying furiously to pump more red blood cells around your body to get a healthy circulation of oxygen.

You may even start to feel cold and shivery as a result and some people even notice a change in their complexion as haemoglobin is also required to keep skin looking bright and healthy. If you’ve got low levels of haemoglobin, your skin will start to become paler and more sallow in tone. Your hair may even become thinner and your nails more brittle – this is because, again, iron is needed for both of these areas.

Finally, you may notice that other bodily functions such as your immune system and digestion have been weakened. This is again because iron is needed to produce enzymes, some of which may be involved with breaking down your food in the digestive tract. You may experience problems such as diarrhoea or constipation and even find yourself more vulnerable to viral infections like the common cold or flu.

What about anaemia?

Anaemia is a condition that occurs when your body does not contain enough haemoglobin or red blood cells. As a result, many of us often assume that iron deficiency and anaemia must go hand in hand, however, while low levels of iron are the most common cause of anaemia in the UK, it is possible to have anaemia without being deficient in iron. This is because other nutritional problems such as folate deficiency (low levels of vitamin B12) can also trigger anaemia.

Who is vulnerable to low levels of iron?

In western countries such as the UK and USA, having low levels of iron is a disturbingly common trend but why are we so deficient in iron compared to other countries such as Japan or China? Well first, it’s important to acknowledge that unfortunately, some groups of people are simply more predisposed to low levels of iron, such as:

Women: It’s estimated that 1 in 5 women of childbearing age will suffer from iron-deficiency anaemia1 and in general, women are more vulnerable to this condition for one simple reason – menstruation. Every month women will naturally lose blood and for some women, particularly if they suffer from heavy periods, this can affect their iron levels.
Even women in menopause can experience low levels of iron, as our menopause expert Eileen details in her blog, ‘Any old iron.’ Pregnant women are also at risk of iron loss as they need twice as much iron as usual to support their growing foetus!

Children: Children naturally require a lot of iron to develop and babies are particularly vulnerable, which is why baby food is often fortified with iron. Surprisingly, it’s thought that young children that drink a lot of cow’s milk might be low in iron as too much milk can inhibit their ability to absorb iron from other foods. Premature babies may suffer from low levels of iron as they won’t have as much iron stored up in their systems as they would have done at full term.

Sufferers of Crohn’s: If you suffer from Crohn’s disease then unfortunately, you may be more vulnerable to iron deficiencies. This is because your body may struggle to absorb iron as efficiently from your food or because of blood loss due to ulcers. It’s estimated that as many as 60-80% of people with Crohn’s are iron deficient, with one-third of that number being classified as anaemic.2 

Vegans and vegetarians: It might be seen as something of a stereotype but iron deficiency is something you really need to be aware of if you follow a vegan or vegetarian lifestyle. As I may explore in a future blog, there are plenty of sources of iron in a vegan diet – pulses, nuts, vegetables and legumes can all provide adequate amounts of iron, however, it’s important that if you are vegan or vegetarian that you follow a diet that includes all of these food groups, otherwise you can easily risk becoming iron deficient.

Why is iron deficiency so common?

What about the rest of us? And why is iron deficiency so common in the West? Unsurprisingly the answer has a lot to do with our diets. Although countries such as China and Japan do consume meat, particularly seafood, it is often not found as prevalently in their diets as it is in ours. Meat is used to flavour dishes and instead their diets contain an abundance of fruit, veg and iron-rich pulses.

In the West, we tend to base most of our meals around meat and while meat can be an excellent source of iron, it isn’t necessarily recommended that we eat it every day. In recent years we’ve also tended to forego fresh fruit and veg in favour of processed alternatives that are quicker and easier to make but are normally saturated with hidden sugars and salt.

This can be a real problem as what we eat can have a noticeable impact on our ability to absorb iron properly. 

  • Dairy: Milk, cheese, yoghurts
  • Polyphenols: Tea, coffee, cocoa
  • Phytate: soy, cereal, whole flours, walnuts, almonds
  • Phosvitin: eggs

At first glance, some of these foods might seem a bit out of place on this list. Don’t dairy products contain calcium which is good for you? Don’t polyphenols act as antioxidants? Well yes, some of these food groups certainly have their good points but it’s important to remember balance. Anything, even healthy food products, can be bad for you if you consume them in enough quantities.

In small amounts, none of these foods are likely to impact your ability to absorb iron but the problem is that many of us consume these products to excess. Calcium, for example, is needed for healthy bones but if you consume too much it can start to affect your absorption of iron.

It’s also important to note that vitamin C plays an important role in iron absorption too! Usually found in brightly coloured fruits and green leafy veg, vitamin C can sometimes be lacking in Western diets and lifestyle habits such as smoking and drinking can affect your levels of vitamin C. In fact it’s estimated that a smoker would need to increase their intake of vitamin C by 2000mg a day to make up for the damage that smoking causes!3

So what’s the solution if you have low levels of iron?


How can you improve your iron intake?

If you suspect that you are suffering from an iron deficiency then the first thing you should do is speak to your doctor. They will be able to conduct a blood test which should confirm your diagnosis and then they will be able to recommend the appropriate treatment for you. Including more vitamin C into your meals couldn’t hurt either as you will need plenty of vitamin C to absorb the iron in your diet more efficiently.

In the meantime, it’s important you think about what you’re eating. As I’ve discussed, it is a leading factor behind iron deficiency so make sure you’re keeping a balanced, healthy diet with plenty of iron-rich foods. Here I’ve listed a few iron-rich foods to get you started.

Food source Iron content (mg)
Pumpkin seeds, 50g 7.5
Lentils, 100g 3.7
Beef, 100g 3.7
Spinach, 100g 3.6
Pine nuts, 50g 3
Tofu, 100g 2.7


Here are a few of my favourite iron-rich recipes…

Spinach & Potato Curry
Spicy Tomato & Red Lentil Soup
Marinated Tofu Stir Fry
Vegetable Satay Stir-fry

What about supplements?

If you are deficient in iron, it’s likely your doctor will recommend that you take an iron supplement. However, particularly if you are suffering from heavy periods or going through menopause, it’s never a bad idea to start taking an iron supplement of your own volition.

Our friends over at Jan de Vries offer a variety of iron supplements but my favourite would be Floradix’s Liquid Iron Formula. Containing a blend of B vitamins and vitamin C in addition to a highly absorbable form of iron, it’s suitable for children over the age of 3 and has a pleasant taste thanks to the inclusion of selected herbs and fruit juices.

If you think it’s possible that you may be struggling to be absorb iron efficiently, then perhaps taking a gentle vitamin C supplement would also be a good option. We offer our own vitamin C supplement, Nature-C, which is made from natural sources of vitamin C so it’s easier for your body to absorb and suitable for children over the age of 6!


2Stein J, Dignass AU. Management of iron deficiency anemia in inflammatory bowel disease – a practical approach. Ann Gastroenterol. 2013;26:104-113.


90,000 What is the threat of a lack of iron? | Family medical center in Solntsevo, Novo-Peredelkino, Peredelkino Blizhnee, Solntsevo Park, Moscow, pos. Western

Iron is one of the main trace elements in our body. The creation of hemoglobin and the work of the hematopoietic system directly depend on it. Thanks to iron, our brain and the entire body as a whole receive oxygen. Iron also affects the formation of natural human immunity, which is especially important on the eve of the season of the first autumn colds.

Iron deficiency is observed in EVERY FIFTH person, EVERY SECOND woman suffers from it.

Signs of a lack of iron in the body can often be seen at the very early stages. The following symptoms usually occur:

  • fatigue;
  • fatigue and memory impairment;
  • headaches and muscle pains; 90,018 90,017 sleep disorders;
  • fragility and hair loss;
  • pallor of the skin and mucous membranes;
  • Burning sensation on the tongue.

What threatens the lack of iron?

  • Disorders in the cardiovascular system, lowering the level of blood pressure.
  • Decreased muscle tone.
  • Delayed physical and mental development, decreased intelligence, impaired memory and concentration (in children).
  • Impaired immune system function.
  • Decreased appetite and impaired stool
  • Beauty hit! Brittle and falling hair, dry, chapped and pale skin, peeling nails.
  • Menstrual irregularities in women.
  • Mood swings, nightmares, anxiety and increased nervous irritability, sleep disturbance.
  • Iron deficiency is especially dangerous during pregnancy. If the fetus does not receive the required amount of such an important trace element, then this threatens with low fetal weight, as well as developmental delay and serious pathologies. In addition, preterm labor often occurs with iron deficiency anemia. There is also a threat of miscarriage.

Fast and effective method for restoring iron balance in the body – drug therapy with special preparations.

At Family Medical Center you can undergo a full diagnosis to determine the level of iron in your body:

  • to pass tests for hemoglobin, vitamin D, ferritin,
  • to pass a triple test: transferrin saturation with iron + Transferrin + Iron,
  • receive professional advice from a specialist based on the test results

and, if necessary, undergo a recovery procedure – intravenous drip of the European drug “Ferinject”

Does your body have enough iron ?!

Iron in the body: why is it needed and how to get it :: RBC Trends

The body is often deficient in iron.This is due to the low bioavailability of iron – upon contact with oxygen, iron forms oxides that are poorly soluble and therefore difficult to be absorbed by the body.

Causes of iron deficiency

Iron deficiency occurs as a result of depletion of iron stores, when the absorption of iron for a long period does not keep pace with metabolic requirements for iron, or there is a sharp loss of iron associated with blood loss.

Main causes of iron deficiency:

  • copious menstrual or uterine blood loss,
  • blood loss during surgery,
  • for anticoagulants or antiplatelet agents,
  • frequent donations,
  • vegetarianism and anorexia,
  • chronic diseases with impaired absorption of iron (various gastrointestinal pathologies, chronic heart, renal failure).

Risk group – pregnant women, premature babies and children during periods of intensive growth, women with heavy periods and vegetarians. Iron deficiency is very common in adolescent girls because menstrual iron loss is superimposed on the need for rapid growth.

When the body’s iron stores are insufficient, hemoglobin synthesis is impaired, and symptoms of iron deficiency and anemia appear.

Most common symptoms of iron deficiency or anemia

  • fatigue and lack of energy,
  • dyspnea on normal exertion,
  • noticeable heartbeat (palpitations),
  • pale skin, gums and oral mucosa.

Less common symptoms

  • Difficulty concentrating,
  • unusual taste preferences (craving to gnaw ice, eat chalk, glue or earth),
  • Severe dry mouth, cracks in the corners of the mouth and flattened tongue,
  • headache and memory impairment,
  • cold intolerance (constantly cold hands and feet),
  • decreased immunity,
  • easy bruising and bleeding on the skin,
  • dry skin, brittle nails and hair loss,
  • restless legs syndrome.

Consequences of iron deficiency

Iron deficiency is a decrease in the level of iron in the body while maintaining a normal concentration of hemoglobin, when its level is still sufficient for the production of red blood cells, but other organs and tissues suffer from iron deficiency.

