When you have to sleep a little and work hard, fatigue, pallor and dizziness can easily be attributed to overwork. However, “harmless” symptoms can signal serious health problems. According to the latest data from the World Health Organization (WHO), about 40% of women around the world face iron deficiency anemia, while almost 80% of Russian women experience latent iron deficiency.
How to protect yourself from the disease and what to do if the diagnosis is confirmed, we figure it out together with specialists: the leading expert of the Center for Molecular Diagnostics (CMD) of the Central Research Institute of Epidemiology of Rospotrebnadzor Elena Tivanova, the chief physician of the Gemotest Laboratory Olga Dekhtyareva and therapist of the Online Doctor service Alena Slepova.
Why women lack iron
Iron deficiency anemia is a condition caused by a lack of iron that results in decreased hemoglobin levels. The disease develops when an important trace element is supplied in insufficient quantities with food (the body itself does not synthesize iron) or is poorly absorbed, as well as with increased blood loss. Doctor Olga Dekhtyareva notes that all redox processes, the supply of oxygen to cells and the antioxidant defense of the body depend on the level of iron in the blood. Despite the fact that people of different sexes and ages can face the problem, iron deficiency anemia is considered a “female” pathology, or rather a disease of women aged 15–45 years. The reason for this is regular menstruation (especially prolonged or heavy discharge), pregnancy and lactation, when the body needs more iron than usual, and childbirth with significant blood loss.
Plant-based or fermented milk diets also contribute to the development of anemia. The fact is that iron is better absorbed from food of animal origin - meat, fish, seafood, and "milk" is rich in calcium, which prevents the absorption of iron. Impaired assimilation of this trace element is another reason why it is not used by the body for its intended purpose. In this case, chronic gastritis, for example, can provoke a problem. Olga Dekhtyareva adds that iron deficiency in the body can cause other diseases or their complications. So, iron deficiency anemia often develops with gastrointestinal (hemorrhoids, peptic ulcer) and uterine (uterine fibroids) bleeding or is associated with chronic diseases: inflammation of the pancreas or duodenum, bronchitis, kidney disease. And some hereditary diseases can disrupt the transport of iron to organs and tissues. According to doctor Elena Tivanova, sometimes health problems are provoked by donation, if the frequency of donations is violated.
How to understand that there is a problem
Dry skin, cracks in the corners of the mouth (angular stomatitis), brittle hair and nails, shortness of breath, dizziness, decreased performance, as well as the desire to taste chalk and inhale deeply the smell of fresh paint or gasoline are symptoms that indicate a lack of iron in the body. However, they are not enough to make a diagnosis. To confirm iron deficiency anemia, you need to pass general and biochemical blood tests. Hemoglobin is responsible for the circulation of oxygen in the blood. In the case of iron deficiency, its level is usually reduced - less than 115-120 g / l (in women).
Moreover, in the early stages of the disease, hemoglobin may be normal. According to therapist Alena Slepova, checking the level of serum iron, as well as transferrin and ferritin - proteins responsible for the transfer of iron to organs and tissues and the creation of a stock of a trace element in the body - allows to prevent mistakes in the diagnosis. These indicators are markers of anemia at the initial stage - their low level indicates a problem. And in order to find out the cause of the disease, you will need to undergo an additional examination - first of all, to check the work of the gastrointestinal tract (using gastroscopy, X-ray of the stomach, colonoscopy) and the organs of the reproductive system.
Do I need to eat apples and buckwheat
Experts agree that a balanced diet that includes foods high in iron is the best prevention (but not a cure!) For iron deficiency. Among the record holders for the amount of a valuable microelement are meat (beef, lamb), fish and seafood, buckwheat, sesame seeds, pumpkin seeds and apples. But Elena Tivanova draws attention to important nuances: iron cannot be absorbed normally with a deficiency of vitamin C and folic acid. Polyphenols and phytates found in tea, coffee, whole grains and dairy products also inhibit its absorption. For example, buckwheat with milk is a useless option if the goal is to maintain the body's iron stores.
