Iron deficiency anemia - types, symptoms and treatment, drugs, diet. Iron deficiency anemia: symptoms and treatment Characteristics of iron deficiency anemia

Do you feel tired, do not have the strength to work, do you constantly want to sleep? Perhaps the reason for your condition is the lack of iron necessary for our body. What is iron deficiency anemia and what causes it? How to prevent the disease, what are the ways of its treatment and prevention? You will find answers to all questions in this article.

Despite the insignificant proportion of the metal in our body (from 2 g to 5 g), its significance is colossal.

Iron is part of the blood, and more precisely in the protein hemoglobin, which is found in red blood cells - erythrocytes. Hemoglobin supplies the body and each of its cells with oxygen, taking it from the lungs, carrying it through the bloodstream, providing oxidation processes accompanied by the release of energy.

Hemoglobin not only saturates the blood with oxygen, but also frees it from carbon dioxide, plays the role of a biological carrier.

Lack of hemoglobin causes oxygen starvation, at the household level, the disease is called "anemia". In scientific circles, a low level of iron in the blood has a medical term - iron deficiency (sideropenic) anemia, hematological syndrome, or IDA for short.

Iron deficiency anemia: symptoms

Iron deficiency anemia differs from other anemias (Addison-Birmer and hypochromic) by a decrease in the number of red blood cells in the blood.

All symptoms of IDA are classified as sideropenic syndrome characteristic of IDA and anemic syndrome, the same for all anemias.

sideropenic syndrome, occurs due to a sharp decrease in red blood cells - erythrocytes in the blood:

• the nail plate becomes brittle and flat with transverse stripes
• hair split, fall out, become dull
• skin is pale, tans poorly in the sun, has an unhealthy appearance
• perverse taste, desire arises, there is coal, earth, chalk, clay
• crimson tongue, smooth, shiny
• red cracks in the corners of the mouth (jammed)
• perverted preferences for smells, desire to sniff kerosene, exhaust fumes, gasoline, paint

Anemia syndrome associated with a lack of hemoglobin in the blood

• drowsiness and fatigue
• shortness of breath with minor physical exertion
• palpitations, tachycardia
• goosebumps before the eyes
• pale skin, sometimes with a bluish or greenish tinge
• pastosity (swelling) of the limbs
• constant colds and infectious diseases.

The occurrence of certain symptoms makes you think about your health and consult a doctor for examination.

Iron deficiency anemia: causes

Anemia caused by iron deficiency in the human body is a common disease. Some scientists believe that such a disease does not exist in nature - these are symptoms of other diseases that affect the human condition. To bring the amount of hemoglobin in the blood back to normal, it is necessary to find out the root cause of iron deficiency by consulting a doctor.

After studying the medical history and summarizing the data, the scientists identified the factors and groups of people who are at an increased risk of developing IDA.

Insufficient intake of iron from food:

• refusal of animal food - vegetarianism (iron is more easily absorbed from animal foods than plant foods)
• starvation, strict diets
• in the products that a person consumes per day, insufficient iron content

As a result of blood loss:

• period after surgery, condition after injury, with extensive burns
• uncontrolled donation and blood transfusion
• bleeding in the digestive organs and hemorrhoidal
• uterine and heavy menstrual bleeding
• kidney disease with increased excretion of red blood cells in the urine

The need for increased levels of iron (Fe):

• infants from 1 to 2 years old, children in the period of active growth, in adolescence
• for people who are actively involved in sports or physical labor
• for pregnant women and during lactation
• in a newborn with congenital anemia

Iron (Fe) is poorly absorbed into the blood through the intestinal wall:

• old age
• Crohn's disease
• intolerance to certain foods - celiac disease
• some drugs block iron absorption

Degrees of iron deficiency anemia

According to statistics, from 15 to 20% of the world's population suffer from a latent form of anemia, they do not know about their illness until they donate blood for analysis.

Statistics show that among patients with anemia, 20% are women, 50% are pregnant, and only 3% are men. Such indicators are not surprising, because men, as representatives of the stronger sex, eat a lot of meat and do not lose blood every month at reproductive age (for biological reasons), like a woman.

IDA stages

1. Mild IDA- mild symptoms (hemoglobin less than 110 g / l).
2. Medium to moderate anemia- the patient complains of headache, poor sleep, appetite. Hair and nails become dull and brittle. Persistent colds that last a long time in a severe form. Pale skin, cracks in the tongue, in the corners of the lips - seized (hemoglobin from 70 g / l to 90 g / l).
3. Severe form of IDA- tachycardia, shortness of breath not only during movement, but also at rest. The pallor of the skin becomes bluish over time, a mental disorder (hemoglobin below 70 g / l).
4. Coma (hypoxic) with IDA- limbs are motionless, a sharp drop in blood pressure, vomiting, fainting.

By contacting a doctor at the first signs indicating a lack of iron in the blood, you can avoid severe consequences and complications caused by IDA.

iron deficiency anemia during pregnancy

The most common anemia in pregnant women is iron deficiency. According to WHO, the incidence of IDA in women at different stages of fetal development ranges from 20% to 80%.

Iron is extremely necessary for pregnant women - with its lack, fatigue occurs, complications arise in the work of internal organs, frequent colds are possible, which negatively affects her well-being and the condition of the fetus. The symptoms of anemia in a pregnant woman are the same as in all those suffering from a lack of iron in the blood.

Why is anemia dangerous during pregnancy? Oxygen starvation of the fetus, which affects intrauterine development and its survival during childbirth. The amount of hemoglobin in a pregnant woman should not fall below 110 g / l.

In a woman's body, on average, 4 g of Fe, which not only enters, but is also excreted through the skin, with urine, during breastfeeding, and menstruation. A non-pregnant woman consumes up to 1.5 mg Fe per day.

For a woman who is expecting a child, Fe intake increases in each trimester of pregnancy.

• in the first trimester, the daily dose is increased by 1 mg
• in the second - 2 mg
• the third - by 3 mg

16-20 weeks in the development of the fetus is characterized by the formation of blood flow and blood elements, this time accounts for the largest consumption of iron in the body of a woman.

Specific Causes of IDA in Pregnant Women

In addition to the factors listed above that cause anemia, for pregnant women there are specific ones associated with its position. Women at risk are:

• who gave birth many times or gave birth with a short period between births
• previous pregnancies were interrupted artificially
• with postpartum bleeding
• twin and twin pregnancy
• early pregnancy (under 17) or late pregnancy (after 30)
• toxicosis (gestosis) at different stages of pregnancy
• premature abruption of the placenta associated with bleeding
• women with low blood pressure

If a pregnant woman has been diagnosed with iron deficiency anemia of 3-4 degrees, experts advise terminating the pregnancy before the 12-week period.

Prevention of anemia in a pregnant woman

To give birth to a healthy child is the main task of a woman. With IDA, the risk of miscarriage and childbirth with complications increases. If you have a latent (latent) form of anemia, you need to restore your hemoglobin levels to normal and take steps to avoid getting sick during pregnancy.

When planning a child, a woman should:

1. Full examination and complete blood count- the main task of a woman, allowing to prevent any disease.
2. From the beginning of bearing a child to the end of feeding, the mother's body loses from 800 to 950 g of iron in order to women need 4-5 years to recover after childbirth. When planning a pregnancy, you should pay attention to this fact in order to avoid iron deficiency anemia.
3. Balanced Diet during pregnancy, rich in protein and plant foods with a high content of easily digestible iron - maintains normal hemoglobin.
4. In the menu, consider the compatibility and incompatibility of products, which contribute to or hinder the enrichment of the blood with iron, otherwise the diet will not be beneficial.
5. The WHO recommends that women take drugs rich in iron during the II and III trimester of gestation and six months of breastfeeding (on the recommendation of a doctor). Excess iron in the blood causes complications during pregnancy.

Observing all the rules, a woman will be able to bear a healthy child and not get sick with iron deficiency anemia herself.

Iron deficiency anemia in children

If your baby was born premature, weak, and you suffered from a lack of hemoglobin during gestation, you need to carefully monitor the health of the newborn. Congenital anemia is possible, which is fortunately extremely rare.

If you notice a change in the behavior of the child, in his appearance, you should seek the advice of a pediatrician. Based on laboratory blood tests, the doctor will make the correct diagnosis.

Signs of anemia in a child:

• the baby constantly cries, is naughty, it is difficult to put him to sleep
• lips, inner eyelids and skin are pale (gypsum-colored)
• the child has no appetite, but he pulls earth, sand, clay, chalk into his mouth
• the baby lags behind in development from his peers, motor skills of speech and movement are not fixed

If your child is switched to artificial formulas, they should be rich in iron. As complementary foods, we choose animal products with a high content of iron, which are better absorbed (rabbit meat, beef liver, veal).

Let's give dairy products some time after iron-containing ones, since calcium in milk is an iron antagonist.

Apples and other fruits rich in iron and other trace elements should be given to babies in the form of juice or puree.

Phytopreparations

The gifts of nature are an excellent replenishment of the child's body not only with iron, but with vitamins and other microelements. It is recommended to make decoctions and infusions of chamomile, rose hips, mint for children - they will help increase hemoglobin and cope with colds.

Vitamins with iron content used only on the recommendation of a pediatrician.

Diagnosis of iron deficiency anemia

To find out the amount of hemoglobin in the blood, it is necessary to do a clinical (general) blood test and a biochemical one.

In people with anemia, there are deviations in the hemogram of a healthy person.

Complete blood count for anemia:

1. As a result of the research, amount of hemoglobin in one unit of blood volume (decreases with IDA).
2. If the IDA test is positive, then number, shape, size of erythrocytes will differ from the norm.
3. RBC staining normal - pink, monochrome, less saturated in the center. Hemoglobin in anemia stains red blood cells unevenly, chaotically.
4. Install white blood cell count, they should be normal, if there are more of them - this indicates health problems.