If the reserves are not replenished, then a more serious disease develops – iron deficiency anemia. This is a condition when iron is not enough for the formation of hemoglobin in erythrocytes, its level and the amount of carried oxygen decrease, which means oxygen starvation of the tissues of the whole organism occurs.

According to the statistics of the World Health Organization, a third of women of childbearing age have anemia, as well as 42% of children under five years of age.

The less iron, the lower the concentration of hemoglobin in the erythrocyte, the more severe the anemia and hypoxia. Even mild to moderate forms of anemia can be associated with functional impairments that affect cognitive development, immune mechanisms, learning ability, and performance.

Risks of iron deficiency during pregnancy

Iron deficiency is dangerous during pregnancy – the need of the mother’s body itself increases and the fetus grows – iron deficiency anemia is rapidly aggravated.

Risks for a woman:

  • underdevelopment of the placenta,
  • spontaneous abortion,
  • premature birth,
  • the likelihood of developing severe PPH.

Risks to the child:

  • intrauterine growth retardation,
  • high risk of intrauterine death,
  • low birth weight or prematurity,
  • Delayed neurocognitive development after birth (lagging behind in development and learning ability).

90,000 Iron Diet. How to deal with fatigue and anemia

  • Dr. Michael Moseley
  • BBC

Photo author, Getty Images

Photo caption,

Red meat, greens and green vegetables, nuts and seeds are the main sources of iron

Do you often feel tired, have shortness of breath and your heart pounds like it’s about to jump out of your chest? Do your friends tell you that you are very pale?

If so, it is possible that you have iron deficiency anemia, one of the most common nutritional and metabolic disorders.

In Britain, this syndrome is especially common among young women. In 2011, 21% of British women between the ages of 19 and 34 suffered from iron deficiency anemia, according to the State Scientific Advisory Committee on Nutrition.

Recently, I advised my friend, who had symptoms of iron deficiency anemia, to see a doctor and get the necessary tests. A blood test showed that the iron content was so low that the doctors did not understand how she had the strength to climb the stairs.Several iron tablets solved the problem.

You should consult your healthcare professional before taking these medications, as the symptoms listed above may also apply to other conditions.

Which foods contain iron?

Our body cannot produce iron on its own, it gets it from what we eat – be it foods that are naturally rich in iron, or food fortified with iron.

But the problem is that not all the iron that enters your stomach with food is absorbed equally well.

Photo by Glenn Dearing

How to get as much iron as possible from food:

  • Eat green leafy vegetables (cabbage, broccoli, sorrel, lettuce) fresh or steamed
  • Spinach rich in iron is better a little Boil
  • Eat or Drink Vitamin C-Rich Foods and Drinks
  • Choose Better Fermented (Sour) Bread

BBC Television Program Trust Me I’m a Doctor asked Professor Paul Sharp of King’s College London, what you need to eat to naturally replenish iron deficiency.

Red meat is especially rich in iron, which is easily absorbed by the body. If you don’t eat meat, there are other good sources of iron. These are primarily green leafy vegetables such as spinach and kale, and legumes such as peas and lentils.

But legumes and green vegetables give you less iron than red meat.

Fermented bread and cereals are also rich in iron, although the iron contained in these products is not always well absorbed by the body.

Swap coffee for orange juice

How these foods are prepared, and what you drink with meals, affects your iron absorption rate. To demonstrate this, Professor Sharp performed a series of experiments that mimic the digestion process.

Sharpe’s research shows that if you drink orange juice with a fermented cereal breakfast, your body can absorb more iron than if you ate the same breakfast without orange juice.

This is due to vitamin C, which aids in the absorption of iron from food.

If instead of juice you choose coffee for breakfast, then your body will absorb much less iron than in the case of breakfast with orange juice or just without coffee.

Photo author, Getty Images

Photo caption,

Who needs raw cabbage?

Why is this happening? According to Sharpe, coffee is rich in polyphenols, chemical compounds that bind iron in foods and make it less available for the body to absorb.

Therefore, if you choose fermented cereals or any other iron-rich product for breakfast, then it is better to add orange juice or fresh orange to it – this will help increase the absorption of iron. You should also consider drinking your morning coffee at least half an hour after breakfast – then the polyphenols in coffee will not interfere with the absorption of iron.

What if you want to get more iron from vegetables? Fresh cabbage is a very good source of iron, but if you fry or boil it, the effect will be less noticeable.

The fact is that cabbage itself is rich in vitamin C, but during heat treatment, especially if you cook cabbage, most of this vitamin is digested.

The same processes occur during cooking and other thermal processing of a number of other green vegetables containing iron and vitamin C: broccoli, cauliflower, and watercress.

However, there is one exception to this rule – spinach. As it turned out, boiled spinach has 55% more easily digestible iron than raw spinach.

The fact is that spinach contains a large amount of oxalates – oxalic acid salts that bind iron.

“When we boil spinach, the oxalates are released into the water and the iron in it becomes available for the body to absorb,” explains Professor Sharp.

And what about bread?

We have found that sourdough bread is the best choice. The fact is that wheat contains phytic acid, which slows down the absorption of iron.

When making sourdough bread, fermentation processes neutralize the effect of phytic acid, due to which iron is better absorbed by the body.

About thyroid gland surgery

These guidelines will help you prepare for thyroid surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect as you recover.

Read this manual at least once before your surgery and use it as a reference as you prepare for the day of your surgery.Take this guide with you to all your visits to MSK, including the day of your surgery. You and your healthcare team will guide you through your treatment.

to come back to the beginning

Operation Information

Thyroid Information

The thyroid gland is a small butterfly-shaped gland located in the lower front of the neck (see Figure 1). It consists of 2 beats. The thyroid gland produces hormones that control how the body converts oxygen and calories into energy.

Lymph nodes are small oval or round structures that are found throughout the body. They produce and store blood cells to fight infection.

The parathyroid glands are located behind the thyroid gland. They produce a hormone that helps maintain blood calcium levels.

Removal of the thyroid gland

During surgery, the thyroid gland is removed in whole or in part. The operation is performed through an incision (surgical cut) in the lower front of the neck.Your surgeon will examine your entire thyroid gland. He will decide which part of the thyroid gland needs to be removed and will also examine nearby lymph nodes.

  • An operation to remove half of the thyroid gland is called a lobectomy or hemithyroidectomy.
  • Surgery to remove the entire thyroid gland is called total thyroidectomy.

The operation will take from 2 to 3 hours.

Figure 1. Thyroid gland

Nerve damage during thyroid surgery

Near the thyroid gland there are 2 nerves that help the larynx (pharynx) work.These nerves are called the recurrent laryngeal nerve and superior laryngeal nerve. They can be affected during thyroid surgery.

Recurrent laryngeal nerve

The recurrent laryngeal nerve is located behind the thyroid gland and goes into the pharynx. If a tumor is close to this nerve, or if this nerve is damaged during surgery, the vocal cords (2 elastic bands of tissue in the throat that help you speak) may be damaged. This can make you hoarse.Hoarseness is normal after thyroid surgery and usually goes away with time.

If the hoarseness persists, you will need to perform a throat examination. You may also need to see a laryngologist (doctor who specializes in voice problems).

There are several ways to improve your voice when the recurrent laryngeal nerve is damaged, including surgery and injection (injection) into the vocal cord. Your doctor will discuss these options with you.

Before surgery, your doctor will examine your vocal cords to make sure the tumor is not close to the recurrent laryngeal nerve. If the tumor is large or close to a nerve, the risk of nerve damage is much higher. Although rare, it can lead to problems with the vocal cords.

Superior laryngeal nerve

The superior laryngeal nerve helps to raise the voice. If this nerve becomes weakened or damaged, it can affect the pitch and tone of your voice.This can make it difficult for you to raise your voice or sing. During thyroid surgery, some nerve injuries are common and will heal over time. If your voice does not recover, you will need to undergo a throat exam.

After your surgery, your doctor will check your airways. If there are any changes in your voice or breathing, you may need a throat exam. In this case, the doctor will provide you with additional information.

to come back to the beginning

Before surgery

The information in this section will help you prepare for your surgery.Read this section after you have assigned your surgery and refer to it as the date of your surgery approaches. It contains important information about what you need to do before your surgery.

Write down any questions you have and be sure to ask your healthcare provider.

Preparation for surgery

You and your healthcare team will prepare for your surgery together. Help us make your transaction as safe as possible by telling us if any of the statements below match your situation, even if you’re not entirely sure.

  • I am taking blood thinning medication. These drugs include aspirin, heparin, warfarin (Jantoven ® , Coumadin ® ), clopidogrel (Plavix ® ), enoxaparin (Lovenox ® ), dabigatran (Pradaxa ® 90aban6 (® Eliquis) ) and rivaroxaban (Xarelto ® ). There are other similar medications, so be sure to tell your healthcare provider about any medications you are taking.
  • I take prescription drugs (prescribed by a healthcare professional), including patches and ointments.
  • I take over-the-counter medicines (which I buy without a prescription), including patches and ointments.
  • I am taking nutritional supplements such as herbs, vitamins, minerals, and natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter defibrillator (AICD), or other cardiac pacemaker.
  • I have sleep apnea.
  • I used to have problems with anesthesia (when a drug is injected that makes the patient fall asleep during the operation).
  • I am allergic to some drugs or materials such as latex.
  • I do not want to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • I am taking soft drugs.
On alcohol use

The amount of alcohol you drink may affect your condition during and after surgery. It is very important to tell healthcare providers how much alcohol you are drinking. This will help us plan your treatment.

  • If you stop drinking abruptly, it can cause seizures, alcoholic delirium and death.
    If we know that you are at risk for these complications, we can prescribe medications for you to avoid them.
  • If you drink alcohol regularly, there is a risk of other complications during and after surgery. These include bleeding, infections, heart problems, and longer hospital care.

To prevent possible problems, before the operation, you can:

  • Tell healthcare providers honestly how much alcohol you drink.
  • After the appointment of the operation, try to stop drinking alcohol. If, after stopping alcoholic beverages, you experience headaches, nausea (vomiting sensation), increased anxiety, or have trouble sleeping, tell your healthcare provider right away.These are early signs of alcohol withdrawal that can be treated.
  • Tell your healthcare provider if you are unable to stop drinking.
  • Ask your healthcare provider questions about how drinking alcohol might affect your body in connection with surgery. As always, we will ensure the confidentiality of all of your medical information.
On smoking

During surgery, smokers may experience breathing problems.Quitting smoking even a few days before surgery will help prevent these problems. If you smoke, your healthcare provider will refer you to our Tobacco Treatment Program. You can also contact this program by calling 212-610-0507.

Sleep Apnea Information

Sleep apnea is a common breathing disorder that causes a person to stop breathing for a short period during sleep.The most common type is obstructive sleep apnea (OSA). In OSA, the airways are completely blocked during sleep. OSA can cause serious complications during and after surgery.

Let us know if you have sleep apnea attacks, or if you suspect you may have such attacks. If you are using a breathing apparatus (such as a CPAP machine) to prevent sleep apnea, take it with you on the day of surgery.

