Iron deficiency anemia is a syndrome caused by
iron deficiency and leading to impaired hemoglobinopoiesis and
tissue hypoxia. Arises, as a rule, at chronic loss
blood or insufficient iron intake
an organism. Manifestations of iron deficiency are present in 60% of adults.
population after 50 years. Symptoms of iron deficiency anemia in latent
The period is often overlooked or taken for other diseases.
Iron deficiency anemia (IDA) used to be better known as
anemia. Is the most common pathology of the system
blood and the most common anemia.
The code for the international classification of diseases ICD-10:
iron deficiency anemia – D50.
According to WHO (World Health Organization), more than 2
billion people on the planet have iron deficiency
the body. Iron is found in most enzymes,
is the main component of hemoglobin. Without it impossible
hematopoietic process and respiration, various vital
oxidative and reducing reactions.
The development of iron deficiency and subsequent anemia can be
due to different mechanisms. Most often iron deficiency
anemia caused by chronic blood loss:
- copious menstruation
- dysfunctional uterine bleeding;
- gastrointestinal bleeding from erosions of the gastric mucosa
- gastroduodenal ulcers,
- anal fissures, etc.
The main causes of deficiency in the body
- unbalanced diet (malnutrition can lead to
development of iron deficiency anemia in both children and
- lack of vitamins;
- increased iron requirements;
- 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;
With prolonged chronic infections (tuberculosis, sepsis,
brucellosis) iron molecules are captured by immunity cells, and in
blood deficiency is detected.
Older people are more likely to suffer from a lack of iron in the body, and
this is understandable: natural degradation occurs
hematopoietic functions, besides various diseases cause losses
blood – for example, infections and inflammation, ulcers and erosion.
The role of iron in humans
Among the trace elements necessary for the life of our
body and overall health, iron is one of the most important.
Without iron, hemoglobin cannot form and
myoglobin – red blood cells and muscle pigment.
The function of iron is the transport of oxygen from the lungs through the bloodstream.
system to all organs and tissues of the body. With a lack of it
trace element suffers the body as a whole.
A deficiency of this substance in the body can occur in
developmental changes in the digestive system, for example, it may
быть гастрит с пониженной кислотностью или дисбактериоз.
The main places of iron in the body are:
- erythrocyte hemoglobin – 57%;
- muscles – 27%;
- liver – 7 – 8%.
The causes of iron deficiency are many: strict diets
meat food, intense physical activity, sports
workouts, pregnancy and breastfeeding. Severe iron shortage
the body experiences blood loss, surgical
An adult’s body contains about 4 grams of iron.
This figure varies according to gender and age.
Нормальный уровень железа в крови составляет:
- in babies up to 24 months – from 7.00 to 18.00 µmol / l;
- adolescents 14 years of age – 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 supply of iron from food in quantities
2 g per day, because every day it is excreted from the body
volume of iron.
Infants and young children need lots of iron,
because they grow fast. Iron deficiency can lead to
Причинами дефицита железа у ребенка могут быть:
- pathology of pregnancy, in which admission is violated
железа к плоду (токсикозы, угроза прерывания, заболевания или
анемия матери во время беременности);
- prematurity, multiple fetus;
- early artificial feeding, cow or infant feeding
goat milk, unbalanced baby food;
- повышенные темпы роста (у недоношенных, детей
с большой массой тела при рождении, во втором полугодии
и на втором году жизни);
- кровотечения (в том числе у части девочек
в период становления менструального цикла) или нарушение
всасывания в кишечнике (хронические энтериты, наследственные
Симптомы железодефицитной анемии
The basis of all clinical manifestations of iron deficiency anemia
iron deficiency that develops when
iron loss exceeds its intake with food (2 mg / day).
Initially, iron reserves in the liver, spleen,
bone marrow that gets reflected in a decrease ferritin levels in
By the time of development of iron deficiency anemia emit:
- Congenital form, the symptoms of which appear from the first days
life and aggravated with age.
- Acquired form, manifestations of which develop after
action etiological factors.
