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Many people think of iron deficiency as an annoyance that leaves you yawning and tired throughout the day.
The truth is, iron deficiency and the anemia that can result from it are serious conditions.
“Iron deficiency can do more than make you feel worn out,” says Hemang Dave, MD, a board-certified hematologist and medical oncologist who practices in the Cape May Court House and Marmora, NJ, offices of Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology and hematology specialists. “Insufficient iron levels can have a negative impact on quality of life and ultimately lead to more significant health issues,” Dr. Dave says. Meanwhile, he adds, iron deficiency anemia (IDA) can be an early warning sign of colorectal cancer or other serious disease marked by internal blood loss.1,2
Iron, a mineral that typically is absorbed into the bloodstream through the digestion of food, supports numerous physiological processes and helps maintain healthy skin, hair, and nails.1 Among its other roles, iron contributes to the production of hemoglobin, the molecule in blood that transports oxygen. The body also uses iron stored in the liver and other organs to create red blood cells.1
Most people need to take in between 8 and 18 milligrams of iron daily.3 The recommended amount is higher for pregnant women and for those who follow a vegan or vegetarian diet.3 If you don’t get enough iron or experience blood loss due to a medical condition or procedure, iron deficiency can result.1,3
In the early stages of iron deficiency, existing iron stores are “recycled” as older red blood cells are broken down and new ones created, so the body initially can compensate for the iron deficit.4 But if that deficit persists over time, the iron stores become further depleted and hemoglobin levels fall.5 Iron deficiency progresses to iron deficiency anemia when red blood cells become abnormally small or pale due to lack of hemoglobin,4 or when the body’s supply of red blood cells becomes significantly reduced due to blood loss.1
Anemia from any cause is common in the United States, affecting nearly 1 in 10 Americans aged 2 years and older.5 Anemia is more prevalent in females than in males (13.5% vs 5.5%), and prevalence also is higher among adults aged 60 years and older (12.5%).5 Anemia also is alarmingly high among African Americans, affecting 1 in 5 Blacks overall and nearly 1 in 3 Black females.5
Meanwhile, research suggests that nearly 1 in 3 Americans are iron deficient to some extent.6
Joseph McLaughlin, MD, explains that many factors can contribute to iron deficiency. Dr. McLaughlin, a board-certified hematologist and medical oncologist who practices in RCCA’s Manchester, CT, office, says those factors include:
He adds that iron deficiency anemia can result from conditions that cause significant blood loss, such as:
“One of the real challenges with iron deficiency and even iron deficiency anemia is that the onset is often gradual and the symptoms, particularly at first, are mild,” says Dr. McLaughlin. He explains that many cases of the conditions are identified from the results of routine blood work in people seeing their doctor for a regularly scheduled physical. Symptoms can include:
When a person’s symptoms, initial blood test results, or both indicate that he or she may have iron deficiency or IDA, a primary care provider typically will take a thorough history, perform a comprehensive exam, and order further lab tests. Those tests often include measurement of vitamin B12; iron; ferritin, a protein that stores iron; and transferrin, a protein that carries iron to cells throughout the body.
Ferritin levels below 30 mg/L indicate iron deficiency, while the level usually dips below 10 or 12 mg/L in IDA. Similarly, hemoglobin counts of <13.0 g/dL in men, <12.0 g/dL in non-pregnant women, and <11.0 g/dL in pregnant women are widely used thresholds for diagnosing IDA. (Hemoglobin levels are measured as part of the complete blood count, or CBC, which is a routine first-line test.)
Dr. Dave says identifying iron deficiency or IDA is the beginning, not the end, of the evaluation process. “Understanding which factors are contributing to iron deficiency can enable people to make helpful lifestyle changes, while determining what is giving rise to IDA is critical to finding or ruling out potentially life-threatening underlying causes, such as colon cancer,” he notes. Depending on a person’s medical history, age, symptoms, and blood test results, evaluations to investigate the cause of IDA may include urinalysis, ultrasound scans, colonoscopy, or other steps, the hematologist notes.
Treatment of iron deficiency or IDA is tailored to each person’s specific situation, he continues, with oral iron supplements often used as initial therapy. “It’s important to talk with your doctor about what dose of iron you should take and about when and how you should take it,” Dr. Dave says. He explains that such guidance is critical for avoiding taking an excessive dose and for minimizing common side effects of iron supplementation, such as stomach upset and constipation. Physicians also typically advise patients to increase their iron intake by eating iron-rich foods, such as meat and fish (if the patient is not vegan/vegetarian), poultry, leafy green vegetables, legumes, and iron-enriched grains.
When oral supplements and dietary changes are not sufficient to resolve iron deficiency or IDA, intravenous iron infusions can be an effective option.
Dr. McLaughlin says, “Iron deficiency is a common condition that can have a significant impact on health and quality of life. IDA, while less common, is more serious, and requires prompt attention. The good news, however, is that both conditions are highly treatable, and correcting them can make a huge difference in people’s lives. The first steps are to have regular wellness visits with your primary care provider and – whether at those visits or when you first notice possible signs of an issue – to talk with your provider about your symptoms or concerns,” he adds.
Drs. Dave and McLaughlin are among 100+ medical oncologists and hematologists who practice with RCCA at 26 locations across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area. RCCA’s cancer specialists see more than 30,000 new patients each year and provide care to more than 265,000 established patients, collaborating closely with those patients’ other physicians. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, as well as access to approximately 300 clinical trials. In addition to serving patients who have solid tumors, blood-based cancers, and benign blood disorders, RCCA care centers also provide infusion services to people with a number of non-oncologic conditions—including multiple sclerosis, Crohn’s disease, asthma, iron-deficiency anemia, and rheumatoid arthritis—who take intravenously-administered medications.
To learn more about Regional Cancer Care Associates, call 1-844-346-7222 or visit RCCA.com.
References
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call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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