Within 30 days prior to surgery

Preoperative study

Before your surgery, you will be assigned a presurgical testing (PST). The date, time and location of the preoperative examination will be indicated in the reminder you will receive at the surgeon’s office.

On the day of your scheduled preoperative examination, you can take your food and medication as usual.

During your visit, you will meet a highly qualified nurse who works with anesthesiologists (medical personnel with specialized training who will perform anesthesia during surgery).A senior nurse / nurse will review your medical record and your surgical history with you. You will need to undergo a number of tests, including an electrocardiogram (EKG) to check your heart rate, chest x-rays, blood tests, and other tests needed to plan your treatment. In addition, a trained nurse can refer you to other specialists.

The Nurse / Nurse will also tell you which medications you will need to take on the morning of your surgery.

You will be of great help to us if you take with you to the preoperative examination:

  • A list of all medicines you take, including prescription and over-the-counter medicines, patches, and creams;
  • Results of any tests you did outside of MSK, such as exercise ECG, echocardiogram, or carotid Doppler
  • 90,017 names and phone numbers of your medical staff.

Determine who will look after you

Your caregiver plays an important role in your treatment.Before your surgery, your healthcare team will tell you and your caregiver about the surgery. In addition, the person will need to take you home after your surgery and discharge from the hospital. Also, this person will help you at home.

Information for caregivers

Existing materials and support are available to help you meet the many responsibilities that come with caring for someone undergoing cancer treatment. For support resources and information, visit www.mskcc.org/caregivers or read the resource Guide for Caregivers

Complete the Health Care Proxy Form

If you have not yet completed the Health Care Proxy, we recommend that you do so now. If you have already completed this form, or have other advance directives, please bring them with you to your next visit.

The Power of Attorney for Health Care Decisions is a legal document that specifies the person who will represent your interests in the event that you are unable to do so on your own.The person listed there will be your health care agent.

Talk to your healthcare provider if you are interested in completing a Health Care Proxy. You can also read the resources Advance Care Planning and How to Be a Care Representative for information about health care proxies, other advance directives, and acting as a care agent.

Perform breathing and coughing exercises

Take deep breaths and clear your throat before surgery. You will receive a stimulation spirometer to help expand your lungs. For more information, see the resource How to use your incentive spirometer. If you have any questions, talk to your nurse or pulmonary therapist.

Physical activity

Try to do aerobic exercise daily.Aerobic exercise is any exercise that increases your heart rate, such as walking, swimming, or cycling. In cold weather, take the stairs in your home, go to the mall or shop. Physical activity will help improve the condition of the body for the operation, as well as help facilitate and speed up the healing process.

Stick to a healthy diet

Aim to eat a well-balanced, healthy diet prior to surgery.If you need help with diet planning, ask your healthcare provider to refer you to a dietitian nutritionist.

Registration on the MyMSK portal

MyMSK is the portal for our patients. If you do not already have a MyMSK account, visit my.mskcc.org or call 646-227-2593 to register. For more information, talk to someone at the surgeon’s office or watch the video How to Enroll in MyMSK: Memorial Sloan Kettering’s Patient Portal on our website www.mskcc.org/pe.

Buy everything you need

When you return home after surgery, you will need the following medications:

  • Calcium additives, e.g. calcium carbonate (Tums Ultra ® )

7 days before surgery

Follow your healthcare provider’s instructions when taking aspirin

If you are taking aspirin and any medicines containing aspirin, you may need to change your dose or not take them for 7 days before your surgery.Aspirin can cause bleeding.

Follow your healthcare provider’s instructions. Do not stop taking aspirin unless directed to do so. Read the resource Common Medicines Containing Aspirin and Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for more information.

Stop taking vitamin E, multivitamins, herbal remedies and other dietary supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before surgery.These medicines can cause bleeding. For more information, read the resource Herbal Remedies and Cancer Treatments.

2 days before surgery

Stop taking nonsteroidal anti-inflammatory drugs [NSAIDs].

Stop taking NSAIDs such as ibuprofen (Advil ® , Motrin ® ) and naproxen (Aleve ® ) 2 days before surgery. These medicines can cause bleeding.For more information, read the resource Common Medicines Containing Aspirin and Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

1 day before surgery

Record the time at which the operation is scheduled

An admissions officer will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, you will receive a call the previous Friday. If no one contacts you by 19:00, please call 212-639-5014.

A staff member will tell you when you should come to the hospital for your surgery. You will also be reminded how to get to the ward.


Go to bed early and try to get a good night’s sleep.

Instructions for eating before surgery

Do not eat after midnight before your surgery. This also applies to candy and chewing gum.

The morning before surgery

Instructions for drinking drinks before surgery

You may drink a maximum of 12 ounces (350 ml) of water between midnight and 2 hours before your arrival time at the hospital.Don’t drink anything else.

Do not drink any liquid two hours before your scheduled arrival time at the hospital. This also applies to water.

Take medication according to instructions

If your healthcare provider tells you to take some medicines in the morning before your surgery, take only those medicines with a small sip of water. Depending on the medications, this may be all or some of the medications you usually take in the morning, or you may not need to take them at all.

Points to Remember
  • Do not use any lotion, cream, deodorant, makeup, powder, perfume or cologne.
  • Remove polish and nail decals.
  • Do not wear metal objects. Remove all jewelry, including body piercings. The equipment used during the operation may cause burns if it comes into contact with metal.
  • Leave valuables at home, such as credit cards, jewelry, or a checkbook.
  • Before going to the operating room, you will need to remove your hearing aid, dentures, dentures, wig, and religious paraphernalia.
  • Put on comfortable, loose-fitting clothing.
  • If you wear contact lenses, remove them and put on your glasses. During surgery, contact lenses can injure your eyes.
What to take with you
  • CPAP device for the prevention of sleep apnea, if you have one.
  • Portable player if desired.That being said, someone will need to store these items when you go into surgery.
  • Stimulating spirometer
  • Health Care Decision Form, if completed.
  • Mobile phone and charger.
  • A bag for storing personal items (such as glasses, hearing aids, dentures, dentures, wig, and religious items), if you have them.
  • These are recommendations. Your healthcare team will use these guidelines to show you how to take care of yourself after your surgery.
Upon arrival at the hospital

You will be asked to state and spell your first and last name several times, as well as indicate your date of birth. This is for your safety. People with the same or similar names can be operated on on the same day.

Change for operation

When it’s time to change before your surgery, you will be given a hospital gown, gown, and non-slip socks.

Nurse appointment

You will meet with the nurse before your surgery.Tell her / him the doses of all medications you took after midnight and when you took them (including all prescription and over-the-counter medications, patches, creams, and ointments).

The nurse may place an intravenous (IV) line into one of the veins, usually in the arm or hand. If your nurse does not give an IV, your anesthesiologist will do it when you are in the operating room.

Meeting with anesthesiologist

You will also meet with your anesthesiologist before your surgery.This specialist:

  • will review the medical record with you;
  • asks if you have had any problems with anesthesia in the past, including nausea or pain;
  • will talk about your comfort and safety during the operation;
  • will tell you about the type of anesthesia you will receive;
  • will answer your questions about anesthesia.
Preparation for operation

You will go to the operating room yourself, or you will be taken there on a gurney.A representative of the operating team will help you lie down on the operating table. Special compression boots will be worn on the bottom of your feet. They will inflate and deflate smoothly to improve blood flow in your legs.

When you are comfortable on the table, the anesthesiologist will administer anesthesia through an IV line and you will fall asleep. Your IV line will also give you fluids during and after your surgery.

to come back to the beginning


The information in this section will let you know what to expect after surgery, while you are in the hospital, and when you leave home.You will learn how to safely recover from surgery.

Write down any questions you have and be sure to ask your healthcare provider.

What to expect on the day of your procedure

When you wake up from your surgery, you will be in a Post-Anesthesia Care Unit (PACU) or a postoperative care unit.

The nurse will monitor your body temperature, heart rate, blood pressure, and oxygen levels.You will receive oxygen through a thin tube under your nose called a nasal cannula.

A drain may be placed in your neck under the incision. It is usually removed the day after surgery.

A nurse will tell you how to recover from surgery. Below are some guidelines to help make this process safer.

  • Start moving as soon as you can. Walking can help reduce the risk of blood clots and pneumonia.It also helps to stimulate and restore bowel function. A nurse or physical therapist will help you get moving. Your nurse will also give you pain relief medication.
  • Use an incentive spirometer. This will help expand the lungs, which will prevent pneumonia from developing. For more information, see the resource How to use your incentive spirometer.

Frequently Asked Questions: During your hospital stay

Will I feel pain?

You will experience pain after surgery.The doctor and nurse will often ask you about your pain and give you medication as needed. If pain persists, tell your doctor or nurse. Pain relief is imperative so that you can use your incentive spirometer and get out of bed and walk.

Your pain medication will first be given through an IV line. When you are able to swallow fluids, you will start taking oral pain medication.Before you leave the hospital, you will be given a prescription for a mild pain reliever. You can take extra Strength Tylenol ® instead. Talk with your doctor or nurse about the possible side effects and when you should switch to over-the-counter pain relievers.

Will I be able to eat after surgery?

A few hours after the operation, you will be able to absorb ice chips and drink fluids.It is normal to experience some discomfort when swallowing. You will gradually return to your normal diet. After the first night, you will not have any dietary restrictions.

What side effects will appear after surgery?

After surgery, you may experience temporary parathyroid dysfunction. This means that the parathyroid glands may not produce enough hormone to maintain blood calcium levels. Although this is temporary, it can cause hypocalcemia.Hypocalcemia is a condition in which there is not enough calcium in the blood.

Hypocalcemia can cause numbness or tingling sensation in the hands, feet, and around the mouth. Call your doctor if you develop any of these symptoms. Your doctor will tell you if you need to take calcium supplements to correct this problem.

Frequently Asked Questions: After Checkout

Read the resource What You Can Do To Avoid Falls and find out what you can do to stay safe and avoid falls at home and during your visits to MSK.

Will I feel pain when I get home?

The duration of the presence of pain and discomfort is different for each person. Painful sensations may remain with you at the time of returning home.

The following guidelines can help you manage pain at home.

  • Take your medicine as directed and as needed.
  • Call your doctor if the prescribed medication does not relieve pain.
  • Do not drive or drink alcohol while taking prescription pain medication.
  • As the incision heals, the pain will decrease and you will need less pain medication. An over-the-counter pain reliever such as acetaminophen (Tylenol ® ) or ibuprofen (Advil ® ) can help relieve pain and discomfort.
  • Follow your doctor or nurse’s advice to stop taking your prescribed pain medication.
  • Do not take more acetaminophen than what is listed on the bottle, or as directed by your doctor or nurse. Too much acetaminophen is bad for the liver.
  • Pain medications should help you get back on track. Take enough medication so you can exercise comfortably. However, it is normal for pain to increase slightly with increased activity levels.
  • Keep track of the time you take your pain medication. They are most effective 30–45 minutes after ingestion. It is better to take the medicine when the pain first appears and not wait for it to intensify.