In the period of latent iron deficiency, many subjective
complaints and clinical signs characteristic of iron deficiency
anemia. Patients note:
- general weakness
- decrease in working capacity.
Already during this period, there may be a perversion of taste, dryness and
tingling of the tongue, violation of swallowing with the sensation of a foreign body in
throat, palpitations, shortness of breath.
If a patient has a moderate decrease in the amount of
iron, then it retains a capacity for a long time and certain
symptoms appear only with excessive physical
In addition to common signs characteristic of anemia, IDA
- low blood pressure on the background of rapid pulse;
- paleness and dryness of the skin;
- peculiar taste preferences, expressed in eating
raw meat and chalk;
- brittle nails and hair loss.
If you have the above symptoms, you should refer to
специалисту и сдать общий и биохимический анализы blood.
Stages and degrees
In the formation of iron deficiency, great importance
has the speed of the process, the stage of the disease and the degree
compensation, because IDA has different reasons and can come from
another disease (for example, repeated bleeding from an ulcer
желудка или 12-перстной кишки, гинекологической патологии либо
Iron deficiency anemia is:
- with a mild degree, the hemoglobin index is reduced, but remains
about 90 g / l;
- with a moderate degree, hemoglobin is between 90 and 70
g / l;
- with severe hemoglobin is less than 70 g / l.
To more accurately determine the severity of the disease,
- No clinical symptoms;
- Moderate severity;
- Severe anemic syndrome;
Симптомы железодефицитной анемии зависят от стадии
At the first stage of iron deficiency clinical manifestations
Latent stage наблюдается при снижении концентрации
serum trace element. Laboratory blood tests show
in such a situation, an increase in the level of transferrin with a decrease in the number
bone marrow sideroblasts.
The hemoglobin level in this stage remains quite high, and
clinical signs are characterized by a decrease in tolerance to
With the progression of iron deficiency signs are aggravated:
- growing weakness (incontinence may develop
- morning dizziness until fainting (fainting
states can occur with long lasting
- perversion of taste (desire to eat chalk, earth, ash, sniff
paint, gasoline, etc.);
- heartbeat, shortness of breath (develop even after minimal
3 стадия ЖДА
Pronounced clinical manifestations, combining the previous two
syndrome Clinical manifestations occur due to oxygen
fasting tissues, and are found in the form:
- asthenic syndrome, etc.
Complications возникают при длительном течении анемии без лечения и
reduce the quality of life. The development of the following is possible.
- lag in growth and development, which is especially characteristic of
- anemic coma;
- infectious complications;
- insufficiency of internal organs.
A doctor of any specialty may suspect anemia.
human, based on the external manifestations of this disease.
However, establishing the type of anemia, identifying its causes and
the appointment of appropriate treatment should be engaged
General inspection (determined by the color of the skin (possible
pallor); pulse can be rapid, arterial (blood)
pressure – reduced).
Diagnostics железодефицитной анемии строится в основном на
The decrease in the number of red blood cells (red
клеток крови, норма 4.0-5,5х109/литр), уменьшение уровня
hemoglobin (a special compound inside the erythrocytes that carries
oxygen, the norm is 130-160 g / l).
With the development of IDA in the biochemical analysis of blood will
- decrease in serum ferritin concentration;
- decrease in serum iron concentration;
- increase OZHSS;
- decrease in transferrin saturation with iron.
The main principles of treatment of iron deficiency anemia include
elimination of etiological factors, dietary correction,
восполнение железодефицита в the body. Etiotropic treatment
appointed and conducted by gastroenterologists,
gynecologists, proctologists, etc .; pathogenetic –
The program for the treatment of iron deficiency anemia:
- elimination of the cause of the disease;
- health food;
- relapse prevention.
The intake of iron from food is able to fill only the normal
daily his loss. The use of iron preparations is
патогенетическим методом лечения железодефицитной anemia. AT
currently used preparations containing bivalent
железо (Fe++), так как оно значительно лучше всасывается
in the intestines. Iron preparations are usually applied by mouth.