Biochemical blood test

If there is not enough hemoglobin in the blood, then an analysis for iron deficiency anemia will show:

• less serum ferritin(not enough iron, the body takes it from ferritin)
• less iron in serum(due to deficiency)
• decreased binding of transferrin to iron(transferrin protein does not tolerate blood iron).

When confirmed in the IDA analysis, an extended analysis is performed to rule out another type of anemia so that no error occurs.

Iron deficiency anemia: treatment

The diagnosis of IDA can be confirmed or denied by a therapist or hematologist. These experts will work with you to develop a step-by-step course of treatment.

Treatment for IDA includes:

• We treat chronic diseases that are associated with large blood loss (gastric ulcer, hemorrhoids, fibroids, heavy menstruation)
• A diet high in iron
• Taking medicinal vitamin complexes rich in trace elements, preparations that contain Fe
• Traditional medicine, herbal medicine
• Quitting smoking, drinking alcohol, exercising
• If you have a low level of hemoglobin in your blood and you are taking iron supplements, you should limit your intake of coffee and tea.
• Juices from citrus fruits, apple and pomegranate will help iron to be absorbed
• Healthy sleep, rest

Diet for iron deficiency anemia

If you do not feel a lack of iron, and the doctor said that a blood test showed a slight deviation of hemoglobin from the norm, you should not aggravate the situation, it is better to prevent the further development of the disease. Supplement your diet with well-known iron foods.

Heme iron(in products of animal origin), absorbed by 15% -35%

Rich in heme iron foods (4 mg or more of Fe per 100 g):

• liver (veal, pork, chicken)
• rabbit meat
• brains, heart, kidneys, beef tongue
• egg yolk
• seafood (oysters, mussels, clams)

Saturated with heme ironfoods (2.5 to 4 mg Fe):

• meat (lamb, beef, turkey, chicken)
• chicken egg

Good heme iron content products (from 1 mg to 2.5 Fe):

• Red caviar
• river fish (carp, burbot)
• sea ​​fish (perch, mackerel)

Non-heme Fe(in products of plant origin) is absorbed by 2% -20%.

Products with excellent content of non-heme iron (more than 6 mg per 100 g):

• apricot, dried apricots, prunes
• dried fruits (apples, pears)
• dried mushrooms
• nuts (cashews, peanuts, almonds)
• legumes (lentils, peas, beans)
• pumpkin seeds
• cocoa powder
• buckwheat
• sea ​​kale (kelp)

Products with good content of non-heme iron (from 2.5 to 6 mg):

• oatmeal
• fruits (apples, pears, peach, plum)
• berries (dogwood, currant)
• vegetables (beets, carrots)
• greens (lettuce, spinach, nettle)

Fortunately, the products around us contain a sufficient amount of iron, it is a pity that the body absorbs it partially. When compiling the menu, remember that some trace elements in foods prevent the absorption of iron into the blood.

Tannin is in antagonism with iron, the substance is present in large quantities in coffee and tea. Do not drink drinks together or after foods containing iron.

Helps iron molecules to enter the bloodstream:

• ascorbic acid (citrus fruits, rose hips, sauerkraut)
• all types of plants from the cruciferous family
• strawberries and sea buckthorn
• all kinds of greens (lettuce, spinach, parsley, dill) green onions

A pregnant woman should eat a balanced diet, get proteins, carbohydrates and fats. Food rich in iron is useful for her, it has a beneficial effect on the fetus, but the liver is not recommended - vitamin A in it has a bad effect on the development of the fetus.

Iron deficiency anemia: treatment drugs

Hemolytic iron preparations for anemia are prescribed by a doctor. There are over-the-counter drugs that are corrective drugs that increase the level of iron in the blood of patients suffering from mild to moderate anemia.

Ferretab composite

• A medicine based on iron salts and folic acid, helps to increase hemoglobin in the blood, is involved in the formation of red blood cells in the human body.
• One or two capsules per day for an adult with latent IDA.
• The drug has a prolonged (long-term) effect on the composition of the blood.

Sorbifer Durules

• Sulphate salt of ferrous iron with ascorbic acid, which improves the absorption of the drug into the blood
• For pregnant women in the II and III trimester, one tablet per day, after the birth of a child and lactation, 2 tablets

Totem

• Gluconate Fe, Cu, Mg in the form of capsules with a dark liquid
• Used 1-2 capsules inside for an adult
• One of the rare drugs that can be given to children after consulting with a pediatrician
• The dose for a child is calculated according to its weight.

Fenyuls

• A complex of vitamins B and C, with a high percentage of ferrous salt
• In capsules it is in the form of a small, multi-colored dragee
• The course of treatment is one capsule 30 days
• Not recommended for children

Ferroplex

• Compound of ferrous sulfate with ascorbic acid in the form of dragees.
• Adults need 6 tablets per day with equal intervals between doses. For children, 1 tablet 3 times is enough. We take dragees without chewing.

Prevention of iron deficiency anemia and treatment with folk remedies

We are surrounded by useful plants, herbs that will cope with a low level of hemoglobin no worse than medicines, and will prevent the appearance of iron deficiency anemia.

• Summer is just beginning, indulge yourself to the fullest with a variety of berries, fruits, vegetables, herbs.
• If you are the owner of your own house or cottage, do not be lazy, stock up on dried fruits for the winter. Freeze the harvest in the freezer.
• The forest gives us herbs, berries, mushrooms. We collect the gifts of the forest, dry, freeze, cook jam, and in winter we support immunity and a normal level of hemoglobin with our preparations. Our ancestors cooked nettle soup, which, according to herbalists, contains the most non-heme iron.
• If you have a breakdown, squeeze a glass of beetroot juice, and drink half a glass every day on an empty stomach. You can cook and use carrot, pomegranate, cabbage juice (from sauerkraut).

Tea, it is better to brew with herbs (melissa, oregano), lime blossom, rose hips.

If you have chronic IDA, hemoglobin is constantly below normal, cook food in a cast iron, like our ancestors. This unusual way to combat iron deficiency anemia was adopted by a doctor from Canada. He came up with a banal, but effective tool - an iron fish.

Around the globe, 2 billion people suffer from iron deficiency anemia. People in poor, underdeveloped countries survive on plant foods, from which iron is absorbed much worse than from meat and fish. There are religions that forbid eating the meat of slaughtered animals.

The scientist offered such people an iron fish: it needs to be boiled for 20 minutes in water or with soup, it saturates the contents of the pan with iron ions. Thus, a person replenishes 75% of the daily iron requirement.

Iron deficiency anemia is a disease that is quite common in society. This is facilitated by food poor in nutrients and an imbalance in the diet. In this article, we have given the main products and drugs that will help prevent iron deficiency anemia and its negative consequences for the body.

Video: How to treat iron deficiency anemia with folk remedies?

Constant overwork, stress, rare walks and malnutrition negatively affect women's health.

Symptoms of many diseases are mistaken for ordinary fatigue and do not go to the doctor. Anemia is a pathology that can be easily confused with overwork.

Let's talk about the symptoms and external signs, treatment, nutrition, the consequences of iron deficiency and other types of anemia in adult women, during pregnancy, breastfeeding, in elderly women over 50 years old.

Kinds

The development of the disease is due to the blood.

is a red protein found in red blood cells. It performs the most important function - it delivers oxygen to the internal organs, ensuring their work.

Anemia occurs when there is a loss of blood or a malfunction in the formation of red blood cells. Most often, anemia occurs in children and adult women of reproductive age.

In medicine, 6 types of anemia are distinguished:

• deficient (most often iron deficiency);
• posthemorrhagic;
• hypoplastic;
• hemolytic;
• folic acid deficiency;
• B12 deficiency.

All species have common symptoms:

• dyspnea;
• pallor;
• weakness;
• violation of the menstrual cycle;
• decrease in working capacity;
• cardiopalmus.

Hemoglobin in the blood in all manifestations of anemia decreases, but a decrease in the number of red blood cells does not always occur.

Anemia is not an independent disease, this is the result of the pathology of the processes of the circulatory system. It is necessary to take tests so that the doctor determines its type and prescribes treatment.

Severity, blood counts

Causes

You need to know how anemia manifests itself in women, because the symptoms differ depending on the type of pathology. Their diversity is shown in the table:

Diagnostic methods, analyzes

When you feel unwell need to see a therapist. General blood tests will also help to identify the pathology.

The most common anemia associated with. If there is a suspicion of a different type of it, an examination of the organs of the gastrointestinal tract may be required, to which your doctor will refer you.

A blood test will show all deviations from the norm. In the presence of anemia, red blood cells in the blood will be smaller in size, less colored than in a healthy person.

The doctor will check the pulse, measure the pressure assess the condition of the skin. After examination, evaluation of tests, treatment is prescribed.

What is anemia, how to treat it, the program "Live healthy!" will tell:

What is dangerous: consequences and complications

What does anemia lead to and what is terrible for a woman? Possible consequences and complications caused by anemia:

1. Decreased immunity. It is more difficult for the body to fight viruses. As a result, the woman often gets sick.
2. Sleep disorders. Sleepless nights have a bad effect on well-being, performance.
3. The mucous membranes become susceptible and vulnerable, which leads to inflammation, infections.
4. Women are more prone to stress, become distracted, vulnerable.
5. Leads to disruption of the cardiovascular system.
6. Prolonged anemia leads to edema, liver disease.
7. The process of absorption of nutrients is disturbed, which leads to diseases of the gastrointestinal tract.
8. With anemia, oxygen starvation occurs. It's detrimental to the brain.
9. Takes away beauty - the skin becomes lethargic, dry, hair - brittle, dull, nails exfoliate.
10. In severe cases, anemia leads to fainting, fever,.

How and what to treat: iron supplements, vitamins

In mild forms of anemia, it is enough to revise the diet: include foods rich in iron, B vitamins.

If the diet is not enough, the specialist will prescribe drugs that make up for the deficiency of the necessary substances.