Pain medications may cause constipation (less frequent bowel movements than usual).

Can I take a shower?

You can shower 48 hours after removing the surgical drain. If you have not had a drain installed, you can shower 48 hours after surgery.

Do not tilt your head back while showering for 4 weeks after surgery. Let the water pour directly onto the cut line. Gently blot the incision dry with a clean towel or washcloth. Call your doctor if you notice redness or discharge from your incision.

Do not take a bath until you discuss it with your doctor at your first visit after surgery.

How do I care for my incision?

Before you leave, your nurse will teach you how to care for your incision.These instructions will be recorded on the document you receive when you check out. In most cases, the staples or stitches are removed during the first appointment with the doctor after surgery.

By the time you are discharged from the hospital, the incision in your body will begin to heal. Check your incision with your nurse and caregiver before you leave the hospital. Knowing what your incision looks like will help you notice how it changes later.

The location of the incision will depend on the type of surgery performed.If the skin under the incision is numb, this is normal, because some of the nerve endings were cut off during the operation. The numbness will disappear after a while

If Steri-Strips are applied to your incision at discharge, they will come off and fall off on their own. If Dermabond adhesive remains on the incision at the time of discharge, it will also come off and peel off by itself. If Steri-Strips and Dermabond have not come off after 10 days, you can remove them.

What other medications do I need to take after surgery?
Thyroid hormone medication

If the thyroid gland is removed completely, you will need to take medication to replace the hormone that is produced by the thyroid gland.You will need to take it every day throughout your life. There are many thyroid hormone medications available. One example is levothyroxine (Levoxyl ® , Synthroid ® ). Read the resource Levothyroxine for more information.

Your doctor will prescribe a thyroid hormone medication and tell you how to take it. You may also need blood tests to make sure you are getting enough medication, but not too much.The doctor will adjust the dose if necessary.

Calcium supplements

If you develop parathyroid dysfunction or hypocalcemia after surgery, you may need to take calcium supplements. You can buy this from your local pharmacy without a prescription. Ask your doctor what dose you need to take. If you are taking calcium, your doctor may recommend taking vitamin D, which helps your body absorb calcium.

Calcium can cause constipation, especially if you are taking pain medication.If you think this might be a problem for you, talk to your nurse. You may be advised to use a stool softener or laxative.

When is it safe for me to drive?

You can drive again 1 week after surgery if you can turn your head and monitor traffic without any problems.

When can I lift weights?

Ask your doctor how long after the operation you will be able to safely lift heavy objects.Most patients should not lift anything heavier than 10 pounds (4.5 kg) for at least 6 weeks after surgery.

What exercises can I do?

Do not use dumbbells or upper body machines for at least 4 weeks after surgery. You can do exercises for your lower body.

Aerobic exercise such as walking and climbing stairs can help you gain strength and improve your well-being. Gradually increase the walking distance.Climb the stairs slowly, resting and stopping as needed.

Consult your doctor or nurse before proceeding with more vigorous exercise.

What other restrictions await me?

Do not tilt your head back (as if you are looking at the ceiling) for at least 4 weeks after surgery. This stretches the incision. You can turn your head to the sides and tilt it down.

Protect the incision area from sunlight for the first year after surgery.Your doctor or nurse will tell you when you can safely use sunscreen, but this usually happens after the incision has completely healed.

How long will it take to recover?

Over the course of a few weeks after the operation, you will see that your energy is gradually returning to you. Some people experience periodic breakdown and burst of energy over the course of 1–2 months.

I have a feeling of tightness in the incision area, is this normal?

A feeling of tightness along the incision may develop as it heals.This feeling can come and go. This can last from a week to several months or longer. This is normal and you shouldn’t worry about it. You may also feel numbness at and around the incision site. This sensation is also normal and will go away with time.

When will my first visit to the doctor after surgery take place?

Your first visit to the doctor will take place 7-10 days after your surgery. The nurse will give you directions on how to make an appointment, including the phone number to call.

Your surgeon will examine the incision. The laboratory results should be ready by this time, and the surgeon will discuss them with you. You will also discuss the need for additional treatment.

Will I need additional treatment?

Many patients do not require additional treatment. However, if you have papillary thyroid cancer, you may need radioiodine therapy. The treatment team will discuss with you if this treatment is right for you. The treatment team includes a surgeon, endocrinologist and a physician from the nuclear medicine department.If radioiodine therapy is needed, the endocrinologist will tell you how the treatment will proceed.

Do I need special blood tests after surgery?

You will have thyroid function tests 6-8 weeks after your surgery. There will be two such studies: thyroid stimulating hormone (TSH) and free thyroxine (FT4). These studies will show if you have enough thyroid hormone in your bloodstream. Based on the results of these tests, your doctor or qualified nurse will adjust the amount of thyroid medication you are taking.

If you have your entire thyroid gland removed due to papillary cancer, you will need to have a thyroglobulin blood test 6 weeks after surgery. You will have this blood test every year so your doctor can keep track of the changes that are taking place.

For medullary thyroid cancer, 6 weeks after surgery, you will need to have blood tests called carcinoembryonic antigen (CEA) and thyrocalcitonin (calcitonin) tests.You will have these blood tests every year so your doctor can keep track of the changes.

What if I have other questions?

If you have any questions or concerns, talk to your doctor or nurse. You can reach them Monday through Friday, 9:00 am to 5:00 pm.

After 5:00 pm and on weekends and holidays, call 212-639-2000 and ask the doctor who is on duty in your place.

When to contact your healthcare provider

Call your healthcare provider if you have:

  • Temperature 100.4 ° F (38 ° C) or higher
  • discharge from the incision;
  • breathing problems;
  • the skin around the incision is warmer than usual;
  • increased discomfort around the incision;
  • increased redness around the incision;
  • has developed or increased swelling around the incision.
  • Numbness, twitching, or tingling around the mouth, fingers, or toes.

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Support services

This section provides a list of support services that can help you prepare for and recover from surgery.

Write down any questions you have and be sure to ask your healthcare provider.

MSK Support Services

Admitting Office
Call if you have questions about hospitalization, including requesting a single room.

Anesthesia Department
Call if you have questions about anesthesia.

Blood Donor Room
Call for more information if you would like to become a blood or platelet donor.

Bobst International Center
MSK accepts patients from all over the world. If you are from another country, call for help arranging your treatment.

Chaplaincy Service
At MSK, chaplains are ready to listen, support family members, pray, reach out to local clergy or religious groups, or simply provide comfort and a helping hand. Anyone can apply for spiritual support, regardless of their formal religious affiliation. The Interfaith Chapel is located next to Memorial Hospital’s main lobby and is open 24 hours a day.If you have an emergency, call the hospital operator and ask to speak to the duty chaplain.

Counseling Center
Psychological counseling helps many people. We provide counseling to individuals, couples, families and groups of individuals, and we provide medications to help you cope with anxiety or depression. To make an appointment, ask your healthcare provider for a referral or call the phone number above.

Food Pantry Program
The Food Pantry Program provides food to low-income patients during cancer treatment. For more information, contact your healthcare provider or call the phone number above.

Integrative Medicine Service
The Integrative Medicine Service offers a variety of services to complement traditional health care.These services include music therapy, mind / body therapy, dance and movement therapy, yoga and tactile therapy.

MSK Library
You can visit our library website or contact library staff for more information on a particular type of cancer. Alternatively, you can check out the LibGuides section on the MSK library website at libguides.mskcc.org.

Patient and caregiver education
Visit our patient and caregiver education website to search for educational materials in our virtual library. You can find learning resources, videos, and online programs.

Patient and Caregiver Peer Support Program
You may be encouraged to talk to someone who has received treatment like yours. Through our Patient and Caregiver Peer Support Program, you can talk to a former MSK patient or caregiver.Such conversations are confidential. You can communicate in person or by phone.

Patient Billing
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
Call if you have questions about a health care power of attorney or concerns about caring for you.

Perioperative Nurse Liaison
Call if you have questions about who MSK will share your information with during surgery.

Private Duty Nursing Office
You can request the assistance of a Private Duty Nursing Office or Companions. Call for more information.

Resources for Life After Cancer [RLAC] Program
At MSK, patient care does not end after active treatment is completed. The Resources for Life After Cancer (RLAC) program is designed for patients who have completed their treatment and for their families. This program offers a variety of services such as workshops, workshops, support groups, and post-treatment counseling.She also helps with health insurance and employment issues.

Sexual Health Programs
Cancer and cancer treatments can affect your sexual health. MSK’s Sexual Health Program can help you take action and address sexual health issues before, during, and after treatment.

  • Our Sexual and Reproductive Medicine Program for Women helps women with cancer-related sexual health problems, including premature menopause and decreased fertility.For more information and to make an appointment, call 646-888-5076.
  • Our Sexual and Reproductive Medicine Program for Men helps men who have cancer-related sexual health problems, including erectile dysfunction. For more information and to make an appointment, call 646-888-6024.

Social Work
Social workers help patients, their families and friends cope with the challenges of cancer.They provide one-on-one counseling and support groups during your treatment and can help you connect with your children and other family members. Our social workers can also refer you to local agencies and programs, and provide information on additional financial resources, if you are eligible.

Tobacco Treatment Program
If you want to quit smoking, MSK has specialists who can help.Call for more information.

Virtual Programs
MSK Virtual Programs offer online training and support for patients and caregivers, even if you cannot come to MSK in person. Through interactive activities, you can learn more about your diagnosis and what to expect during treatment and how to prepare for the different stages of cancer treatment. Classes are held confidentially, free of charge and with the involvement of highly qualified medical professionals.If you would like to join a virtual training program, visit our website at www.mskcc.org/vp for more information.

For more information online, see the Cancer Types section of www.mskcc.org.

External Support Services

Access-A-Ride Organization
MTA New York offers ridesharing and escort services for people with disabilities who are not can take the bus or metro.

Air Charity Network
Provides travel to treatment centers.

American Cancer Society (ACS)
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Shelter of Hope ( Hope Lodge is a free stay for patients and their caregivers during cancer treatment.

Cancer and Careers website
A resource for educational materials, tools and information on various activities for working people with cancer.

Cancer Organization Care
275 Seventh Avenue (between West 25 th Street and 26 th Street)
New York, NY 10001
Consulting, groups support, educational workshops, publications and financial assistance.

Cancer Support Community
Provides support and educational materials for people facing cancer.

Caregiver Action Network
Provides educational materials and support for people caring for loved ones with chronic diseases or disabilities.

Corporate Angel Network Organization
Offers free travel for medical treatment around the country through available seats on corporate flights.

Gilda’s Club
A place where men, women and children with cancer receive social and emotional support through communication, workshops, lectures and social events.

Good Days Organization
Offers financial assistance to cover copayments during treatment. Patients must have health insurance, they must meet a number of criteria, and they must be prescribed medications that are on the Good Days formulary.

