- You may not always feel symptoms because the body can adapt to iron deficiency and you may suffer from iron deficiency even if you are fully healthy.
- Iron deficiency and chronic inflammation (functional iron deficiency) are the dominant causes of anemia in ulcerative colitis and Crohn’s disease.
- In the case of intravenous treatment, iron is given directly into the bloodstream, and the capacity to absorb is then faster than, for example, tablet treatment.
Being tired and walking around feeling depressed or powerless may be due to iron deficiency. Iron deficiency is one of our most common folk diseases and what many people also do not know is that you can have a good blood value (Hb) but still have iron deficiency. Iron deficiency can be treated with tablets, intravenously or injections.
Everyone can suffer from iron deficiency but it is known that it is especially common in pregnancy and in certain diseases such as heart failure or inflammatory diseases. Age can also be a factor contributing to the occurrence of iron deficiency. In the event of an iron deficiency investigation, it is good that both you, the patient or the family member have these factors in mind when talking to your doctor.
Therefore, iron deficiency occurs
The body gets its iron from the food. Iron is found in meat, eggs, fish and leafy vegetables. In order for the body to receive enough oxygen, red blood cells containing hemoglobin are needed. The hemoglobin binds and transports oxygen into our body. If we do not get enough iron, not enough red blood cells are formed and this in turn leads to poorer oxygenation of the body. The body has a particularly high iron requirement during adolescence, during pregnancy or breastfeeding and after blood loss. Healthy adult men in themselves get enough iron through their food and rarely develop iron deficiency. They have enough iron in their body for years of need even if they would not get any more iron at all. Women, on the other hand, lose iron from the body during menstruation, pregnancy and breastfeeding. Therefore, women are at greater risk than men of iron deficiency and may need to take iron as a dietary supplement.
Women who have passed menopause and adult men may in some cases suffer from iron deficiency. This may be due to bleeding in the stomach or intestines, in connection with, for example, ulcer or bowel cancer or in connection with diseases such as inflammatory bowel disease or heart failure. In some cases, older people may also suffer from iron deficiency. Iron deficiency can be divided into three categories:
Absolute iron deficiency If your body has used so much iron for a period of time that your body’s iron supply is insufficient or simply emptied, you have developed something called “absolute iron deficiency”. A lowered blood value, means that your supplies have been empty for a long time. The diagnosis is confirmed by measuring a substance in the blood called ferritin.
Functional iron deficiency You may have iron deficiency even if there is iron in the body stock, then it is called “functional iron deficiency”. It is common in inflammatory conditions and kidney disease. In case of functional iron deficiency, absorption of iron in the intestine is inhibited and the iron that is stored cannot be utilized. Functional iron deficiency is most easily detected through a blood test that measures iron saturation.
Iron deficiency without blood deficiency Women have easier to develop iron deficiency and iron deficiency anemia which has been noticed recently. This may be the reason, for example, if you as a woman feel inexplicably tired.
Symptoms of iron deficiency – test if you can suffer from iron deficiency
You may not always feel symptoms because the body can adapt to iron deficiency and you may suffer from iron deficiency even if you are fully healthy. This may be because, for example, you get too little iron through your food or lost large amounts of blood in connection with, for example, menstruation, blood donation or an accident. Iron deficiency can also be caused by gastrointestinal disease, inflammatory conditions and kidney disease. In pregnancy, the need for iron increases and for the elderly, the ability to absorb and store iron decreases – both of these factors can be causes of iron deficiency.
Do you recognize any of the statements below?
- I feel tired and powerless
- I’m getting dizzy
- I am easily breathed
- I get a palpitations
- I get a headache
- I have a whisper in my ears
If you recognize yourself in the statements above, you may suffer from iron deficiency.
It is important that you check this with a doctor, so contact your health care provider if you suspect you have an iron deficiency. Most people with iron deficiency anemia get rid of anemia after a few weeks of treatment. If it is a disease that is behind the anemia, you may need a different treatment for it.
