Iron Deficiency Anemia
- Admin
- Dec 4, 2024
- 5 min read
Updated: Sep 10
Keep reading for more information Iron Deficiency Anemia, other forms of Anemia, Recommended Dietary Allowance (RDA) for iron, dietary sources of iron, and how to optimize iron absorption by scrolling through the following slides!
What is Anemia?
The body has insufficient red blood cells or hemoglobin
Anemia does not automatically mean you are deficient in iron! There are various types of anemia:
Iron Deficiency Anemia
Vitamin B12 Deficiency Anemia
Aplastic Anemia
Hemolytic Anemias
Iron Deficiency Anemia is the most common cause of deficiency worldwide (1, 2) and affects nearly one third of the population (3)
What are the symptoms of Anemia?
How to diagnose anemia?
A diagnosis can be made using bloodwork, checking levels of:
Total iron
Ferritin (4)
Transferrin
Total iron binding capacity
Vitamin B12
It's important to stay ahead of this diagnosis to prevent the unpleasant symptoms listed above, and to reduce unnecessary complications in the future. People with iron-deficiency anemia tend to have longer hospital stays, along with a higher number of adverse events. (1)
What are common reasons for Iron deficiency?
How common is Iron Deficiency Anemia?
Iron Deficiency Anemia most commonly affects women of reproductive age, the developing fetus, children, patients with chronic and inflammatory diseases, and the elderly. (7)
"Iron Deficiency Anemia is the most frequent hematological disorder in children, with an incidence in industrialized countries of 20.1% between 0 and 4 years of age and 5.9% between 5 and 14 years (39% and 48.1% in developing countries)". (7)
How can I get enough dietary iron from my diet?
Iron comes in 2 forms:
Heme iron (7)
Meat, poultry, fish
More easily absorbed
Non-Heme iron (7)
Fruits, veggies, nuts, grains
Absorption enhanced by both vitamin C and heme iron
Heme iron (from animal sources) is more bioavailable, and therefore, better absorbed than non-heme iron (from plants). (7) Once the iron is absorbed, the body can’t tell the difference between the two kinds.
Coffee and tea can inhibit absorption, so try to limit these during meal times!
Recommended Dietary Allowance (RDA) for Iron:
What is the Recommended Dietary Allowance (RDA) for Iron for men and women of different age groups?
Age | RDA for Males | RDA for Females |
Birth to 6 months | 0.27 mg* | 0.27 mg* |
7-12 months | 11 mg | 11 mg |
1-3 years | 7 mg | 7 mg |
4-8 years | 10 mg | 10 mg |
9-13 years | 8 mg | 8 mg |
14-18 years | 11 mg | 15 mg |
19-50 years | 8 mg | 18 mg |
51+ years | 8 mg | 8 mg |
*Adequate Intake (AI)
For women during pregnancy, the RDA is 27 mg, and 10 mg during lactation.
Putting these numbers in perspective, Check out some common foods with at least 2 mg iron!
Food | Serving Size |
Beef, veal | 3 ounces |
Clams, oysters, shrimp, sardines | 3 ounces |
Bran flakes | 3/4 cup |
Cream of wheat | 1/2 cup |
Oatmeal (fortified) | 3/4 cup |
Baked potato, with skin | 1 |
Dried bean, cooked (kidney, lentils, lima, navy) | 1/2 cup |
Soybeans | 1/2 cup |
Tofu | 1/2 cup |
Spinach | 1 cup |
Dried prunes | 4 pieces |
Iron Supplementation
Supplementation may be necessary to treat Iron Deficiency Anemia. Oral iron replacement is considered standard front-line therapy for iron-deficiency anemia, although is occasionally associated with adverse side effects. (2) Iron supplements can in liquid, tablet, or intravenous (IV) form. (6)
Side effects of iron supplementation?