Mandatory administration of iron preparations: in the first three months
treatment of anemia – in therapeutic doses, subsequently – in
preventive. Iron preparations are prescribed orally between doses.
food, washed down with fresh fruit juices or water, you can not drink
Iron preparations can not drink milk, tea or coffee – these
products bind iron and reduce its entry into the blood.
Taking iron supplements can cause:
- stomach ache,
- blackening of teeth (if drugs are used in the form of
List of drugs used in the treatment
iron deficiency anemia:
- Gectofer (Jectofer);
- Conference (Conferon);
- Maltofer (Maltofer);
- Sorbifer durules;
- Tardiferon (Tardiferon);
- Ferramid (Ferramidum);
- Ferro-gradumet (Ferro-gradumet);
- Ferropleks (Ferroplex);
- Ferroceron (Ferroceronum);
- Ferrum lek.
- Totem (tothema)
Manifestations of side effects from taking drugs
- metallic taste in the mouth;
- darkening of the teeth and gums;
- epigastric pain;
- dyspeptic disorders due to mucosal irritation
digestive tract membranes (nausea, belching, vomiting, diarrhea, constipation);
- dark staining of the chair;
- allergic reactions (usually by the type of urticaria);
- necrosis of the intestinal mucosa (overdose or
poisoning with salt OP).
Severe iron deficiency anemia, which is treated in
hospital requires installation causes of iron loss. At the same time with
eliminating the causes eliminate the pathological symptoms
Injectables are used exclusively in the hospital.
(you need to be able to provide anti-shock care)
contraindicated in pregnancy and lactation.
- venofer (solution strictly for intravenous administration, dose calculation and
the rate of injection is done individually).
- cosmofer (solution for intravenous and intramuscular injection, dose calculation and method
introduction is made individually).
- ferrinezhekt (solution for introduction in / in or in dialysis
Nutrition and diet while waiting
The goal pursued by therapeutic nutrition in anemia is
providing the body with all the nutrients, vitamins and
microelements, in particular, iron, which is necessary to increase
This diet increases the body’s defenses, restores
its function and improves the patient’s quality of life.
The body may lack both heme and non-heme
- Heme iron – contained in animal products
origin. Of these products, our body absorbs up to
35% of the desired trace elements.
- Non-heme iron is legumes, seeds and nuts (pumpkin, sesame),
dried fruits (raisins, dried apricots), dark-colored vegetables, enriched
iron porridge for breakfast.
|Foods containing heme iron||
Iron (mg / 100 g of product)
|Foods containing non-heme iron||Iron (mg / 100 g of product)|
|Liver paste||5.6||Jam assorted||10.0|
|Turkey meat||4.0||Mushrooms (dried)||10.0|
|Duck or Goose Meat||4.0||Dry beans||4.0-7,0|
|Fish (trout, salmon, chum)||1.2||Currant||4.5|
Improves the absorption of iron from fruits and cereals ascorbic and
lactic acid, therefore it is recommended to take such
products like meat, legumes or cereals, fruits and vegetables.
Sometimes the diet is a complete way to treat the initial forms.
The diet of children and adolescents should be varied, beneficial and
delicious; it is necessary to ensure that it is always present
animal and plant products containing
Do not attempt to treat iron deficiency anemia in children with a diet or
biologically active additives.
Herbal medicine is acceptable as an adjunct to treatment, but not
will replace iron preparations. AT сборах чаще всего используются:
- nettle – it increases blood coagulation and reduces
- strawberries – its constituent microelements stimulate
- rose hips – contain large amounts of vitamin C,
improves iron absorption; juice is used for the same purpose
beet, pomegranate, black currant.
Профилактика железодефицитной анемии
Для профилактики ЖДА рекомендуется периодически сдавать
blood test, consume more food containing iron and
promptly eliminate sources of blood loss.
A very important point is the prevention of anemia in children
age It includes: correct day regimen, rational
feeding, prophylactic courses of iron supplementation to