No need to self-medicate - this can aggravate well-being. In the case when therapy does not work, the doctor prescribes drugs containing hormones.

The age of the woman suffering from anemia is taken into account. If the disease is associated with menopause, when it is necessary to consult a therapist, gynecologist, endocrinologist.

Rules for taking iron supplements for the treatment of iron deficiency anemia in women:

• taking tablets is more effective than intramuscular injections, since iron is better absorbed if it passes through the intestinal tract;
• the optimal dose of pure iron is 80-160 mg - exceeding the dose is unacceptable;
• taking in the form of tablets is more effective than in liquid form;
• preparations contain ferrous or trivalent iron: in the first case, vitamin C contributes to good absorption, in the second - amino acids;
• use preparations coated with a protective shell that will protect the mucous membrane of the esophagus and stomach from irritation.

From ferrous iron, drugs Sorbifer durules, Tardiferon are prescribed. They are consumed twice a day, 30 minutes before meals, with a glass of water.

Ferric iron preparations- Ferrum Lek, Biofer - used during meals or after.

Injections are prescribed for patients with diseases of the gastrointestinal tract with large blood losses.

In complex forms of anemia - posthemorrhagic, hemolytic, hypoplastic - are prescribed:

• glucocorticosteroids;
• anabolic steroid;
• androgens;
• cytostatics;
• erythropoietin preparations.

Uncontrolled treatment is unacceptable. The dosage is prescribed by the doctor based on the results of a blood test, diagnostics of narrow specialists.

In order for iron-containing preparations to be absorbed faster, vitamins are prescribed:

• ascorbic acid;
• vitamin B6;
• folic acid.

Rarely, the cause of anemia is copper or zinc deficiency.

Together with vitamins, the intake of mineral complexes (the doctor will tell you their names) helps to alleviate the symptoms of anemia in women, helps to quickly cope with oxygen starvation.

With posthemorrhagic anemia, blood or its substitutes are transfused. Iron and vitamins are prescribed until hemoglobin is completely restored.

Folk remedies

With alarming symptoms, it is impossible to self-medicate, because. anemia can be a sign of serious illness, including malignant tumors.

Folk remedies relieve symptoms, raise the level of hemoglobin in the blood, but with some forms of anemia, home treatment will not work.

If anemia is associated with a lack of iron, natural formulations will give a positive effect without side effects for the body.

Folk methods of treatment:

strawberry infusion.

A handful of dry berries should be poured with 200 ml of boiled water, closed with a lid, left for 3-4 hours.

Infusion to use once a day;

Garlic will help overcome weakness with anemia. They make a tincture out of it.

To prepare 300 g of peeled garlic, pour 96% alcohol solution, place the mixture in a bottle. Leave the mixture for 3 weeks. Take 3 times a day, 20 drops dissolved in 100 ml of milk;

• rose hips are rich in vitamin C, therefore, with anemia, it is useful to drink a decoction of its fruits. This will help the iron deficiency drugs to be absorbed. 2 tsp fruits should be brewed with a glass of boiling water and drink a decoction after meals 3 times a day;

oat groats. A decoction is prepared from it. To do this, take 1 liter of water and a glass of cereal. Cook the mixture until the consistency of liquid jelly.

The resulting broth is filtered through cheesecloth, 2 cups of milk, 4 tsp are added to it. honey, boil. The decoction should be consumed during the day for 2-3 doses.

What to eat: nutrition and diet

Proper diet plays an important role in the treatment of pathology. Beef will help restore strength: this meat is a champion in the content of nutrients during oxygen starvation.

It is necessary to introduce protein-rich foods into the diet:

• veal;
• liver;
• dairy products;
• fish;
• eggs;
• butter and vegetable oils.

To raise the level of hemoglobin will help included in the menu for iron deficiency anemia in women cereals, especially from buckwheat, apples, honey, dried fruits.

But it is better to refuse fatty foods, semi-finished products. They will only bring harm.

Coffee drinkers need to limit the number of cups they drink per day, because it flushes out vitamins and minerals from the body.

If a woman has problems with the gastrointestinal tract, the doctor may prescribe a diet that excludes certain foods.

Course duration

The treatment regimen depends on age. Women of reproductive age most often develop anemia during pregnancy and lactation.

In the period, in old age, the doctor studies the manifestations of anemia in detail, since it is often associated with specific diseases.

The duration of treatment depends on the form and severity of anemia, age. Older women need more time to heal.

Age-related changes slow down metabolic processes in the body, so it is difficult to cope with the disease.

After the age of 60, most people have a whole bunch of concomitant diseases, which makes it difficult for the positive dynamics of therapy.

During pregnancy and breastfeeding

When a pregnant woman registers at the clinic, she is prescribed a series of tests. If a low hemoglobin level is detected, expectant mother is prescribed iron supplements and diet.

Timely correction and therapy helps to avoid complications in the second half of pregnancy.

Oxygen starvation affects not only the condition of the woman, but also the development of the fetus and placenta. It is important to follow the doctor's recommendations.

Even mild anemia in women increases the risk of fetal hypoxia leading to developmental disorders of the nervous system of the baby. Pathology can cause weak labor activity.

If a woman loses a lot of blood during childbirth, she is given a transfusion. Then hemoglobin can be quickly raised. Iron injections are less effective.

To avoid anemia while breastfeeding, a woman should eat regularly, eat right. When discharged from the hospital, they give a list of products that are necessary for use during lactation.

In situations where it is required to raise hemoglobin, iron-containing preparations are prescribed. Do not exceed the dosage prescribed by a specialist in order to avoid irreversible consequences in the baby.

Prevention measures

The main factors that reduce the risk of anemia are- Proper nutrition, regular walks in the fresh air. Compliance with preventive measures is especially important for women with heavy, prolonged menstruation.

The intake of vitamins from food plays an important role. Doctors recommend eating 500 g of vegetables and fruits daily. This reduces the risk of anemia and other diseases.

At risk are pregnant women and donors. For prevention, they are often prescribed iron preparations, vitamin complexes.

Timely diagnosis and treatment of anemia will relieve unpleasant symptoms. The main thing is to follow the recommendations of the doctor, to review your diet.

Then you can defeat anemia and continue to enjoy life.

• Prevention of iron deficiency anemia
• Which Doctors Should You See If You Have Iron Deficiency Anemia

What is iron deficiency anemia

Among various anemic conditions iron deficiency anemia are the most common and account for about 80% of all anemias.

Iron-deficiency anemia- hypochromic microcytic anemia, which develops as a result of an absolute decrease in iron stores in the body. Iron deficiency anemia occurs, as a rule, with chronic blood loss or insufficient intake of iron in the body.

According to the World Health Organization, every 3rd woman and every 6th man in the world (200 million people) suffer from iron deficiency anemia.

iron exchange
Iron is an essential biometal that plays an important role in the functioning of cells in many body systems. The biological significance of iron is determined by its ability to reversibly oxidize and reduce. This property ensures the participation of iron in the processes of tissue respiration. Iron makes up only 0.0065% of body weight. The body of a man weighing 70 kg contains approximately 3.5 g (50 mg/kg body weight) of iron. The iron content in the body of a woman weighing 60 kg is approximately 2.1 g (35 mg/kg of body weight). Iron compounds have a different structure, have a functional activity characteristic only for them, and play an important biological role. The most important iron-containing compounds include: hemoproteins, the structural component of which is heme (hemoglobin, myoglobin, cytochromes, catalase, peroxidase), non-heme group enzymes (succinate dehydrogenase, acetyl-CoA dehydrogenase, xanthine oxidase), ferritin, hemosiderin, transferrin. Iron is part of complex compounds and is distributed in the body as follows:
- heme iron - 70%;
- iron depot - 18% (intracellular accumulation in the form of ferritin and hemosiderin);
- functioning iron - 12% (myoglobin and iron-containing enzymes);
- transported iron - 0.1% (iron associated with transferrin).

There are two types of iron: heme and non-heme. Heme iron is part of hemoglobin. It is contained only in a small part of the diet (meat products), is well absorbed (by 20-30%), its absorption is practically not affected by other food components. Non-heme iron is in free ionic form - ferrous (Fe II) or ferric (Fe III). Most dietary iron is non-heme iron (found primarily in vegetables). The degree of its assimilation is lower than that of heme, and depends on a number of factors. From food, only divalent non-heme iron is absorbed. To “turn” ferric iron into ferrous, a reducing agent is needed, the role of which in most cases is played by ascorbic acid (vitamin C). In the process of absorption in the cells of the intestinal mucosa, ferrous iron Fe2 + turns into oxide Fe3 + and binds to a special carrier protein - transferrin, which transports iron to hematopoietic tissues and iron deposition sites.

The accumulation of iron is carried out by the proteins ferritin and hemosiderin. If necessary, iron can be actively released from ferritin and used for erythropoiesis. Hemosiderin is a ferritin derivative with a higher iron content. From hemosiderin, iron is released slowly. Beginning (prelatent) iron deficiency can be identified by a reduced concentration of ferritin even before the exhaustion of iron stores, while still maintaining normal concentrations of iron and transferrin in the blood serum.

What causes iron deficiency anemia

The main etiopathogenetic factor in the development of iron deficiency anemia is iron deficiency. The most common causes of iron deficiency conditions are:
1. iron loss in chronic bleeding (the most common cause, reaching 80%):
- bleeding from the gastrointestinal tract: peptic ulcer, erosive gastritis, esophageal varicose veins, colonic diverticula, hookworm invasions, tumors, UC, hemorrhoids;
- prolonged and heavy menstruation, endometriosis, fibromyoma;
- macro- and microhematuria: chronic glomerulo- and pyelonephritis, urolithiasis, polycystic kidney disease, tumors of the kidneys and bladder;
- nasal, pulmonary bleeding;
- blood loss during hemodialysis;
- uncontrolled donation;
2. insufficient absorption of iron:
- resection of the small intestine;
- chronic enteritis;
- malabsorption syndrome;
- intestinal amyloidosis;
3. increased need for iron:
- intensive growth;
- pregnancy;
- the period of breastfeeding;
- sports activities;
4. insufficient intake of iron from food:
- newborns;
-- Small children;
- Vegetarianism.