We recently talked about new data from the WHO, according to which 40% of women in the world suffer from anemia. The World Health Organization recommends that all women with an established menstrual cycle take iron courses for three months a year, at a dose of 30-60 mg per day, to prevent anemia. According to some reports, the optimal dosing regimen is to take iron every other day, rather than daily.
Alena Slepova emphasizes that if anemia has already arisen, then it is impossible to cope with it with the help of one diet: in order to compensate for the daily need for iron, you need to eat about 10 kg of apples or 700 g of buckwheat. It is also important to take into account the fact that the longer the product has been heat treated, the less iron remains in it. Therefore, for the prevention of iron deficiency for women of fertile age, doctors also recommend not only eating right, but also taking dietary supplements with an important micronutrient.
How to heal
Iron deficiency anemia does not appear in a couple of days (except in cases of acute blood loss) - it develops slowly and leads to chronic oxygen starvation of tissues. Hence the increased fatigue and low efficiency. Getting rid of anemia by diversifying your diet with iron-containing foods is a bad idea: a balanced diet of 2000 calories contains only 10 mg of elemental iron, while the required dose of a trace element for treatment is 100 mg or more. The surest way to solve the problem is to start taking iron supplements. In this case, the type of medicine, dose and method of administration should be prescribed by a doctor.
According to Alena Slepova, the most effective and safe drugs are not in salt form, but in the form of a polymaltose complex of hydroxide with ferric iron. They reduce the likelihood of side effects - metallic taste in the mouth, nausea, vomiting - and reduce the risk of overdose. The doctor reminds that iron is absorbed best in an acidic environment, so it is recommended to combine it with the use of ascorbic acid. For example, you can drink the medicine with a glass of orange or apple juice. It is also important not to forget that the absorption of the trace element is impaired with the simultaneous intake of certain foods (tea, coffee, milk), and the drugs themselves are incompatible with some drugs: antacids, proton pump inhibitors, and others.
Experts agree: it is wrong to stop therapy immediately after it has gotten better - you need to complete the full course, which can take 3-6 months. Improvement in general well-being usually occurs 1–1.5 months after starting treatment. When the hemoglobin level has returned to normal, it is important to compensate for the depleted iron stores in the body (that is, to wait for the transferrin and ferritin levels to normalize) while continuing to take the medication. If, after a month of treatment, hemoglobin remains at the same level, it is very likely that the problem is in the absorption of iron. In this case, additional examination is required.
What else is anemia
In most cases, anemia is not an independent deviation - it accompanies the underlying disease, therefore, treatment of the disease without establishing its cause is not only meaningless, but also dangerous. Thus, B12-deficiency anemia is associated with insufficient intake of vitamin B12 or impaired absorption and is often found in gastric diseases. Elena Tivanova explains that the vitamin is absorbed in the stomach and small intestine, and this ability decreases with age, therefore B12-deficiency anemia is often called "anemia of the elderly." It is interesting that vitamin B12 can be synthesized by healthy intestinal microflora, but only in limited quantities, and it is not enough for the body's tasks. Anemia can also be caused by a deficiency of folic acid, which, like vitamin B12, is actively involved in the formation of red blood cells.
A large group of diseases is anemia that accompanies chronic diseases. They arise as a result of prolonged toxic effects of inflammation products. For example, in chronic renal failure, anemia is one of the characteristic syndromes. According to Elena Tivanova, the mechanism of its development is complex and not fully understood, but it is known that one of the main reasons is a decrease in endogenous erythropoietin, a protein that stimulates the production of red blood cells in the bone marrow. Treatment of anemia of chronic diseases is impossible without eliminating the underlying disease, the focus of chronic infection, therefore, one intake of iron supplements will not be enough.
Another group of diseases - hemolytic anemias - is associated with increased destruction of red blood cells, when the body produces antibodies against its own red blood cells. The result is the same - the massive destruction of red blood cells and, as a result, a decrease in the level of hemoglobin.
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