Healthwell Foundation
Provides financial assistance to cover copayments, health insurance premiums, and deductibles for certain drugs and treatments.

Joe’s House
Provides cancer patients and their families with a list of places to stay near treatment centers.

LGBT Cancer Project Resource
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT tolerant clinical trials.

LIVESTRONG Fertility Organization
Provides information on fertility and support for cancer patients whose treatment involves fertility risks and cancer survivors.

Look Good Feel Better Program
800-395-LOOK (800-395-5665)
This program offers workshops to help you learn more positively perceive your appearance.For more information or to sign up for a workshop, call the above phone number or visit the program website.

National Cancer Institute
800-4-CANCER (800-422-6237)

National Cancer Legal Services Network
Free Cancer Legal Advocacy Program.

National LGBT Cancer Network
Provides educational materials, training courses, and advocacy for LGBT cancer survivors at risk.

Needy Meds Resource
Provides a list of programs that support patients in obtaining generic and registered brand drugs.

NYRx Organization
Provides prescription drug benefits to eligible current and eligible NYS public sector employees.

Partnership for Prescription Assistance
Helps eligible patients who do not have prescription drug coverage get drugs for free or purchase them at a low cost.

Patient Access Network Foundation
Provides co-pay assistance for insured patients.

Patient Advocate Foundation
Provides access to medical care, financial assistance, insurance assistance, job security and access to a national resource directory for people with insufficient health insurance.

RxHope Organization
Provides help with getting drugs that people may not have enough money for.

Thyroid Cancer Support Services

Support for People with Oral and Head and Neck Cancer (SPOHNC)
Provides information and support for patients with cancer diseases of the mouth, head and neck.

Thyroid Cancer Survivors’ Association

SHARE Organization
Offers support groups for survivors of breast cancer, metastatic breast cancer and ovarian carcinoma in Manhattan, Queens, Brooklyn and Staten Island.

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Educational Resources

This section provides a list of the training materials that have been referenced in this manual.These resources will help you prepare for your surgery and recover safely from it.

Write down any questions you have and be sure to ask your healthcare provider.

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90,000 Frequently asked questions – Federal State Budgetary Institution “NMITs Hematology” of the Ministry of Health of Russia

Why should I donate blood? Aren’t there enough donors already?

In Russia, only 1.7% of the population are donors. In order to ensure an adequate supply of blood, at least 4% of the population must be donors.Many people are not eligible for donation due to contraindications, as the blood must be safe for patients. Donors can only be healthy people aged 18.

Hematology Research Center constantly needs whole blood donors, plasma donors, platelet donors, stem cell donors. The Center undergoes long-term treatment for cancer patients, for whom blood and its components are vital. Without them, they simply cannot survive after immunosuppressive doses of chemotherapy.

What is the current state of blood donation?

There are less than half of donors in Russia than it should be in order for the needs of hospitals to be covered. That is why it is imperative that donors donate blood regularly. In addition to major tragic events (terrorist attacks, fires, etc.), there is a constant need of modern medicine for components and preparations of donated blood, because almost any of its areas nowadays cannot do without the use of transfusion therapy (operations, hematology, emergencies, road accidents, women in labor, children, oncology and etc.).

Do I have enough blood to share?

An adult has 4-5 liters of blood. During the blood supply, 450 ml of blood is taken – this is 8% of the total blood, which are restored within 72 hours. The blood supply is completely safe, stimulates the immune and hematopoietic systems.

How long does it take to donate blood?

When you go to donate whole blood, count on 1 hour 10 minutes. It will take you so much time to fill out the questionnaire, medical examination and rest after the blood donation.The whole blood supply itself takes only 5-10 minutes.

If you donate plasma, then spend 1 hour 40 minutes, including directly on the procedure itself donating plasma – 40 minutes.

The whole process of donating platelets will take you 2 hours 30 minutes, including the donation itself – 1 hour 30 minutes.

How are donors selected?

All donors undergo a medical examination before each blood donation. At this time, a clinical analysis of capillary blood from a finger is carried out, a thorough interview with a transfusion doctor, who reviews the questionnaire completed by the donor and, based on the donor’s health status and the results of the analysis, determines whether the person is suitable for donation.It is very important that the donor who fills out the questionnaire answers the questions posed objectively.

All information about the donor is confidential.

But there are well-known contraindications to donation, temporary and permanent, with which we recommend that those who wish to become a donor familiarize themselves.

Can I get a viral infection while giving blood?

Infection of the donor during the blood supply is impossible, since his blood does not come into contact with the blood of another person, and during the procedure, disposable sterile needles and bags are used, instruments for blood sampling, which completely exclude the possibility of interaction of the donor’s body with the external environment.

Platelet donation (thrombocytapheresis) uses a closed, disposable system where the thrombocytapheresis machine is charged directly in front of each donor.

Only highly qualified medical specialists of the donor service with many years of experience work with donors.

Why is it necessary to rest after the blood donation?

Each donor should rest for at least 10 minutes after giving blood. Even if you feel well after giving blood, drink juice, tea, water, or coffee.This helps to replenish the loss of fluid in the body. If you feel faint after donating blood, experienced donor staff can help you quickly.

I don’t remember the last time I donated blood. How can I find out?

This information can be clarified in the donor department of the National Medical Research Center of Hematology on weekdays from 9:00 to 17:30 by phone:

+7 (495) 612-35-33
+7 (905) 568-57-60

What will they do with my blood?

The blood of each donor is thoroughly examined.First, the blood group is determined according to the AB0-system, Rh-affiliation and Kell affiliation. This is necessary in order for the patient to receive a suitable blood component. Then, to ensure a safe transfusion, a test is carried out for blood-borne infections and syphilis.

Whole donated blood is not used. Each blood dose is divided into erythrocyte suspension and plasma. The patient receives exactly the component that he needs. Thus, the blood of one donor can save the lives of several patients.

Erythrocyte suspension is used during routine operations, for blood loss, trauma and for the treatment of anemia.

Plasma is used in liver disease, blood loss, to treat blood clotting problems, and to treat shock.

Is it possible to purchase (buy) blood and its components from you?

Blood and its components cannot be purchased.

Blood taken from donors at the Hematology Research Center is used exclusively for the patients of the Center.

Is there a blood substitute?

Blood is a unique organic material that cannot be artificially produced. The only source of blood is the donor.

What do I get for giving blood?

The donor who donated blood (components), first of all, will receive monetary compensation for food in the amount of 5% of the established subsistence minimum, 2 days off at the place of work (on the day of giving blood and any other day of choice within a year after donation), as well as high self-esteem from the realization that you have helped other people.

In addition, the donor will have constant monitoring of his health status.

Is the employer obligated to let me go from work while I donate blood?

Yes, according to the Law of the Russian Federation “On the donation of blood and its components” dated 20.07.2012 No. 125-FZ and the Labor Code of the Russian Federation (Art. 186).

How often can blood and its components be donated?

There are different types of donation: whole blood donation and component donation.

Whole blood is allowed to donate no more than 5 times a year to men and no more than 4 times a year to women, while the intervals between blood donations must be at least 60 days.

Individual blood components can be donated more often. The intervals between different types of donation of blood components are indicated in the table (read more).

When donating plasma, it is allowed to donate a total of no more than 12 liters of plasma per year.

With regard to thrombocytapheresis, the donor is allowed to donate platelets no more than once a month. This is due to the fact that in the NMIC Hematology, hardware thrombocytapheresis is used, in which the dose of platelets taken at a time is greater than with intermittent ones (read more).

How is donating blood different from donating plasma and donating platelets?

When donating plasma, after the separation of a part of the plasma from it, the blood immediately returns back to the donor’s body. When donating platelets, only platelets are released from the donor blood, and the rest of the components are returned to the donor.

Plasma and platelets are isolated from blood by passing donor blood through a special apparatus with a closed disposable centrifugation system.

Plasma can be donated at intervals of at least 2 weeks, no more than 12 liters per year, whole blood – no more than 5 times a year at intervals of 2 months, platelets – 12 times a year with an interval of 1 month.

After five regular blood donations, it is better to take a break for 3-4 months. Plasma is restored within a few days, blood – within a month.

The process of donating platelets takes about 1.5 hours, plasma – about 40 minutes, blood sampling – about 10-15 minutes. However, the total time that the donor will need to spend in a medical institution will be 2.5 hours in the first case, 1 hour 40 minutes in the second case, and 1 hour 10 minutes in the latter case.

Can a smoker be a donor?

Smoking is not a contraindication to donation.Experts recommend refraining from smoking an hour before the blood donation procedure and not smoking for one to two hours after donation.

What should be done to restore the body after donating blood?

Heavy physical and sports activities, heavy lifting are not recommended on the day of blood supply. There are no restrictions on driving a car on the day of the blood donation.

For two days, it is recommended to eat well and regularly, drink at least 1-2 liters of liquid per day (alcohol is not recommended).

Continue with your usual way of life.

Vaccinations after blood supply can be done after 10 days.

Complete restoration of blood composition occurs within 5-7 days. The recovery rate of different blood components is different. In order for the blood composition to recover faster, it is recommended to drink more liquid: juices, tea. Proper nutrition is necessary: ​​the donor’s diet should always contain protein, on which the level of hemoglobin in the blood depends, as well as foods with a high content of iron and calcium.

Are regular donors required to use the blood donation leave during the calendar year?

In accordance with article 186 of the Labor Code of the Russian Federation, after each day of donating blood and its components, the employee is given an additional day of rest. The specified day of rest, at the request of the employee, can be added to the annual paid leave or used at other times during the year, after donating blood and its components.

In the previous edition of this article, the employee’s right to use an additional day of rest after donating blood was limited to a calendar year (from January 1 to December 31), which infringed upon the interests of donors. Moreover, in a number of cases, namely when donating blood in the last days of the calendar year, it did not allow it to be realized.

In accordance with the amendments made to the Labor Code by the Federal Law of June 30, 2006 No. 90-FZ, the word “calendar” has been excluded from Article 186. Thus, donors can use their extra day of rest for 365 days after donating blood.

Is it legal for an employer to refuse to grant days to a donor employee, citing the fact that he donated blood before he got a job in this organization?

The legislation of the Russian Federation does not contain a direct answer to this question. On the one hand, the provision of unused additional days of rest, provided for by Part 4 of Art. 186 of the Labor Code of the Russian Federation, for a new place of work (with another employer) is not provided for by law.

On the other hand, Art.186 of the Labor Code of the Russian Federation does not in any way limit the donor’s right to use rest days only at the previous place of work, however, this position may lead to a labor dispute with the employer, which will have to be resolved in the bodies for considering individual labor disputes (Chapter 60 of the Labor Code of the Russian Federation).

How to confirm the right to the title of “Honorary Donor”?

Thanks to the unified donor registration system being created in our country, all donations are recorded in the databases of the Blood Service institutions, the data must be stored there for many years.

Please note that only gratuitous donations are taken into account in order to obtain the right to award the Honorary Donor of Russia badge.