Pathogenesis (what happens?) during iron deficiency anemia

Pathogenetically, the development of an iron deficiency state can be divided into several stages:
1. prelatent iron deficiency (insufficiency of accumulation) - there is a decrease in the level of ferritin and a decrease in the iron content in the bone marrow, iron absorption is increased;
2. latent iron deficiency (iron-deficient erythropoiesis) - the serum iron is additionally reduced, the concentration of transferrin is increased, the content of sideroblasts in the bone marrow is reduced;
3. severe iron deficiency = iron deficiency anemia - the concentration of hemoglobin, red blood cells and hematocrit is additionally reduced.

Symptoms of iron deficiency anemia

During the period of latent iron deficiency, many subjective complaints and clinical signs characteristic of iron deficiency anemia appear. Patients report general weakness, malaise, decreased performance. Already during this period, there may be a perversion of taste, dryness and tingling of the tongue, a violation of swallowing with a sensation of a foreign body in the throat, palpitations, shortness of breath.
An objective examination of patients reveals "small symptoms of iron deficiency": atrophy of the papillae of the tongue, cheilitis, dry skin and hair, brittle nails, burning and itching of the vulva. All these signs of violation of the trophism of epithelial tissues are associated with tissue sideropenia and hypoxia.

Patients with iron deficiency anemia note general weakness, fatigue, difficulty concentrating, and sometimes drowsiness. There is a headache, dizziness. With severe anemia, fainting is possible. These complaints, as a rule, do not depend on the degree of decrease in hemoglobin, but on the duration of the disease and the age of the patients.

Iron deficiency anemia is also characterized by changes in the skin, nails, and hair. The skin is usually pale, sometimes with a slight greenish tint (chlorosis) and with an easy blush of the cheeks, it becomes dry, flabby, flaky, cracks easily. Hair loses its luster, becomes gray, thinner, breaks easily, thins and turns gray early. Nail changes are specific: they become thin, dull, flatten, easily exfoliate and break, striation appears. With pronounced changes, the nails acquire a concave, spoon-shaped shape (koilonychia). In patients with iron deficiency anemia, muscle weakness occurs, which is not observed in other types of anemia. It is referred to as a manifestation of tissue sideropenia. Atrophic changes occur in the mucous membranes of the digestive canal, respiratory organs, and genital organs. Damage to the mucous membrane of the digestive canal is a typical sign of iron deficiency conditions.
There is a decrease in appetite. There is a need for sour, spicy, salty foods. In more severe cases, there are perversions of smell, taste (pica chlorotica): eating chalk, lime, raw cereals, pogophagy (an attraction to eating ice). Signs of tissue sideropenia quickly disappear after taking iron supplements.

Diagnosis of iron deficiency anemia

Main landmarks in the laboratory diagnosis of iron deficiency anemia the following:
1. The average content of hemoglobin in an erythrocyte in picograms (norm 27-35 pg) is reduced. To calculate it, the color index is multiplied by 33.3. For example, with a color index of 0.7 x 33.3, the hemoglobin content is 23.3 pg.
2. The average concentration of hemoglobin in the erythrocyte is reduced; normally, it is 31-36 g / dl.
3. Hypochromia of erythrocytes is determined by microscopy of a smear of peripheral blood and is characterized by an increase in the zone of central enlightenment in the erythrocyte; Normally, the ratio of central enlightenment to peripheral darkening is 1:1; with iron deficiency anemia - 2 + 3: 1.
4. Microcytosis of erythrocytes - a decrease in their size.
5. Coloring of erythrocytes of different intensity - anisochromia; the presence of both hypo- and normochromic erythrocytes.
6. Different form of erythrocytes - poikilocytosis.
7. The number of reticulocytes (in the absence of blood loss and the period of ferrotherapy) with iron deficiency anemia remains normal.
8. The content of leukocytes is also within the normal range (with the exception of cases of blood loss or oncopathology).
9. The content of platelets often remains within the normal range; moderate thrombocytosis is possible with blood loss at the time of examination, and the platelet count decreases when blood loss due to thrombocytopenia is the basis of iron deficiency anemia (for example, with DIC, Werlhof's disease).
10. Reducing the number of siderocytes up to their disappearance (siderocyte is an erythrocyte containing iron granules). In order to standardize the production of peripheral blood smears, it is recommended to use special automatic devices; the resulting monolayer of cells improves the quality of their identification.

Blood chemistry:
1. Decreased iron content in the blood serum (normal in men 13-30 µmol/l, in women 12-25 µmol/l).
2. TIBC is increased (reflects the amount of iron that can be bound by free transferrin; TIBC is normal - 30-86 µmol / l).
3. Study of transferrin receptors by enzyme immunoassay; their level is increased in patients with iron deficiency anemia (in patients with anemia of chronic diseases - normal or reduced, despite similar indicators of iron metabolism.
4. The latent iron-binding capacity of the blood serum is increased (determined by subtracting the serum iron content from the FIA ​​values).
5. The percentage of saturation of transferrin with iron (the ratio of the serum iron index to the total body fat; normally 16-50%) is reduced.
6. The level of serum ferritin is also reduced (normally 15-150 mcg/l).

At the same time, in patients with iron deficiency anemia, the number of transferrin receptors is increased and the level of erythropoietin in the blood serum is increased (compensatory reactions of hematopoiesis). The volume of erythropoietin secretion is inversely proportional to the oxygen transport capacity of the blood and is directly proportional to the oxygen demand of the blood. It should be borne in mind that the level of serum iron is higher in the morning; before and during menstruation, it is higher than after menstruation. The content of iron in the blood serum in the first weeks of pregnancy is higher than in its last trimester. The level of serum iron increases on the 2nd-4th day after treatment with iron-containing drugs, and then decreases. Significant consumption of meat products on the eve of the study is accompanied by hypersideremia. These data must be taken into account when evaluating the results of a serum iron study. It is equally important to observe the technique of laboratory research, the rules of blood sampling. Thus, the test tubes in which blood is collected must first be washed with hydrochloric acid and bidistilled water.

Myelogram study reveals a moderate normoblastic reaction and a sharp decrease in the content of sideroblasts (erythrocaryocytes containing iron granules).

The iron stores in the body are judged by the results of the desferal test. In a healthy person, after intravenous administration of 500 mg of desferal, 0.8 to 1.2 mg of iron is excreted in the urine, while in a patient with iron deficiency anemia, iron excretion decreases to 0.2 mg. The new domestic drug defericolixam is identical to desferal, but circulates in the blood longer and therefore more accurately reflects the level of iron stores in the body.

Based on the level of hemoglobin, iron deficiency anemia, like other forms of anemia, is divided into severe, moderate and mild anemia. With mild iron deficiency anemia, the hemoglobin concentration is below normal, but more than 90 g / l; with moderate iron deficiency anemia, the hemoglobin content is less than 90 g / l, but more than 70 g / l; with severe iron deficiency anemia, the hemoglobin concentration is less than 70 g / l. However, clinical signs of the severity of anemia (symptoms of a hypoxic nature) do not always correspond to the severity of anemia according to laboratory criteria. Therefore, a classification of anemia according to the severity of clinical symptoms has been proposed.

According to clinical manifestations, 5 degrees of severity of anemia are distinguished:
1. anemia without clinical manifestations;
2. anemic syndrome of moderate severity;
3. severe anemic syndrome;
4. anemic precoma;
5. anemic coma.

Moderate severity of anemia is characterized by general weakness, specific signs (for example, sideropenic or signs of vitamin B12 deficiency); with a pronounced degree of severity of anemia, palpitations, shortness of breath, dizziness, etc. appear. Precomatous and comatose states can develop in a matter of hours, which is especially characteristic of megaloblastic anemia.

Modern clinical studies show that laboratory and clinical heterogeneity is observed among patients with iron deficiency anemia. So, in some patients with signs of iron deficiency anemia and concomitant inflammatory and infectious diseases, the level of serum and erythrocyte ferritin does not decrease, however, after the elimination of the exacerbation of the underlying disease, their content drops, which indicates the activation of macrophages in the processes of iron consumption. In some patients, the level of erythrocyte ferritin even increases, especially in patients with a long course of iron deficiency anemia, which leads to ineffective erythropoiesis. Sometimes there is an increase in the level of serum iron and erythrocyte ferritin, a decrease in serum transferrin. It is assumed that in these cases, the process of iron transfer to hemosynthetic cells is disrupted. In some cases, a deficiency of iron, vitamin B12 and folic acid is determined simultaneously.

Thus, even the level of serum iron does not always reflect the degree of iron deficiency in the body in the presence of other signs of iron deficiency anemia. Only the level of TIBC in iron deficiency anemia is always elevated. Therefore, not a single biochemical indicator, incl. TIA cannot be considered as an absolute diagnostic criterion for iron deficiency anemia. At the same time, the morphological characteristics of peripheral blood erythrocytes and computer analysis of the main parameters of erythrocytes are decisive in the screening diagnosis of iron deficiency anemia.

Diagnosis of iron deficiency conditions is difficult in cases where the hemoglobin content remains normal. Iron deficiency anemia develops in the presence of the same risk factors as in iron deficiency anemia, as well as in individuals with an increased physiological need for iron, especially in premature babies at an early age, in adolescents with a rapid increase in body height and weight, in blood donors, with nutritional dystrophy. At the first stage of iron deficiency, there are no clinical manifestations, and iron deficiency is determined by the content of hemosiderin in bone marrow macrophages and by the absorption of radioactive iron in the gastrointestinal tract. At the second stage (latent iron deficiency), there is an increase in the concentration of protoporphyrin in erythrocytes, a decrease in the number of sideroblasts, morphological signs appear (microcytosis, hypochromia of erythrocytes), a decrease in the average content and concentration of hemoglobin in erythrocytes, a decrease in the level of serum and erythrocyte ferritin, saturation of transferrin with iron. The level of hemoglobin in this stage remains quite high, and clinical signs are characterized by a decrease in exercise tolerance. The third stage is manifested by clear clinical and laboratory signs of anemia.