"Although ferrous iron preparations are better absorbed than ferric iron preparations because of the low solubility of ferric iron and the physiology of iron absorption, ferrous iron is more irritating to mucosal surfaces and less well tolerated by patients than ferric iron, prompting a resurgence of interest in ferric iron therapy". (7)
Oral Iron Supplements
(table taken from Iolascon et. al.)(7)
Formulations | Accessibility to therapy and possible side effects |
Ferrous Ascorbate | Affordable and readily accessible but often associated with gastrointestinal side effects. |
Ferrous Fumarate | Affordable and readily accessible but often associated with gastrointestinal side effects. |
Ferrous Sulfate | Affordable and readily accessible but often associated with gastrointestinal side effects. |
Ferrous Sulfate | Affordable and readily accessible but often associated with gastrointestinal side effects. |
Polysaccharide-iron complex | With a reduced likelihood of gastrointestinal discomfort and a more favorable taste profile. |
Carbonyl iron | Cost‐effective with no discernible advantage in terms of efficacy or side effects when compared. |
Iron proteinsuccinylate | There are some data suggesting potential improvements in tolerability and efficacy compared to ferrous salts. However, it is unsuitable for individuals with hypersensitivity to milk protein. |
Iron amino acid chelates (ferrousbisglycinate, ferrictrisglycinate) | Less prone to dietary interactions but potentially higher in cost compared to ferrous salts. |
Indications for intravenous iron treatment include: (5, 8)
Intolerance to oral IRT (including daily and alternate‐daily dosing)
Inadequate response to oral IRT (Hb < 10 g/dL by the 4th week of oral IRT)
Rapid iron replacement is required (moderately symptomatic patient or preoperative anemic patient whenever less than six weeks is available up to surgery)
Inflammatory bowel disease
Chronic kidney disease
Chronic heart failure
In patients with intestinal malabsorption like short bowel syndrome, allergic enteritis, atrophic gastritis
After bariatric surgery
Ongoing abnormal uterine bleeding in case gynecological intervention is delayed
IDA in the second or third trimester of pregnancy
IRIDA.
Resources
1. Warner MJ, Kamran MT. Iron Deficiency Anemia. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448065/
2. Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015; 372(19):1832-1843. https://www.nejm.org/doi/full/10.1056/NEJMra1401038
3. Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014; 123(5): 615-624. https://www.sciencedirect.com/science/article/pii/S0006497120360663?pes=vor&utm_source=wiley&getft_integrator=wiley
4. DeLoughery TG. Iron Deficiency Anemia. Med Clin North Am. 2017 Mar;101(2):319-332. doi: 10.1016/j.mcna.2016.09.004. Epub 2016 Dec 8. PMID: 28189173. https://pubmed.ncbi.nlm.nih.gov/28189173/
5. Snook J, Bhala N, Beales ILP, et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021;70:2030‐2051. 10.1136/gutjnl-2021-325210. https://gut.bmj.com/content/70/11/2030
6. Elstrott B, Khan L, Olson S, Raghunathan V, DeLoughery T, Shatzel JJ. The role of iron repletion in adult iron deficiency anemia and other diseases. Eur J Haematol. 2020 Mar;104(3):153-161. doi: 10.1111/ejh.13345. Epub 2019 Dec 26. PMID: 31715055; PMCID: PMC7031048. https://pubmed.ncbi.nlm.nih.gov/31715055/
7. Iolascon A, Andolfo I, Russo R, Sanchez M, Busti F, Swinkels D, Aguilar Martinez P, Bou-Fakhredin R, Muckenthaler MU, Unal S, Porto G, Ganz T, Kattamis A, De Franceschi L, Cappellini MD, Munro MG, Taher A; from EHA‐SWG Red Cell and Iron. Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia. Hemasphere. 2024 Jul 15;8(7):e108. doi: 10.1002/hem3.108. PMID: 39011129; PMCID: PMC11247274. https://pubmed.ncbi.nlm.nih.gov/39011129/
8. Okam MM, Koch TA, Tran M‐H. Iron deficiency anemia treatment response to oral iron therapy: a pooled analysis of five randomized controlled trials. Haematologica. 2016;101:e6‐e7. 10.3324/haematol.2015.129114. https://haematologica.org/article/view/7622
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