Can you become an “Honorary Donor of Moscow”?

No, the badge “Honorary Donor of Moscow” is provided only by blood service institutions subordinate to the Moscow Department of Health. The Hematological Research Center is an institution subordinate to the Ministry of Health of Russia, here you can get the “Honorary Donor of Russia” badge.

Is it possible to donate to a nursing mother?

Today, one of the temporary contraindications is the period of pregnancy and lactation. Should pass 1 year after childbirth and 3 months after the end of lactation.

Could the presence of Kell (+) antigens in the blood be a trigger for donation?

The presence of Kell (+) antigens in the donor’s erythrocytes does not mean that a person cannot become an active donor.

In the presence of such an indicator in the blood, it can be a donor of plasma and platelets.

Read more about the Kell accessory at this link.

Is it possible to become a donor if a close relative has inactive chronic hepatitis B?

In this situation, a person is a contact person with a patient with hepatitis and must be retracted from donation.

What causes the citrate reaction?

When donating platelets, in order to avoid blood clotting when passing through a centrifuge to isolate platelets and plasma from it, sodium citrate (sodium citrate trisubstituted 2-water) is used.

The citrate reaction is the body’s reaction to sodium citrate intolerance.

Therefore, regular platelet donors should try to donate platelets every two to three months, as well as take calcium vitamins after donation and follow dietary recommendations (read more).

Is chilez a blood disorder?

Chilez is not a disease, but a condition that indicates the presence of triglycerides in the blood – fatty particles (neutral fats) that do not allow an accurate diagnosis.Normally, they should not be in the blood. After centrifugation, such blood becomes white and very thick, outwardly reminiscent of sour cream.

The reason for the high level of neutral fats and the formation of chyle serum is improper preparation for blood sampling, when alcohol or fatty foods are consumed before donation.

Chile serum does not make it possible to isolate blood components. Therefore, a blood test is not possible. It is also impossible to use “fat” blood for transfusion to the recipient.

After 10-12 hours, the level of triglycerides in the blood decreases to the initial level.

Learn how to eat well for your donor.

How long after donation can workers in hazardous industries go to work?

If you work in a hazardous industry, the interval between donation and going to work must be at least 12 hours.

Can donations for which compensation have been paid for meals be considered free of charge? Will they be considered for the title of “Honorary Donor”?

All donations, after which you received only monetary compensation for food, will be taken into account when receiving the badge “Honorary Donor of Russia”.

Donors who donated blood and (or) its components (except for blood plasma) 40 or more times or blood plasma 60 or more times will be awarded the badge “Honorary Donor of Russia”.

Also, by the amendments introduced by Article 61 of the Federal Law of November 25, 2013 No. 317-FZ “On Amendments to Certain Legislative Acts of the Russian Federation and the Recognition of Certain Provisions of Legislative Acts of the Russian Federation on the Protection of Citizens’ Health in the Russian Federation” of the Law of June 20, 2012 No. 125-FZ “On the donation of blood and its components”, the most optimal formula for calculating quantitative criteria for achieving the right to an award in cases of mixed donation has been established.

Now, if a donor has behind him, for example, twenty-five or more gratuitous whole blood donations, and then began to donate plasma free of charge, the right to an award will come with a total number of donations 40 times.

If the donor has passed into the category of plasma donors, having donated whole blood free of charge less than 25 times before, then in order to receive the right to be awarded, he will need to collect free plasma donations until the total number of donations reaches 60 times.

The law provides that the donation of any cellular component (erythrocytes, platelets or granulocytes) is equivalent to donating whole blood.Read more.

Lack of vitamins and minerals: how the body signals for help

Most of the essential vitamins and minerals we get with food. When certain elements are deficient, problems associated with digestion, skin diseases, bone health, or even the development of dementia can occur.

It is important to know the level of vitamins and minerals inside your body, because even the healthiest person can have gaps in specific elements.Vitamin and mineral levels in the body can also be altered by stress, environmental pollution and hormonal changes. Therefore, while proper nutrition can significantly reduce the risk of vitamin deficiencies and other problems with the body, it is not an ironclad guarantee that you are getting the optimal amount of all the elements your body needs.

The causes of common symptoms such as fatigue and muscle aches may lie in nutritional deficiencies.Are you at risk? There are several ways to check: read the general symptoms that we have selected below, or do a spectral analysis of the hair and get an expert opinion on 33 chemical elements.

An abundance of food and pill vitamins does not mean that people are no longer deficient in vital vitamins and minerals that the body needs to function optimally. The situation could be much more serious. Nutrient deficiencies alter physical functions and processes at the most basic cellular level: there is a violation of water balance, fermentation functions, the functioning of the nervous and digestive systems, and metabolism.

Nutrient deficiencies can also lead to serious illness. For example, calcium and vitamin D deficiencies can cause osteopenia or osteoporosis, conditions that are particularly fragile.

How to recognize a deficiency of the most common substances?

1. Calcium strengthens the musculoskeletal system

Calcium is essential for maintaining strong bones and controlling muscle and nerve function. Signs of low calcium levels include muscle cramps and abnormal heart rhythms.Make sure you get enough mineral with at least three servings of milk or yogurt a day. Other good sources of calcium include cheese, calcium-fortified orange juice, and green vegetables.

2. Vitamin D is essential for maintaining strong bones

This vitamin is also critical for bone health. Symptoms of vitamin D deficiency can be vague – fatigue and muscle aches, weakness. Ultimately, a lack of vitamin D can lead to softening of the bones.

The best way to make up for the deficiency of this vitamin in the body is to spend more time in the sun every day, but in the case of St. Petersburg, it is more logical to consume foods rich in vitamin D. For example, vitamin D is found in oily fish such as salmon or tuna. A significant proportion of your daily intake of vitamin D is found in a glass of whole natural milk. Particular attention should be paid to hard cheese, butter and sour cream.

3. Potassium helps muscles and nerves to function normally

Potassium helps the heart, nerves and muscles work properly.In the short term, the level of potassium in the body may decrease, for example, due to vomiting or diarrhea, antibiotics or diuretics, due to chronic conditions such as a digestive system disorder or kidney disease. Symptoms of a deficiency include muscle weakness, constipation, tingling and numbness, and in severe cases, an abnormal heart rhythm.

Natural sources of potassium are bananas, milk, vegetables, beans and peas.

4. Iron is necessary for enriching blood with oxygen

Iron is essential for the production of red blood cells, which carry oxygen throughout the body.When iron levels get too low, a deficiency of red blood cells, a condition called anemia, can occur. Anemia causes fatigue, pale skin and thinning hair. To increase your iron levels, experts recommend eating iron-fortified grains, beef, oysters, beans (especially white beans, chickpeas, and beans), lentils, and spinach.

5. Vitamin B12 helps in brain function

Vitamin B12 helps in the production of DNA and helps in the work of neurotransmitters (types of hormones in the brain that transmit information from one neuron to another.Synthesized by amino acids). Symptoms of vitamin B12 deficiency include numbness in the arms or legs, problems with walking and balance, anemia, fatigue, swollen, sore tongue, memory loss, paranoia, and hallucinations.

Vitamin B12 can be obtained from animal sources. Eat more fish, chicken, milk, and yogurt. If you’re a vegan, choose B12-fortified vegan foods like meat substitutes and breakfast cereals.

6. Folate is vital for women of childbearing age

Folate or folic acid is an especially important vitamin for women of childbearing age, which is why prenatal vitamins contain such a healthy dose.

Folate is the general term used for the group of water-soluble B vitamins, also known by the acronym Vitamin B-9. It is this substance that occurs naturally in nature and products.

Folate deficiency can decrease the total number of cells and large red blood cells. Symptoms of folate deficiency include fatigue, mouth ulcers, stunted growth, and discoloration of hair, skin, and nails.

The Institute of Medicine’s Committee on Nutrition and Nutrition recommends that women who may become pregnant make sure they get 400 mcg of folate daily, whether it be food or a supplement.For folate from food, focus on fortified grains, beans, lentils, and leafy greens.

7. Magnesium can increase the overall energy level

Magnesium helps maintain healthy bones and aids in energy production. While this deficiency is quite uncommon in healthy people, it can affect those who take certain medications or consume too much alcohol.

Magnesium deficiency can lead to loss of appetite, nausea and vomiting, fatigue and weakness.In more severe cases, it can lead to numbness, muscle cramps, abnormal heart rhythms, minor personality changes, or low levels of potassium or calcium.

To restore magnesium levels, add more magnesium-rich foods such as almonds, cashews, peanuts, spinach, and black beans to your diet.

What to do next?

The best way to avoid or compensate for nutrient deficiencies is to make sure you are following a balanced, nutrient-rich diet.Proper nutrition is paramount in this situation, and only then – complexes of multivitamins and supplements in tablets and supplements. Be sure to consult your doctor if you are in doubt about taking medications, medications, or if you have a risk of an allergic reaction to certain foods.

If you think you are nutritionally deficient, talk to your doctor. A blood test, trace element analysis, or spectral hair analysis can help determine which vitamins and minerals your body is lacking.

Direct indications for the study of the chemical composition of hair

  • Deterioration of skin, hair, nails
  • Intensive fitness activities
  • Large physical and emotional stress
  • Decreased immunity
  • Allergic reactions
  • Ineffective conventional therapy
  • Cardiovascular diseases
  • Chronic fatigue syndrome
  • Irritability, nervousness
  • Osteochondrosis, osteoporosis
  • Thyroid disease
  • Dysbacteriosis and other gastrointestinal diseases
  • Planning pregnancy, infertility, decreased potency in men
  • Living in a metropolis
  • Work in hazardous industries
  • Unbalanced nutrition

Why can’t blood serum be used to determine the trace element status?

The chemical composition of the body’s blood is in a stable state and cannot be a reflection of a chronic imbalance of trace elements.

Blood serum is used for research only in acute poisoning, in the first 6 hours after the toxin enters the human body. Hair is able to give us information about the imbalance of trace elements on average over the past 1-2 months.

For analysis, 3-4 small strands of hair are taken (6-10 hairs in a strand), from the back of the head closer to the roots. If the hair is short, then the volume is approximately equal to a teaspoon (without a slide).

Then the hair is defatted in acetone, dried, weighed, and poured with concentrated nitric acid.Next, ashing is carried out (dissolved at high temperature and pressure) using the MARS5 microwave decomposition system. The dissolved sample is quantitatively transferred into a test tube, diluting the sample by 1000 times. Next, analysis is carried out on an inductively coupled plasma mass spectrometer, which provides multi-element analysis of any liquid samples – from trace elements to fractions of a percent.

Thyroid diseases / Diseases / Clinic EXPERT

General understanding of the thyroid gland and its functions

The thyroid gland (thyroid gland) is an endocrine organ located on the anterior surface of the neck.The gland is separated from the skin only by thin fascia (“plates” of connective tissue), therefore it is located almost under the skin. Due to its location, it is well accessible to palpation (palpation during examination), and with a significant increase it is clearly visible “by eye”, deforming the contour of the neck. The thyroid gland normally consists of two lobes connected by an isthmus. This structure resembles a butterfly.