Examination of patients with iron deficiency anemia
To exclude anemia that has common features with iron deficiency anemia, and to identify the cause of iron deficiency, a complete clinical examination of the patient is necessary:

General blood analysis with the obligatory determination of the number of platelets, reticulocytes, the study of the morphology of erythrocytes.

Blood chemistry: determination of the level of iron, OZhSS, ferritin, bilirubin (bound and free), hemoglobin.

In all cases it is necessary examine bone marrow punctate before the appointment of vitamin B12 (primarily for differential diagnosis with megaloblastic anemia).

To identify the cause of iron deficiency anemia in women, a preliminary consultation with a gynecologist is required to exclude diseases of the uterus and its appendages, and in men, an examination by a proctologist to exclude bleeding hemorrhoids and a urologist to exclude prostate pathology.

There are cases of extragenital endometriosis, for example in the respiratory tract. In these cases, hemoptysis is observed; fibrobronchoscopy with histological examination of the biopsy of the bronchial mucosa allows you to establish a diagnosis.

The examination plan also includes X-ray and endoscopic examination of the stomach and intestines in order to exclude ulcers, tumors, incl. glomic, as well as polyps, diverticulum, Crohn's disease, ulcerative colitis, etc. If pulmonary siderosis is suspected, radiography and tomography of the lungs are performed, sputum examination for alveolar macrophages containing hemosiderin; in rare cases, a histological examination of a lung biopsy is necessary. If a kidney pathology is suspected, a general urinalysis, a blood serum test for urea and creatinine are necessary, and, if indicated, an ultrasound and X-ray examination of the kidneys. In some cases, it is necessary to exclude endocrine pathology: myxedema, in which iron deficiency can develop a second time due to damage to the small intestine; polymyalgia rheumatica is a rare connective tissue disease in older women (less often in men), characterized by pain in the muscles of the shoulder or pelvic girdle without any objective changes in them, and in the blood test - anemia and an increase in ESR.

Differential diagnosis of iron deficiency anemia
When making a diagnosis of iron deficiency anemia, it is necessary to make a differential diagnosis with other hypochromic anemias.

Iron-redistributive anemia is a fairly common pathology and, in terms of frequency of development, ranks second among all anemias (after iron deficiency anemia). It develops in acute and chronic infectious and inflammatory diseases, sepsis, tuberculosis, rheumatoid arthritis, liver diseases, oncological diseases, ischemic heart disease, etc. The mechanism for the development of hypochromic anemia in these conditions is associated with the redistribution of iron in the body (it is located mainly in the depot) and a violation mechanism for the recycling of iron from the depot. In the above diseases, the activation of the macrophage system occurs, when macrophages, under conditions of activation, firmly retain iron, thereby disrupting the process of its reutilization. In the general blood test, a moderate decrease in hemoglobin is noted (The main difference from iron deficiency anemia is:
- elevated serum ferritin, indicating an increased iron content in the depot;
- the level of serum iron may remain within normal limits or be moderately reduced;
- TIBC remains within normal limits or decreases, which indicates the absence of serum Fe-starvation.

Iron-saturated anemia develops as a result of impaired heme synthesis, which is due to heredity or may be acquired. Heme is formed from protoporphyrin and iron in erythrokaryocytes. With iron-saturated anemia, there is a violation of the activity of enzymes involved in the synthesis of protoporphyrin. The consequence of this is a violation of heme synthesis. Iron that has not been used for heme synthesis is deposited as ferritin in bone marrow macrophages, as well as in the form of hemosiderin in the skin, liver, pancreas, and myocardium, resulting in secondary hemosiderosis. Anemia, erythropenia, and a decrease in color index will be recorded in the general blood test.

The indicators of iron metabolism in the body are characterized by an increase in the concentration of ferritin and the level of serum iron, normal indicators of TIBC, and an increase in the saturation of transferrin with iron (in some cases it reaches 100%). Thus, the main biochemical indicators that allow assessing the state of iron metabolism in the body are ferritin, serum iron, TIBC, and % saturation of transferrin with iron.

The use of indicators of iron metabolism in the body allows the clinician to:
- to identify the presence and nature of violations of iron metabolism in the body;
- identify the presence of iron deficiency in the body at the preclinical stage;
- to carry out differential diagnostics of hypochromic anemias;
- evaluate the effectiveness of the therapy.

Treatment of iron deficiency anemia

In all cases of iron deficiency anemia, it is necessary to establish the immediate cause of this condition and, if possible, eliminate it (most often, eliminate the source of blood loss or treat the underlying disease complicated by sideropenia).

Treatment of iron deficiency anemia should be pathogenetically substantiated, comprehensive and aimed not only at eliminating anemia as a symptom, but also at eliminating iron deficiency and replenishing its reserves in the body.

Treatment program for iron deficiency anemia:
- elimination of the cause of iron deficiency anemia;
- medical nutrition;
- ferrotherapy;
- prevention of relapses.

Patients with iron deficiency anemia are recommended a varied diet, including meat products (veal, liver) and vegetable products (beans, soybeans, parsley, peas, spinach, dried apricots, prunes, pomegranates, raisins, rice, buckwheat, bread). However, it is impossible to achieve an antianemic effect with diet alone. Even if the patient eats high-calorie foods containing animal protein, iron salts, vitamins, microelements, iron absorption can be achieved no more than 3-5 mg per day. It is necessary to use iron preparations. Currently, the doctor has a large arsenal of iron preparations, characterized by different composition and properties, the amount of iron they contain, the presence of additional components that affect the pharmacokinetics of the drug, and various dosage forms.

According to the recommendations developed by WHO, when prescribing iron preparations, preference is given to preparations containing ferrous iron. The daily dose should reach 2 mg/kg of elemental iron in adults. The total duration of treatment is at least three months (sometimes up to 4-6 months). An ideal iron-containing preparation should have a minimum number of side effects, have a simple regimen of administration, the best ratio of effectiveness / price, optimal iron content, preferably the presence of factors that enhance absorption and stimulate hematopoiesis.

Indications for parenteral administration of iron preparations occur with intolerance to all oral preparations, malabsorption (ulcerative colitis, enteritis), peptic ulcer of the stomach and duodenum during an exacerbation, with severe anemia and the vital need for rapid replenishment of iron deficiency. The effectiveness of iron preparations is judged by changes in laboratory parameters over time. By the 5th-7th day of treatment, the number of reticulocytes increases by 1.5-2 times compared with the initial data. Starting from the 10th day of therapy, the hemoglobin content increases.

Taking into account the prooxidant and lysosomotropic effect of iron preparations, their parenteral administration can be combined with intravenous drip administration of rheopolyglucin (400 ml once a week), which allows protecting the cell and avoiding overload of macrophages with iron. Taking into account significant changes in the functional state of the erythrocyte membrane, activation of lipid peroxidation and a decrease in the antioxidant protection of erythrocytes in iron deficiency anemia, it is necessary to introduce antioxidants, membrane stabilizers, cytoprotectors, antihypoxants, such as a-tocopherol up to 100-150 mg per day (or ascorutin, vitamin A, vitamin C, lipostabil, methionine, mildronate, etc.), and also combined with vitamins B1, B2, B6, B15, lipoic acid. In some cases, it is advisable to use ceruloplasmin.

List of drugs that are used in the treatment of iron deficiency anemia: 14.11.2019

Experts agree that it is necessary to attract public attention to the problems of cardiovascular diseases. Some of them are rare, progressive and difficult to diagnose. These include, for example, transthyretin amyloid cardiomyopathy.

14.10.2019

On October 12, 13 and 14, Russia is hosting a large-scale social campaign for a free blood coagulation test - “INR Day”. The action is timed to coincide with World Thrombosis Day.

07.05.2019

The incidence of meningococcal infection in the Russian Federation in 2018 (compared to 2017) increased by 10% (1). One of the most common ways to prevent infectious diseases is vaccination. Modern conjugate vaccines are aimed at preventing the occurrence of meningococcal disease and meningococcal meningitis in children (even very young children), adolescents and adults.

Viruses not only hover in the air, but can also get on handrails, seats and other surfaces, while maintaining their activity. Therefore, when traveling or in public places, it is advisable not only to exclude communication with other people, but also to avoid ...

Returning good vision and saying goodbye to glasses and contact lenses forever is the dream of many people. Now it can be made a reality quickly and safely. New opportunities for laser vision correction are opened by a completely non-contact Femto-LASIK technique.

Interesting Facts

• The first documented mention of iron deficiency anemia dates back to 1554. In those days, this disease mainly affected girls aged 14-17, in connection with which the disease was called “de morbo virgineo”, which means “virgin disease”.
• The first attempts to treat the disease with iron preparations were made in 1700.
• Latent ( hidden) iron deficiency can occur in children during a period of intensive growth.
• The iron requirement of a pregnant woman is twice that of two healthy adult men.
• During pregnancy and childbirth, a woman loses more than 1 gram of iron. With normal nutrition, these losses will be restored only after 3-4 years.

What are erythrocytes?

Structure and function of erythrocytes

More than 95% of the intracellular space of the erythrocyte is filled with hemoglobin - a substance consisting of the protein globin and the non-protein component - heme. The hemoglobin molecule consists of four globin chains, each of which has a heme in the center. Each red blood cell contains over 300 million hemoglobin molecules.

