Ask the Doctor: Iron Deficiency Anemia Has Many Causes, Cures

Readers: Here is the second installment of a two-part column:

Q: How can I find out if I am anemic?

A: If you believe you are anemic or your doctor suspects it from general findings on your physical exam, your doctor may perform some tests. Some of the tests include a complete blood count (CBC) to measure levels of red blood cells and hemoglobin in the blood. On average, a normal hemoglobin range should be between 12 and 18 g/dl (grams per deciliter of blood). Your doctor may also order tests to determine the size of red blood cells, serum iron levels, and iron binding capacity in the blood. Once the diagnosis of IDA is made, your doctor will identify the cause and be certain to look for reasons such as forms of cancer that must be diagnosed promptly.

Q: Who is at risk to develop iron deficiency anemia?

A: High-risk groups include women of child-bearing age who have blood loss from menstruation, pregnant or lactating women who have a greater requirement for iron, children and adolescents in rapid growth phases, and people with poor dietary intake of iron through a diet of little or no meat or eggs for several years. People who drink alcoholic beverages in excess are also at risk. Risk factors related to anemia from blood loss include peptic ulcer disease, long-term aspirin use, or colon cancer.

Q: What is the treatment for IDA?

A: Treatment of anemia varies greatly depending on the type and cause. Treatment for anemia from serious diseases such as cancer tends to focus first on addressing the underlying disease process. Treatment may also include eating a diet rich in iron containing foods such as red meats, dark meat poultry, leafy greens, beans, iron-enriched white bread, pasta, rice and cereals. The Recommended Dietary Allowance (RDA) for iron is 10 milligrams for adult males and postmenopausal females. Males (ages 11 to 18) need 12 milligrams of iron per day.

Females (ages 11-50 years) need 15 milligrams. Iron supplements such as ferrous sulfate can also be taken over several months to increase iron levels. The supplements can cause irritation of the stomach and discoloration of bowel movements so they should be taken on an empty stomach, or with orange juice to increase the absorption. If you have just started taking iron supplements, give it time before your lack of energy improves. Iron supplements often cause constipation, so to offset the side effect make sure you eat sufficient fiber and drink enough water. Always consult with your physician before starting any iron supplement.

Q: What can I do to prevent IDA?

A: The Centers for Disease Control and Prevention recommends screening girls ages 12-18 and nonpregnant women of childbearing age every 5-10 years. Pregnant women should consult with their doctor during their prenatal visit to start iron supplements. Men and postmenopausal women with diagnosed IDA need a complete evaluation for sources of blood loss to rule out malignancy (or forms of cancer). Everybody’s diet should contain foods rich in iron and if not you should consult with your doctor to start an iron supplement.

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Submit questions to Dr. Bharat Sangani at bsangani@encore.bz or 5601 Sound Bluff Road, Ocean Springs, MS 39564. Sangani also would like to hear from physicians interested in contributing to this column.

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(c) 2006, The Sun Herald (Biloxi, Miss.).

Visit The Sun Herald Online at http://www.sunherald.com/

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