The main task of the thyroid gland is the production of specific substances – thyroid hormones. This process takes place with the obligatory participation of iodine.The thyroid gland is the only gland that captures iodine from the bloodstream and is capable of synthesizing hormones only with an adequate supply of it.

Thyroid hormones affect the entire body. If you describe in one phrase the action of “thyroid” hormones – they regulate metabolism. With a normal content of thyroid hormones in the blood, all processes in the body proceed in a physiological rhythm. The mechanism of hormone production in adults does not depend on gender and age.


There is definitely a hereditary predisposition to thyroid diseases.It has long been noted that such diseases are more often suffered in the same family. Usually, patients already at the first visit report that the closest blood relatives had problems with the thyroid gland. Women are more susceptible to thyroid diseases (10 times more often than men).

There is a connection between the onset of thyroid disease and:

  • suffered stress
  • infection
  • intense sun exposure
  • unfavorable environmental conditions

Against the background of a genetic predisposition, provoking external factors trigger a pathological mechanism that results in thyroid disease glands.

Diseases of the thyroid gland

All diseases of the thyroid gland occur either with impaired production of thyroid hormones, or without them.

In turn, thyroid dysfunction occurs in the direction of

  • decrease – hypofunction, hypothyroidism
  • increase – hyperfunction, hyperthyroidism.


Primary hypothyroidism can be caused by:

  • Autoimmune thyroiditis
  • Thyroid gland removal during surgery (postoperative hypothyroidism)
  • Thyroid destruction under the influence of radioactive substances (post-radiation hypothyroidism)

Thyroid disease 9000 , belonging to the category of autoimmune, when its own immune system produces antibodies that affect the work of the thyroid gland.

Typical for AIT are antibodies to thyroperoxidase (at to TPO) – more specific for the disease and antibodies to thyroglobulin (at to TG). With immune aggression, these antibodies develop a gradual decrease in the work of the thyroid gland, i.e. hypothyroidism occurs – one of the natural manifestations of AIT.

The pathological process occurring in the thyroid gland can change not only the function, but also its structure. Ultrasound of the thyroid gland determines the changes specific to AIT.Since AIT leads to hypothyroidism, the treatment of the disease is reduced to the appointment of the thyroid hormone (thyroxine) to compensate for the deficiency of hormones in the body.

Treatment is prescribed only when the thyroid gland function decreases. If the patient only has an increased level of antibodies in the blood, but the thyroid function is normal, no treatment is prescribed. Thyroid function is retained for annual monitoring and more frequent monitoring in women during pregnancy. It is also believed that the presence of an autoimmune disease of one organ can be combined with other autoimmune diseases (of other organs).Therefore, the detection of AIT often entails examination of other endocrine glands.

To establish the diagnosis of “Autoimmune thyroiditis”, it is necessary to identify at least two of the three indicators (decreased thyroid function (hypothyroidism), the presence of antibodies to the thyroid gland, a specific picture of the thyroid gland structure during ultrasound).

If there is only one parameter, then the diagnosis is put “in question” and is taken under control.

Postoperative and post-radiation hypothyroidism (AIT)

As a result of partial or complete removal / destruction of the thyroid gland (surgery or treatment with radioactive iodine), the body finds itself in conditions of thyroid hormone deficiency.The disease is detected immediately after treatment (with complete removal of the thyroid gland) or after a short time (with incomplete removal of the organ or after radioiodine therapy). The only treatment is to replenish thyroid hormones by taking thyroxine.

Causes of secondary hypothyroidism

A rare reason for a decrease in the thyroid gland is the pathology of the organs regulating its function (pituitary gland and hypothalamus). This means that it is not the thyroid gland itself that is affected, but the “bosses” above it. The cause of the pathology of the pituitary gland and hypothalamus can be tumors, trauma, cysts in this area.Very rarely, the pituitary gland can produce the “inactive” hormone TSH, which is unable to stimulate the thyroid gland to produce hormones.


Diseases occurring with increased thyroid function

Diffuse toxic goiter (DTZ, Graves ‘disease, Graves’ disease)

This is an autoimmune thyroid disease, when the immune system produces specific antibodies that stimulate thyroid stimulation (thyroid TSH receptor). The production of hormones in the thyroid gland becomes pathologically increased, clinically manifested by thyrotoxicosis (the reaction of various tissues of the body to a large amount of thyroid hormones in the thyroid gland), and in the laboratory – by an increased concentration of T3 and T4 in the blood and a reduced TSH index.Often, DTZ is combined with autoimmune endocrine ophthalmopathy (specific eye damage). These two diseases have common autoimmune roots, so it is not uncommon to combine them. There are three treatment options for this disease:

  • conservative therapy (with pills) for 1-1.5 years
  • Thyroid surgery
  • Radioactive iodine treatment (radioiodine therapy).

Success from pill therapy is the least persistent (the disease can relapse in 30-70% of cases).

More often Graves’ disease occurs in young patients, more often in women.

Nodular (and multinodular) toxic goiter (UTZ, MUTZ)

The disease is the same as nodular non-toxic goiter: for an unknown reason, nodules form in the structure of the thyroid gland, but they (nodes) are pathologically active and capable of producing a high amount of thyroid hormones with the development of the clinical picture of thyrotoxicosis. Often the disease is accompanied by an abnormal heart rhythm.In addition to routinely determining the level of thyroid hormones (they will be like in Graves’ disease), the disease is also confirmed by thyroid scintigraphy to determine the autonomy of the node. Treatment – surgery or radioiodine therapy after drug preparation of the patient.

Diseases proceeding without dysfunction of the thyroid gland:

Nodular (and multinodular) non-toxic goiter (UNZ, MNZ)

Disease of unspecified etiology (causes), when nodules form in the thyroid tissue.In most cases, the nodes are small (from 1 cm to 2.5-3 cm), are benign in their cellular composition, do not impair thyroid function and do not require any treatment. Observation is carried out, an annual dynamic examination is performed.

Diffuse non-toxic goiter (DNZ)

This term describes a diffuse enlargement of the thyroid gland in size with unchanged organ function, the absence of laboratory and ultrasound data for an autoimmune process. Most often, an increase in thyroid gland is associated with iodine deficiency.When this fact is eliminated, the size of the thyroid gland returns to normal.

Malignant diseases

This is a separate group of thyroid cancer. Distinguish between papillary cancer, follicular cancer, medullary cancer, anaplastic thyroid cancer. They differ in their cellular composition, each with features of diagnosis, treatment and observation. The most common variants of thyroid cancer (papillary and follicular) are successfully treated, respectively, patients have a good chance of cure and a prognosis for life.More aggressive cancer – medullary and anaplastic – has its own diagnostic and therapeutic characteristics, gives a worse prognosis for treatment and survival. Patients with thyroid cancer are monitored by an oncologist and an endocrinologist, who draw up an individual treatment and follow-up plan.

Symptoms of thyroid diseases

The most typical manifestations of thyroid diseases:

  • general and muscle weakness
  • uncontrolled weight loss with increased appetite or, conversely, poorly controlled weight gain
  • memory impairment, attention, apathy, depression
  • nervousness, anger, increased emotionality, tearfulness, decreased performance
  • low productivity, lack of “strength to work”
  • common edema (face, arms, legs, anterior abdominal wall, tongue)
  • stool disorder (constipation or diarrhea )
  • heart rhythm disturbance (especially in elderly patients)
  • anemia, difficult to treat
  • a constant feeling of internal trembling, anxiety, hand tremors (up to a change in handwriting and the inability to perform small movements)
  • changes in the eyes (bulging, change in view lada, swelling of the eyelids, lacrimation, especially from bright light)
  • Finally, the patient may complain of an increase in the front surface of the neck in size, deformation of the neck contour.

Symptoms of thyroid disease are not always specific. It is not at all necessary that all these symptoms are observed at the same time. If you have at least one of the listed symptoms, you need to check your thyroid function. The endocrinologist will also pay attention to these complaints when talking and examining the patient.


Since the influence of thyroid hormones on the body is very significant and diverse, its diseases will undoubtedly affect the functions of all organs, therefore timely diagnosis is important.

The survey is simple and very affordable.

The first step is an appointment with an endocrinologist, which includes a conversation and examination. As a rule, when questioning the patient, you can identify some disturbing symptoms that make you think about a violation of the thyroid gland. These symptoms are mostly nonspecific and can be observed in many patients, and sometimes healthy people under stress and fatigue.

The second step, if there is a reasonable suspicion of a violation of the function or structure of the thyroid gland, is to refer the patient to a blood test to determine the content of thyroid hormones.

  • in the blood, the level of T4, T3 (thyroid hormones) and TSH (pituitary hormone) is determined
  • , the study is often supplemented by the determination of the level of various antibodies to thyroid gland in the blood

T3 is reduced, and the “boss hormone” (TSH) is increased. On the contrary, with increased production of thyroid hormones, the level of T4 and T3 is increased, but TSH is reduced.

The third step in diagnosis is to visualize the thyroid gland.

The simplest, most accessible and informative method is ultrasound examination of the thyroid gland, in which the size and structure of the organ tissue is determined.

At the same time, one study does not replace another study. Examination, laboratory and instrumental examinations are three key points in the diagnosis of thyroid diseases.

Doctors of the EXPERT Clinic have compiled a list of all necessary examinations required for a basic examination of the thyroid gland.

There are also more specialized studies that are needed only in some cases:

Thyroid scintigraphy is a method used when there is a suspicion of actively functioning nodules in the thyroid gland.It can also be used for differential diagnosis in conditions of thyrotoxicosis to confirm / exclude destructive thyroiditis.

Other instrumental examination methods (MRI, CT, PET) are used much less frequently in routine clinical practice. Good reasons are needed to carry out these survey methods additionally.

Of particular importance is the assessment of the functional state of the thyroid gland in a pregnant woman due to the fact that the development of the child – especially his nervous system – depends on the level of thyroxine (the main form of thyroid hormones) in the expectant mother.

Treatment of thyroid disorders

Treatment depends on the specific pathology and thyroid dysfunction.

Treatment of all forms of hypothyroidism is the same – the appointment of the drug thyroxine. The treatment is well tolerated and completely compensates for the deficiency of hormones in the body.

Treatment of hyperthyroidism is more complex. A number of drugs are required: some reduce the excessive work of the thyroid gland, others normalize the work of the heart and intestines. Often, participation in the treatment is required not only of an endocrinologist, but also of other specialists (cardiologist, gastroenterologist).

In the absence of thyroid dysfunctions, they are most often limited to monitoring the pathology.


Any thyroid disease can be treated. Most often, it is possible to achieve a good response to drug (pill) therapy with a decent chance of a complete cure. Treatment of some thyroid diseases allows them to be transferred into long-term remission (the disease does not manifest itself actively, does not progress and does not violate the patient’s quality of life, and, accordingly, does not require constant treatment).Thyroid diseases occurring with persistent hypothyroidism can also be successfully compensated for with medication, when you have to constantly (all your life) take pills to replenish the lost thyroid function. In this case, the treatment is absolutely safe, since when prescribed for the purpose of treating thyroid hormone drugs, there are no side effects from the treatment.