The non-protein part of hemoglobin, namely the iron atom, which is part of the heme, is responsible for transporting oxygen in the body. Enrichment of blood with oxygen oxygenation) occurs in the pulmonary capillaries, when passing through which each iron atom attaches 4 oxygen molecules to itself ( oxyhemoglobin is formed). Oxygenated blood is carried through the arteries to all tissues of the body, where oxygen is transferred to the cells of organs. Instead, carbon dioxide is released from the cells ( by-product of cellular respiration), which attaches to hemoglobin ( carbhemoglobin is formed) and is transported through the veins to the lungs, where it is released into the environment along with the exhaled air.

In addition to the transport of respiratory gases, additional functions of red blood cells are:

• antigenic function. Erythrocytes have their own antigens, which determine belonging to one of the four main blood groups ( according to the AB0 system).
• transport function. To the outer surface of the erythrocyte membrane antigens of microorganisms, various antibodies and some medications can be attached, which are carried with the bloodstream throughout the body.
• buffer function. Hemoglobin is involved in maintaining the acid-base balance in the body.
• Stop bleeding. Erythrocytes are included in the thrombus, which is formed when the vessels are damaged.

RBC formation

The normal process of erythropoiesis requires:

• Iron. This trace element is part of the heme ( non-protein part of the hemoglobin molecule) and has the ability to reversibly bind oxygen and carbon dioxide, which determines the transport function of erythrocytes.
• Vitamins ( B2, B6, B9 and B12). Regulate the formation of DNA in the hematopoietic cells of the red bone marrow, as well as the processes of differentiation ( maturation) erythrocytes.
• Erythropoietin. A hormonal substance produced by the kidneys that stimulates the formation of red blood cells in the red bone marrow. With a decrease in the concentration of red blood cells in the blood, hypoxia develops ( lack of oxygen), which is the main stimulator of erythropoietin production.

In the process of becoming an erythrocyte, the stem cell undergoes a number of changes. It decreases in size, gradually loses the nucleus and almost all organelles ( as a result of which its further division becomes impossible), and also accumulates hemoglobin. The final step in erythropoiesis in the red bone marrow is the reticulocyte ( immature erythrocyte). It is washed out of the bones into the peripheral bloodstream, and during the day it matures to the stage of a normal erythrocyte, capable of fully performing its functions.

RBC destruction

When an erythrocyte is destroyed, hemoglobin is released from it, which quickly breaks down into protein and non-protein parts. Globin undergoes a series of transformations, resulting in the formation of a yellow pigment complex - bilirubin ( unbound form). It is insoluble in water and highly toxic ( able to penetrate into the cells of the body, disrupting their vital processes). Bilirubin is rapidly transported to the liver, where it binds to glucuronic acid and is excreted along with bile.

The non-protein part of hemoglobin ( gem) is also destroyed, resulting in the release of free iron. It is toxic to the body, so it quickly binds to transferrin ( blood transport protein). Most of the iron released during the destruction of red blood cells is transported to the red bone marrow, where it is reused for the synthesis of red blood cells.

What is iron deficiency anemia?

The body of an adult contains about 4 grams of iron. This figure varies by gender and age.

The concentration of iron in the body is:

• in newborns - 75 mg per 1 kilogram of body weight ( mg/kg);
• in men - more than 50 mg / kg;
• in women - 35 mg / kg ( associated with monthly blood loss).

• erythrocyte hemoglobin - 57%;
• muscles - 27%;
• liver - 7 - 8%.

The absorption of iron in the human body occurs mainly in the duodenum, while all iron entering the body is usually divided into heme ( bivalent, Fe +2), contained in the meat of animals and birds, in fish, and non-heme ( trivalent, Fe +3), the main source of which are dairy products and vegetables. An important condition necessary for the normal absorption of iron is a sufficient amount of hydrochloric acid, which is part of the gastric juice. With a decrease in its amount, the absorption of iron slows down significantly.

The absorbed iron binds to transferrin and is transported to the red bone marrow, where it is used for the synthesis of red blood cells, as well as to depot organs. Iron stores in the body are mainly represented by ferritin, a complex consisting of the protein apoferritin and iron atoms. Each ferritin molecule contains an average of 3-4 thousand iron atoms. With a decrease in the concentration of this trace element in the blood, it is released from ferritin and used for the needs of the body.

The rate of absorption of iron in the intestine is strictly limited and cannot exceed 2.5 mg per day. This amount is only enough to restore the daily loss of this trace element, which is normally about 1 mg in men and 2 mg in women. Therefore, under various pathological conditions, accompanied by impaired absorption of iron or increased losses, a deficiency of this microelement may develop. With a decrease in the concentration of iron in plasma, the amount of hemoglobin synthesized decreases, as a result of which the resulting red blood cells will be smaller. In addition, the growth processes of erythrocytes are disrupted, which leads to a decrease in their number.

Causes of iron deficiency anemia

The cause of iron deficiency in the body can be:

• insufficient intake of iron from food;
• increasing the body's need for iron;
• congenital iron deficiency in the body;
• iron absorption disorder;
• disruption of transferrin synthesis;
• increased blood loss;
• the use of medicines.

Insufficient intake of iron from food

The main reasons for insufficient intake of iron in the body are:

• prolonged fasting;
• monotonous diet with a low content of animal products.

Increased body needs for iron

Although some iron is retained during pregnancy ( due to lack of menstrual bleeding), the need for it increases several times.

Causes of increased iron requirements in pregnant women

Thus, during the time of bearing and breastfeeding one child, a woman loses at least 1 gram of iron. These figures increase with multiple pregnancy, when 2, 3 or more fetuses can develop simultaneously in the mother's body. Given that the rate of iron absorption cannot exceed 2.5 mg per day, it becomes clear that almost any pregnancy is accompanied by the development of an iron deficiency state of varying severity.

Congenital iron deficiency in the body

The cause of congenital iron deficiency in the body can be:

• severe iron deficiency anemia in the mother;
• multiple pregnancy;
• prematurity.

Iron malabsorption

To reduce the absorption of iron in the duodenum can lead to:

• Enteritis - inflammation of the mucous membrane of the small intestine.
• celiac disease a hereditary disease characterized by gluten protein intolerance and associated malabsorption in the small intestine.
• Helicobacter pylori- an infectious agent that affects the gastric mucosa, which ultimately leads to a decrease in the secretion of hydrochloric acid and malabsorption of iron.
• Atrophic gastritis - disease associated with atrophy reduction in size and function) of the gastric mucosa.
• Autoimmune gastritis - a disease caused by a malfunction of the immune system and the production of antibodies to its own cells of the gastric mucosa, followed by their destruction.
• Removal of the stomach and / or small intestine - at the same time, both the amount of hydrochloric acid formed and the functional area of ​​the duodenum, where iron is absorbed, decreases.
• Crohn's disease - an autoimmune disease, manifested by an inflammatory lesion of the mucous membrane of all parts of the intestine and, possibly, the stomach.
• Cystic fibrosis - a hereditary disease manifested by a violation of the secretion of all glands of the body, including the gastric mucosa.
• Cancer of the stomach or duodenum.

Disruption of transferrin synthesis

Since transferrin is synthesized only in liver cells, various liver lesions ( cirrhosis, hepatitis and others) can also lead to a decrease in the plasma concentration of this protein and the development of symptoms of iron deficiency anemia.

Increased blood loss

The cause of chronic blood loss can be:

• nonspecific ulcerative colitis ( inflammation of the intestinal mucosa);
• intestinal polyposis;
• disintegrating tumors of the gastrointestinal tract ( and other localization);
• hiatal hernia;
• endometriosis ( proliferation of cells in the inner layer of the uterine wall);
• systemic vasculitis ( inflammation of blood vessels of various localization);
• blood donation by donors more than 4 times a year ( 300 ml of donated blood contains about 150 mg of iron).

Alcoholism

The use of drugs

Drugs that can cause iron deficiency in the body are:

• Non-steroidal anti-inflammatory drugs ( aspirin and others). The mechanism of action of these drugs is associated with an improvement in blood flow, which can lead to chronic internal bleeding. In addition, they contribute to the development of stomach ulcers.
• Antacids ( Rennie, Almagel). This group of drugs neutralizes or reduces the rate of secretion of gastric juice containing hydrochloric acid, which is necessary for the normal absorption of iron.
• Iron-binding drugs ( Desferal, Exjade). These drugs have the ability to bind and remove iron from the body, both free and included in the composition of transferrin and ferritin. In case of an overdose, the development of an iron deficiency state is possible.

Symptoms of iron deficiency anemia

Manifestations of iron deficiency anemia are:

• muscle weakness;
• increased fatigue;
• cardiopalmus;
• changes in the skin and its appendages ( hair, nails);
• damage to the mucous membranes;
• language loss;
• violation of taste and smell;
• susceptibility to infectious diseases;
• intellectual development disorders.

Muscle weakness and fatigue

Shortness of breath and palpitations

Changes in the skin and its appendages

Hair becomes thinner, loses its usual shine, becomes less durable, breaks easily and falls out. Gray hair appears early.

Nail involvement is a very specific manifestation of iron deficiency anemia. They become thinner, acquire a matte shade, exfoliate and break easily. Characteristic is the transverse striation of the nails. With a pronounced iron deficiency, koilonychia can develop - the edges of the nails rise and bend in the opposite direction, acquiring a spoon-shaped shape.

Mucosal damage

Iron deficiency anemia affects:

• The mucous membrane of the oral cavity. It becomes dry, pale, areas of atrophy appear. Difficulty chewing and swallowing food. Also characteristic are the presence of cracks on the lips, the formation of jamming in the corners of the mouth ( cheilosis). In severe cases, the color changes and the strength of the tooth enamel decreases.
• The mucous membrane of the stomach and intestines. Under normal conditions, the mucous membrane of these organs plays an important role in the absorption of food, and also contains many glands that produce gastric juice, mucus and other substances. With its atrophy ( caused by iron deficiency) digestion is disturbed, which can be manifested by diarrhea or constipation, abdominal pain, and malabsorption of various nutrients.
• The mucous membrane of the respiratory tract. Damage to the larynx and trachea can be manifested by perspiration, a feeling of having a foreign body in the throat, which will be accompanied by an unproductive ( dry, no moisture) cough. In addition, the mucous membrane of the respiratory tract normally performs a protective function, preventing foreign microorganisms and chemicals from entering the lungs. With its atrophy, the risk of developing bronchitis, pneumonia and other infectious diseases of the respiratory system increases.
• The mucous membrane of the genitourinary system. Violation of its function can be manifested by pain during urination and during sexual intercourse, urinary incontinence ( more common in children), as well as frequent infectious diseases in the affected area.