Treatment of iron deficiency
There are various ways to treat iron deficiency depending on your need and the amount of iron you need. Regardless, iron deficiency itself is rarely too problematic to rectify, instead it can be the underlying cause that is troublesome.
Reviewing the diet is always a good start – if you have an iron deficiency it is good to increase the intake of foods that contain larger amounts of iron, such as legumes, meat and more.
The most common treatment for iron deficiency is iron tablets. These can be obtained both by prescription or purchased without a prescription. However, the body is slow to absorb iron in tablet form as the gut can only absorb a small portion of the iron contained in the tablets. Some also experience gastric and intestinal problems when treated with iron tablets. It is important to talk to a treating physician or pharmacist if you eat iron tablets and experience any side effects.
You can also get iron intravenously (drip) or via injections. The treatment is then done at the hospital to ensure that you receive the right amount of iron. The iron is given directly into the bloodstream, which means that the absorption capacity is considerably faster than, for example, tablet treatment.
In the trade there are also iron supplements to buy. However, supplements usually contain too little iron to restore balance to those suffering from iron deficiency. Regardless of the treatment method, it is good that you look over your diet and have the opportunity to add more foods that are rich in iron.
Iron deficiency in chronic heart failure
There is anemia (anemia) in chronic heart failure and it is not uncommon for iron deficiency to occur with or without anemia. Anemia in chronic heart failure is a risk factor that not only risks worsening the condition but also increases mortality. Recent studies have shown that even iron deficiency without anemia can worsen the disease state and also increase mortality.
In the fall of 2015, the National Board of Health and Welfare published new national guidelines for cardiac care. In Sweden, approximately 250,000 patients are estimated to suffer from heart failure and half of these have iron deficiency, which often leads to impaired quality of life, increased hospitalization and increased mortality for this large patient group. This is the first time the National Board of Health is evaluating intravenous iron treatment for heart failure patients with iron deficiency, something that was not included in the preliminary version of the guidelines. In the guidelines, the National Board of Health and Welfare writes about iron deficiency in heart failure that “The condition has a large to very high degree of difficulty”. For iron deficiency, with or without anemia (anemia), in the case of symptomatic chronic heart failure, treatment with parenteral iron is recommended, iron that is not given in tablet form but preferably intravenously. The measure gets the rating six on a ten-point recommendation scale.
When treating chronic heart failure, care should be taken to determine if there is iron deficiency (check ferretin and iron saturation). If iron deficiency should occur, it has been documented that treatment with intravenous iron can improve the quality of life, reduce symptoms such as fatigue and shortness of breath, and increase the physical performance of the affected person. This was true regardless of whether you are simultaneously suffering from anemia. The positive treatment results apply precisely to intravenous treatment, the same effect has not been demonstrated when giving iron orally (in tablet form).
Iron deficiency and IBD
Anemia (anemia) is a common and often overlooked problem in inflammatory bowel disease (IBD). Iron deficiency and chronic inflammation (functional iron deficiency) are the dominant causes of anemia in ulcerative colitis and Crohn’s disease. It is important that you who belong to this patient group have the opportunity to have a discussion with the care about inflammatory bowel disease and iron deficiency. Iron deficiency should and can be treated and different treatment paths are used depending on the patient.
Patients with IBD and concomitant iron deficiency anemia should receive iron replacement (oral) or via drip (intravenous). If you as a patient cannot tolerate treatment orally, or if your body does not absorb enough iron that way, you can start intravenous treatment. This also applies to patients with severe anemia or pronounced disease activity. However, for patients with mild – moderate anemia without active inflammation, oral treatment is preferred.
You who suffer from iron deficiency can get help
If you recognize the symptoms and find that you are suffering from iron deficiency, do not despair. There is help to get, the most important thing is to get to the bottom of what the iron deficiency is due to and at the same time start the optimal treatment for you and to follow up and monitor your iron values (ferritin and iron saturation).
It is not always like supplements and changing diets are sufficient and then it is important that you get the amount of iron your body needs for you to feel good.
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