If the disease cannot be compensated (or cured) with tablet drugs (this mainly concerns pathologies occurring with thyrotoxicosis; with large sizes of the thyroid gland and nodes in it; thyroid cancer), then surgery on the thyroid gland allows in the overwhelming majority of cases to solve disease problem.

Competent and timely treatment of thyroid diseases will prevent complications of the disease from other systems in the body: cardiovascular, digestive, bone, etc.

Lack of treatment for a long time will eventually cause changes in vital organs. They can be irreversible – even when starting therapy!

Prevention and recommendations

As such, there is no prevention of thyroid disease.Therefore, a high degree of importance is acquired by periodic preventive examination (examination by an endocrinologist, ultrasound of the thyroid gland, blood tests), especially for risk groups (they include in the presence of heredity factors, unfavorable ecology of the place of residence, occupational harm, frequent stress).

Leading a healthy lifestyle, a protective attitude towards one’s nervous system, physiological consumption of products containing iodine, etc. will act as the best prevention of the pathology of this endocrine organ.

Frequently asked questions

Close relatives diagnosed with thyroid disease, is there a risk of getting sick?

Thyroid diseases are not “contagious”, but there is a genetic predisposition to thyroid pathology. Often (but not at all 100%), in one family, several people have thyroid disease. The pathology of the thyroid gland does not have to be the same for everyone; it can be completely different variants of thyroid diseases.

The only serious thyroid disease – medullary cancer – must be specified in all close blood relatives of the patient with this pathology, i.e.because there are genetic variants of the disease that affect relatives with 100% probability.

Nothing worries, but laboratory examination revealed very high levels of antibodies to thyroid gland in the blood, what next?

Approximately 15-20% of healthy people have antibodies (AT) in the blood to various structures of the thyroid gland (as a rule, these are antibodies to TPO and TG, less often to the TSH receptor). If the thyroid gland function is not impaired, then the fact of the presence of antibodies will not have clinical significance, let us call it an “individual feature”.Of course, the mere fact of the presence of antibodies will not be treated, whatever their level is recorded in the blood. In case of thyroid dysfunction or with an increase in thyroid size, the determination of the presence of antibodies (mainly antibodies to TPO) will report the cause of abnormalities in the gland. The combination of impaired thyroid function and a high titer of antibodies to the thyroid gland makes it possible to diagnose thyroid autoimmune damage. The presence of antibodies to the thyroid gland will dictate the need for a more frequent assessment of thyroid function in conditions of taking drugs with a large (non-physiological) amount of iodine and lithium preparations, as well as during pregnancy, since there may be peculiarities in the functioning of the thyroid gland against this background.Note that the presence of antibodies in the blood itself has no effect on well-being. In most cases, the patient is more afraid of the “number” of antibodies in the laboratory form, sometimes hundreds of times higher than the upper limit of the norm. There is no need to treat the “level of antibodies in the blood”.

What can be done to reduce the risk of illness?

We are not able to influence the genetic predisposition to the disease. It was given to us from birth. The starting point in the implementation of a pathological hereditary predisposition may be stress, severe infectious diseases, taking certain medications, etc.Therefore, the implementation of general recommendations for a healthy lifestyle will to some extent prevent the manifestation of the disease.

To exclude thyroid dysfunction, which test should be taken?

The first (and sometimes the only) test to be performed if thyroid dysfunction is suspected is thyroid stimulating hormone (TSH). If this indicator is normal, then not a single disorder in the patient’s well-being can be associated with the thyroid gland. In fairness, it must be said that there are very rare diseases of the endocrine system, in which TSH remains normal, but there is a violation of hormone production.Determining the indications for expanding the examination is the prerogative of the endocrinologist who examines the patient. Sometimes the patients themselves ask the doctor to issue a referral for the study of “all thyroid hormones”, explaining such a desire by the “dislike” for taking blood for analysis, but this is not always justified. A detailed conversation, an explanation of when an in-depth examination of thyroid function may be required, will help the patient not to waste “unnecessary”, but also not to miss the “necessary”.

A blood test for thyroid hormones is performed in the first half of the day, on an empty stomach.In women, regardless of the day of the menstrual cycle.

Changes in TSH level were detected for the first time, should they be treated immediately?

Most often, a very moderate (up to 10 Med / l) increase in the TSH level is detected with normal T4 values. This situation first requires re-monitoring in 2-3 months. If the increase is persistent, i.e. there was no independent normalization of the level of hormones, then individually with the patient, with a thorough assessment of the concomitant pathology, the endocrinologist decides whether to prescribe treatment.It is possible that the situation will simply be “taken on a pencil”. The only category of our patients for whom an increase in TSH levels does not require additional rechecking is pregnant women. In this case, thyroxine therapy is prescribed immediately, because “No time” to recheck in a few months.

Diagnosed with autoimmune thyroiditis, what should I do?

When such a diagnosis is established and substitution therapy with thyroxine drugs is prescribed, the dose of the drug is selected under the control of the TSH level.At the onset of the disease, the decrease in the function of one’s own thyroid gland may not be total, i.e. to compensate for the lack of thyroxine, a small dose of the hormone is required. Over the course of the disease, all new thyroid cells are captured by the pathological process and to replenish the lost, a corresponding increase in the thyroxine dose is required, which eventually reaches the individual daily requirement. Patients often draw “their” conclusions from this fact: “Taking the drug has stopped the work of my thyroid gland, now I will be“ dependent on hormones ”.This narrow-minded view is absolutely not true. Not taking the drug, but the thyroid gland itself gradually decreased and finally stopped its work. This is a completely natural course of autoimmune thyroiditis, when the need for thyroxine increases over time.

How often should thyroid function be monitored?

There are more common and less common thyroid diseases.

With autoimmune thyroiditis and a selected dose of thyroxine, it is sufficient to control the TSH level once a year.An exception is pregnancy, when control is carried out once a month. The need for correction of therapy is discussed with the doctor after receiving the results.

In Graves disease, thyroid hormone control is much more frequent. At first monthly, and with a good response to treatment, then once every 2 months. A doctor’s examination is mandatory, because correction of therapy is possible.

In case of a nodular goiter with a confirmed benign structure of a node in the thyroid gland, thyroid hormones are monitored once a year.

Other, more rare diseases, require an individual plan and dynamic examination and observation by an endocrinologist.

What parameters, besides thyroid hormones, should be monitored?

In some thyroid diseases, periodic monitoring requires thyroid ultrasound. To a greater extent, this concerns the nodular non-toxic goiter, when the dimensions of the nodules in the thyroid gland are assessed in dynamics. Also, dynamic thyroid ultrasound is performed with a diffuse increase in the thyroid gland, when it is necessary to assess the dynamics of thyroid size with or without treatment.Ultrasound of the bed of the removed thyroid gland and lymph nodes is necessary after radical treatment of thyroid cancer.

As a rule, there is no need for dynamic performance of thyroid ultrasound when observing a patient with autoimmune thyroiditis.

Other special methods of dynamic examination (scintigraphy, computed tomography, MRI of the neck) are rarely prescribed, only if there are special indications for that.

The material was prepared using data from the “Clinical guidelines of the Russian Association of Endocrinologists for the diagnosis and treatment of autoimmune thyroiditis in adults”; “Clinical recommendations of the Russian Association of Endocrinologists for the diagnosis and treatment of nodular goiter”

Treatment histories

Nodular goiter

Patient V., 45 years. I turned to the EXPERT Clinic with the ultrasound data of the thyroid gland. There were no complaints about the state of health. I went to be examined “for the company” with a friend. The patient’s family has no relatives suffering from thyroid pathology. The first ultrasound revealed multiple very small changes in the gland tissue 3-6 mm in diameter, described by the ultrasound specialist as “multiple nodes”. The patient performed a blood test for thyroid hormones, there were no abnormalities in the laboratory examination data.The patient was offered dynamic observation (ultrasound control) every six months, which the patient did. She came to the appointment with five ultrasound reports, in which there were no changes in the size of the lesions in the thyroid gland. However, dynamic examination was recommended by the ultrasound specialist.

Important! The “nodes” in the thyroid gland revealed in this patient, which do not have negative dynamics, do not require any treatment and monitoring in dynamics at all. These are accidental findings that have no clinical significance.

Patient I., 32 years old. She did not complain about her health. Sent to an endocrinologist after a dispensary examination, during which the therapist suspected a node in the thyroid gland. Examination of the nodular goiter was confirmed – a 12 mm diameter node with indistinct contours and increased blood flow inside. The hormonal function of the gland was not disturbed. A biopsy of the node was performed, which revealed a suspicion of thyroid cancer. The patient was operated on (the gland and partly the lymph nodes in the neck were removed).Subsequent histological examination confirmed the diagnosis of cancer, additionally revealed metastases to the lymph nodes. The patient required further treatment – radioiodine therapy. Currently, the patient is receiving treatment and is under the dynamic control of an endocrinologist and oncologist. There are no data on the progression and return of the disease after 2 years.

Subsequently (after 3 years), after making sure that the disease has not returned, the patient plans to become pregnant.

Important! Timely diagnosis and treatment allows the patient to be adequately treated, giving him a good chance of recovery.


Patient M., 20 years old. Over the course of 3 years, it gradually and steadily gains weight. He notes swelling on the face, hands, legs, and abdomen. During all this time, persistent constipation is troubling. The skin became pale, with a yellowish tinge. The patient is studying at the institute in the third year. I began to study worse, tk. attention and ability to remember worsened, it became difficult to assimilate a large amount of information, although earlier learning was easy. I tried to study more.All the described complaints – in particular, weight change, swelling and constipation – were associated with the fact that she leads a predominantly sedentary lifestyle. I tried to use “different diets” for weight loss. They did not bring a significant effect. To normalize the stool, I used laxatives, enemas. I went to the student clinic. The examination revealed a reduced level of hemoglobin. Prescribed iron supplements, vitamin preparations, but there was no significant effect of the treatment.

Turned to the EXPERT Clinic.The examination revealed hypothyroidism against the background of autoimmune thyroiditis. The patient was prescribed treatment, all symptoms of the disease disappeared within 3 months.

Important! Hypothyroidism in adults, which most often occurs against the background of an autoimmune thyroid gland, is a common disease. It is easy to diagnose and easy to treat. The main thing is to diagnose in time and choose the right treatment. The patient’s quality of life will depend on this.

Diffuse toxic goiter

Patient N., 32 years. I went to the EXPERT Clinic with complaints of tearfulness, instability of mood, increased irritability. Became a conflict with family members and work colleagues. I was worried about increased sweating, trembling hands – both during nervous stress and at rest. I began to notice frequent loose stools; weight loss. All these changes occurred in 3-4 months. The patient herself indicated that her state of health was disturbed soon after a traumatic situation in the family.