Tongue lesion

Taste and smell disorders

Olfactory disturbances can be manifested by olfactory hallucinations ( smells that aren't really there) or addiction to unusual smells ( varnish, paint, gasoline and others).

Tendency to infectious diseases
With iron deficiency, the formation of not only erythrocytes is disrupted, but also leukocytes - the cellular elements of the blood that protect the body from foreign microorganisms. The lack of these cells in the peripheral blood increases the risk of developing various bacterial and viral infections, which increases even more with the development of anemia and impaired blood microcirculation in the skin and other organs.

Intellectual Development Disorders

Diagnosis of iron deficiency anemia

It is important to note that the treatment of iron deficiency anemia will be ineffective if the cause of its occurrence is not identified and eliminated.

In the diagnosis of iron deficiency anemia is used:

• questioning and examination of the patient;
• bone marrow puncture.

Questioning and examining the patient

The doctor may ask the following questions:

• When and in what sequence did the symptoms of the disease begin to appear?
• How fast did they develop?
• Do family members or close relatives have similar symptoms?
• How is the patient eating?
• Does the patient suffer from any chronic diseases?
• What is your attitude towards alcohol?
• Has the patient taken any medication in the past months?
• If a pregnant woman is sick, the gestational age, the presence and outcome of previous pregnancies, and whether she takes iron supplements are specified.
• If a child is sick, his birth weight is specified, whether he was born full-term, whether the mother took iron supplements during pregnancy.

• The nature of nutrition- according to the degree of expression of subcutaneous fat.
• Skin color and visible mucous membranes- special attention is paid to the oral mucosa and tongue.
• skin appendages - hair, nails.
• muscle strength- the doctor asks the patient to squeeze his hand or uses a special device ( dynamometer).
• Arterial pressure - it can be reduced.
• Taste and smell.

General blood analysis

Blood for general analysis can be taken from a finger or from a vein. The first option is more suitable if the general analysis is the only laboratory test assigned to the patient ( when a small amount of blood is enough). Before taking blood, the skin of the finger is always treated with cotton wool soaked in 70% alcohol to avoid infection. The puncture is made with a special disposable needle ( scarifier) to a depth of 2–3 mm. Bleeding in this case is not strong and completely stops almost immediately after taking blood.

In the event that it is planned to perform several studies at once ( e.g. general and biochemical analysis) - take venous blood, as it is easier to obtain in large quantities. Before blood sampling, a rubber tourniquet is applied to the middle third of the upper arm, which leads to the filling of the veins with blood and makes it easier to determine their location under the skin. The puncture site should also be treated with an alcohol solution, after which the nurse pierces the vein with a disposable syringe and collects blood for analysis.

The blood obtained by one of the described methods is sent to the laboratory, where it is examined in a hematological analyzer - a modern high-precision device available in most laboratories in the world. Part of the received blood is stained with special dyes and examined under a light microscope, which allows you to visually assess the shape of erythrocytes, their structure, and in the absence or malfunction of a hematological analyzer, to count all the cellular elements of the blood.

In iron deficiency anemia, a peripheral blood smear is characterized by:

• Poikilocytosis - the presence in the smear of erythrocytes of various forms.
• Microcytosis - the predominance of erythrocytes, the size of which is less than normal ( normal erythrocytes may also occur).
• Hypochromia - the color of red blood cells changes from bright red to pale pink.

The results of a complete blood count for iron deficiency anemia

Blood chemistry

There are several dozens of biochemical indicators determined in the blood. In this section, only those of them that are relevant in the diagnosis of iron deficiency anemia will be described.

Biochemical blood test for iron deficiency anemia

Puncture of the bone marrow

At the onset of the disease, there will be no changes in the bone marrow punctate. With the development of anemia, there may be an increase in the erythroid germ of hematopoiesis ( an increase in the number of erythrocyte progenitor cells).

To identify the cause of iron deficiency anemia, the following is used:

• analysis of feces for the presence of occult blood;
• x-ray examination;
• endoscopic studies;
• advice from other experts.

Examination of feces for the presence of occult blood

Massive single bleeding practically does not lead to the development of iron deficiency anemia, as they are quickly diagnosed and eliminated. In this regard, the danger is represented by long-term, small-volume blood loss that occurs during damage ( or ulceration) small vessels of gastrointestinal waste. In this case, it is possible to detect blood in the feces only with the help of a special study, which is prescribed in all cases of anemia of unknown origin.

X-ray studies

Before conducting the study, it is necessary to exclude food intake for the last 8 hours, and when examining the lower intestines, cleansing enemas are prescribed.

Endoscopy

In order to determine the cause of iron deficiency anemia, the following is used:

• Fibroesophagogastroduodenoscopy ( FEGDS) – introduction of the endoscope through the mouth and examination of the mucous membrane of the esophagus, stomach and upper intestines.
• Sigmoidoscopy - examination of the rectum and lower sigmoid colon.
• Colonoscopy - study of the mucous membrane of the large intestine.
• Laparoscopy - piercing the skin of the anterior wall of the abdomen and inserting an endoscope into the abdominal cavity.
• Colposcopy - examination of the vaginal part of the cervix.

Consultations of other specialists

Consultation may be needed to identify the cause of iron deficiency anemia:

• Nutritionist - upon detection of malnutrition.
• Gastrologist - if you suspect the presence of an ulcer or other diseases of the gastrointestinal tract.
• Surgeon - in the presence of bleeding from the gastrointestinal tract or other localization.
• Oncologist - if you suspect a tumor of the stomach or intestines.
• Obstetrician-gynecologist - if there are signs of pregnancy.

Treatment of iron deficiency anemia

Diet for iron deficiency anemia

Approximate iron content in various foods

Treatment of iron deficiency anemia with medicines

Tablets are the method of choice. Parenteral ( intravenous or intramuscular) the introduction of iron is prescribed if it is impossible to fully absorb this microelement in the intestine ( for example, after removing part of the duodenum), it is necessary to quickly replenish iron stores ( with massive hemorrhage) or with the development of adverse reactions from the use of oral forms of the drug.

Drug therapy for iron deficiency anemia

Substances affecting the absorption of iron

RBC transfusion

Indications for erythrocyte transfusion are:

• massive blood loss;
• decrease in hemoglobin concentration less than 70 g/l;
• sustained decrease in systolic blood pressure ( below 70 millimeters of mercury);
• upcoming surgery;
• forthcoming birth.

Prognosis for iron deficiency anemia

The cause of difficulties in the treatment of iron deficiency anemia may be:

• misdiagnosis;
• unknown cause of iron deficiency;
• late treatment;
• taking insufficient doses of iron preparations;
• violation of the regimen of medication or diet.

Complications of iron deficiency anemia can include:

• Lagging behind in growth and development. This complication is typical for children. It is caused by ischemia and related changes in various organs, including brain tissue. There is both a delay in physical development and a violation of the intellectual abilities of the child, which, with a long course of the disease, may be irreversible.
into the bloodstream and body tissues), which is especially dangerous in children and the elderly.

Iron deficiency anemia is a syndrome caused by iron deficiency and leading to impaired hemoglobinopoiesis and tissue hypoxia. It occurs, as a rule, with chronic blood loss or insufficient intake of iron in the body. Manifestations of iron deficiency are present in 60% of the adult population after 50 years. Symptoms of iron deficiency anemia in the latent period are often overlooked or mistaken for other diseases.

Causes

Iron deficiency anemia (IDA) used to be better known as anemia. It is the most common pathology of the blood system and the most common.

Code according to the international classification of diseases ICD-10: iron deficiency anemia - D50.

According to the WHO (World Health Organization), more than 2 billion people on the planet have an iron deficiency in the body. Iron is part of most enzymes, is the main component of hemoglobin. Without it, the hematopoietic process and respiration, various vital oxidative and reducing reactions are impossible.

The development of iron deficiency and subsequent anemia can be due to various mechanisms. Most often, iron deficiency anemia is caused by chronic blood loss:

• profuse menstruation,
• dysfunctional uterine bleeding;
• gastrointestinal bleeding from erosions of the mucous membrane of the stomach and intestines,
• gastroduodenal ulcers,
• hemorrhoids,
• anal fissures, etc.

The main causes of deficiency in the body are:

• unbalanced diet (malnutrition can lead to the development of iron deficiency anemia in both children and adults);
• lack of vitamins;
• increased need for iron;
• diseases of the gastrointestinal tract.

The cause of congenital iron deficiency in the body can be:

• severe iron deficiency anemia in the mother;
• multiple pregnancy;
• prematurity.

With prolonged chronic infections (tuberculosis,) iron molecules are captured by immune cells, and a deficiency is found in the blood.

Older people often suffer from a lack of iron in the body, and this is understandable: there is a natural degradation of hematopoietic functions, in addition, various diseases cause blood loss - for example, infections and inflammations, ulcers and erosion.

The role of iron in the human body

Among the trace elements necessary for the life of our body and full health, iron is one of the most important. Without iron, the formation of hemoglobin and myoglobin, red blood cells and muscle pigment, cannot occur.

The function of iron is the transport of oxygen from the lungs through the circulatory system to all organs and tissues of the body. With a lack of this trace element, the body as a whole suffers.

A deficiency of this substance in the body may occur in the event of development of changes in the digestive system, for example, it may be with low acidity or dysbacteriosis.

The main places where iron is found in the body are:

• erythrocyte hemoglobin - 57%;
• muscles - 27%;
• liver - 7 - 8%.

There are many reasons for iron deficiency: strict diets, rejection of meat foods, intense physical activity, sports training, pregnancy and breastfeeding. The body experiences a sharp lack of iron during blood loss, surgical interventions.

The body of an adult contains about 4 grams of iron. This figure varies by gender and age.

The normal level of iron in the blood is:

• in babies up to 24 months - from 7.00 to 18.00 µmol / l;
• in adolescents 14 years old - from 9.00 to 22.00;
• for adult men - from 11.00 to 31.00;
• for adult women - from 9.00 to 30.00.

In order not to provoke iron deficiency anemia, it is enough to ensure the intake of iron with food in the amount of 2 g per day, since just such a volume of iron is excreted from the body every day.

Infants and young children need a lot of iron because they grow quickly. Iron deficiency can lead to anemia.

The causes of iron deficiency in a child can be:

• pathology of pregnancy, in which the supply of iron to the fetus is disturbed (toxicosis, the threat of interruption, illness or anemia of the mother during pregnancy);
• prematurity, multiple pregnancy;
• early artificial feeding, feeding with cow or goat milk, unbalanced nutrition of the baby;
• increased growth rates (in premature babies, children with large body weight at birth, in the second half of the year and in the second year of life);
• bleeding (including in some girls during the formation of the menstrual cycle) or malabsorption in the intestine (chronic enteritis, hereditary syndromes).

Symptoms of iron deficiency anemia

The basis of all clinical manifestations of iron deficiency anemia is iron deficiency, which develops in cases where the loss of iron exceeds its intake with food (2 mg / day). Initially, iron stores in the liver, spleen, and bone marrow decrease, which is reflected in a decrease in the level of ferritin in the blood.

According to the time of development of iron deficiency anemia, there are:

• Congenital form, the symptoms of which appear from the first days of life and worsen with age.
• The acquired form, the manifestations of which develop after the action of etiological factors.

During the period of latent iron deficiency, many subjective complaints and clinical signs characteristic of iron deficiency anemia appear. Patients note:

• general weakness,
• malaise,
• decrease in performance.

Already during this period, there may be a perversion of taste, dryness and tingling of the tongue, a violation of swallowing with a sensation of a foreign body in the throat, palpitations, shortness of breath.

If the patient has a moderate decrease in the amount of iron, then he retains his ability to work for a long time and certain symptoms appear only with excessive physical activity.

In addition to the general signs characteristic of anemia, IDA is manifested by:

• low blood pressure against the background of a rapid pulse;
• pallor and dryness of the skin;
• peculiar taste preferences, expressed in eating raw meat and chalk;
• brittle nails and hair loss.

In the presence of the above symptoms, it is necessary to consult a specialist and pass a general and biochemical blood test.

Stages and degrees

In the formation of iron deficiency states, the rate of development of the process, the stage of the course of the disease and the degree of compensation are of great importance, because IDA has different causes and can come from another disease (for example, repeated bleeding in or 12 duodenal ulcer, gynecological pathology or chronic infections).

Iron deficiency anemia is:

• with a mild degree, the hemoglobin index is reduced, but remains about 90 g / l;
• with an average degree, hemoglobin is kept in the range from 90 to 70 g / l;
• in severe hemoglobin is less than 70 g / l.

In order to more adequately determine the severity of the disease, a classification was adopted:

• Without clinical symptoms;
• Moderate expression;
• Severe anemic syndrome;
• Precoma;
• Coma.

Symptoms of iron deficiency anemia depend on the stage of the disease:

1 stage

There are no clinical manifestations in the first stage of iron deficiency.

Latent stage

The latent stage is observed with a decrease in the concentration of the serum trace element. Laboratory blood tests show in this situation an increase in the level of transferrin with a decrease in the number of sideroblasts in the bone marrow.

The level of hemoglobin in this stage remains quite high, and clinical signs are characterized by a decrease in exercise tolerance.

With the progression of iron deficiency, the symptoms worsen:

• increasing weakness (may develop urinary incontinence);
• morning dizziness up to fainting (fainting can also occur with prolonged mild iron deficiency);
• perversion of taste (the desire to eat chalk, earth, ash, smell paint, gasoline, etc.);
• palpitations, shortness of breath (develop even after minimal exercise).

Stage 3 IDA

Severe clinical manifestations that combine the two previous syndromes. Clinical manifestations occur due to oxygen starvation of tissues, and are found in the form of:

• tinnitus,
• tachycardia,
• fainting states,
• dizziness,
• asthenic syndrome, etc.

Complications

Complications occur with a long course of anemia without treatment and reduce the quality of life. The following complications may develop:

• lag in growth and development, which is especially characteristic of childhood;
• anemic coma;
• complications of an infectious nature;
• insufficiency of internal organs.

Diagnostics

A doctor of any specialty can suspect the presence of anemia in a person, based on the external manifestations of this disease. However, establishing the type of anemia, identifying its cause and prescribing appropriate treatment should be handled by a hematologist.

General examination (the color of the skin is determined (pallor is possible); the pulse may be rapid, arterial (blood) pressure - reduced).

Diagnosis of iron deficiency anemia is based mainly on laboratory tests.

Blood analysis

A decrease in the number of red blood cells (red blood cells, the norm is 4.0-5.5x10 9 / liter), a decrease in the level of hemoglobin (a special compound inside the red blood cells that carries oxygen, the norm is 130-160 g / l) can be determined.

Blood chemistry

With the development of IDA in a biochemical blood test, the following will be recorded:

• decrease in serum ferritin concentration;
• decrease in serum iron concentration;
• increase in OZhSS;
• decrease in transferrin saturation with iron.

Treatment

The main principles of the treatment of iron deficiency anemia include the elimination of etiological factors, correction of the diet, replenishment of iron deficiency in the body. Etiotropic treatment is prescribed and carried out by specialists gastroenterologists, gynecologists, proctologists, etc.; pathogenetic – by hematologists.

Treatment program for iron deficiency anemia:

• elimination of the cause of the disease;
• medical nutrition;
• ferrotherapy;
• relapse prevention.

The intake of iron with food can only compensate for its normal daily loss. The use of iron preparations is a pathogenetic method for the treatment of iron deficiency anemia. Currently, preparations containing ferrous iron (Fe ++) are used, since it is much better absorbed in the intestine. Iron supplements are usually taken orally.

Mandatory appointment of iron preparations: in the first three months of treatment of anemia - in therapeutic doses, later - in preventive doses. Iron preparations are administered orally between meals, washed down with fresh fruit juices or water, and should not be taken with milk.

Iron preparations should not be taken with milk, tea or coffee - these products bind iron and reduce its flow into the blood. Taking iron supplements can cause:

• nausea,
• vomiting,
• stomach ache,
• constipation,
• blackening of the teeth (if drugs are used in the form of drops).

List of drugs that are used in the treatment of iron deficiency anemia:

• Zhektofer (Jectofer);
• Conferon (Conferon);
• Maltofer (Maltofer);
• Sorbifer durules (Sorbifer durules);
• Tardiferon (Tardiferon);
• Feramid (Ferramidum);
• Ferro-gradumet (Ferro-gradumet);
• Ferroplex (Ferroplex);
• Ferroceron (Ferroceronum);
• Ferrum lek (Ferrum lek).
• Totem (tothema)

Manifestations of side effects from taking drugs are:

• metallic taste in the mouth;
• darkening of teeth and gums;
• pain in the epigastrium;
• dyspeptic disorders due to irritation of the gastrointestinal mucosa (nausea, belching, vomiting, diarrhea, constipation);
• dark staining of the stool;
• allergic reactions (more often by the type of urticaria);
• necrosis of the intestinal mucosa (with overdose or poisoning with saline FP).

Severe iron deficiency anemia, which is treated in a hospital, requires establishing the cause of iron loss. Simultaneously with the elimination of the causes, the pathological symptoms of the disease are eliminated.

Injectable drugs are used exclusively in a hospital (it is necessary to be able to provide anti-shock assistance), they are contraindicated during pregnancy and lactation.

• venofer (the solution is strictly for intravenous administration, the dose and rate of administration are calculated individually).
• kosmofer (solution for intravenous and intramuscular injection, the calculation of the dose and route of administration is made individually).
• ferrinject (solution for intravenous or dialysis system administration).

Nutrition and diet for IDA

The goal pursued by therapeutic nutrition for anemia is to provide the body with all the nutrients, vitamins and trace elements, in particular iron, which is necessary to increase the level of hemoglobin.

This diet increases the body's defenses, restores its functions and improves the patient's quality of life.

The body may lack both heme and non-heme iron:

1. Heme iron is found in animal products. Of these products, our body absorbs up to 35% of the desired trace element.
2. Non-heme iron is legumes, seeds and nuts (pumpkin, sesame), dried fruits (raisins, dried apricots), dark-colored vegetables, iron-fortified breakfast cereals.

Improves the absorption of iron from fruits and cereals ascorbic and lactic acid, so the simultaneous intake of foods such as meat, legumes or cereals, fruits and vegetables is recommended. Sometimes a diet is a complete way to treat the initial forms of iron deficiency anemia.

The diet of children and adolescents should be varied, healthy and tasty; it is necessary to ensure that it always contains products of animal and vegetable origin, containing a sufficient amount of iron.

Do not attempt to treat iron deficiency anemia in children with diet or supplements.

Phytotherapy is quite acceptable as an addition to treatment, but will not replace iron supplements. The collections are most often used:

• nettle - it increases blood clotting and reduces bleeding;
• strawberries - the microelements included in its composition stimulate hematopoiesis;
• rose hips - contain a large amount of vitamin C, which improves the absorption of iron; for the same purpose, beet juice, pomegranate, black currant juice is used.

Prevention of iron deficiency anemia

A very important point is the prevention of anemia in childhood. It includes: the correct daily routine, rational feeding, preventive courses of taking iron supplements up to 1.5 years.