Pregnant? Low Energy? This Might Be the Cause!

Big, bloated, hyperventilating and painfully pale – this is the description of a typical Pakistani pregnant female. Remove ‘big’ from the description above and replace it with average weighing, hyperventilating and pale: this is the description of an average Pakistani female of a young child bearing age.

In a study conducted at the Department of Medicine, at the Jinnah Postgraduate Medical Center, 200 patients with signs and symptoms of anaemia were recruited. Of those 200, eighty-nine (89) patients were found to have iron deficiency anemia in various age groups. The results also showed that one of the causes that led to iron deficiency anemia was their dietary habit.

Other causes of iron deficiency could be

• Inability to absorb iron. This means that you might be taking right amount of iron, but it is not reaching your circulatory system from your intestines.
• Increased demand. For example in a pregnant woman, iron demand physiologically increases as the baby develops or in a person suddenly travelling in higher altitudes.
• Excessive blood loss. This could be due to injury, trauma or internal blood loss, as in hemorrhage and heavy menstrual bleeding.

How Does Iron Deficiency Lead to Anemia?

Let’s first define anemia. Anemia is when the body does not have healthy red blood cells. Iron is needed in those blood cells to help carry oxygen throughout the body. However, if there is less iron in red blood cells itself, they become damaged. Due to any of the causes mentioned above, iron is decreased in the blood. The body uses iron stores from the liver to let the body function normally. As these stores are depleted, there is a decrease in haemoglobin (a protein in the blood that helps carry iron). Therefore, a decrease in iron leads to a direct decrease in this protein and further, red blood cells. If there is a decrease of red blood cells, then there is an inefficiency of oxygen transported throughout the body, leading to anemia.

Consequence and Symptoms

Before declaring yourself as anaemic, you should consult your doctor, who will recommend you to take a serum iron test. Blood is drawn from the body using injection and then tested for iron levels. Generally, normal results are

• Iron: 60-170 mcg/dL
• TIBC: 240-450 mcg/dL
• Transferrin saturation: 20-50 percent

However, make sure you ask your doctor for the normal range according to your age and if you are pregnant or not. Low serum iron indicates iron deficiency and anaemia.

Symptoms for iron deficiency include:

• Brittle nails
• Frequent infections
• Sore tongue
• Pica (craving for inedible items such as dirt or paper)

When iron deficiency gets worst, and all the iron stores in the body are depleted, the haemoglobin levels also fall low and, it is followed by anaemia.

Symptoms for anaemia include:

• Fatigue (tiredness) – this occurs because the body does not have enough iron for oxygen to bind with. Hence, oxygen cannot be efficiently transferred to all the cells, making the body work harder.
• Shortness of breath – This occurs as a body mechanism to compensate for the low oxygen delivering throughout your body. When there is not enough oxygen being supplied to the lungs, they start hyperventilating to draw more oxygen into the blood stream.
• Dizziness or headache – This occurs due to the lack of oxygen going to the brain
• Cold hands and feet – This is another mechanism of the body to compensate. When there isn’t enough iron in the blood to bind with oxygen, the blood is pushed to the more vital organs to the body and the limbs do not receive much blood therefore, they go cold.
• Pale skin – The skin turns pale because haemoglobin is a red pigment that gives colour to skin, in anemic conditions it is reduced giving skin pallor.
• Chest pain – This occurs in very severe cases of chronic anemia. The heart has to pump harder to meet the oxygen supply of the cells and organs as its job is to supply oxygenated blood to all parts. The heart often enlarges, which can lead to heart failure and death.

What Can You Do?

First of all, NEVER make a self-diagnosis of iron deficiency. Since iron supplements are available over the counter, people tend to make such decisions. Always visit your physician in case of any of the symptoms mentioned above. Most of these symptoms are also common to other diseases, and you might miss out on a bigger problem you might have. Always remember: excessive intake or iron can be toxic and fatal in case of very high doses. Make sure your supplement bottle is tightly sealed and kept away from the reach of children.

Sources of Iron

You might have to rely on supplements in case of severe deficiency, taking about 1-3 pills a day, according to your doctor’s prescription. You might need IV transfusions in case of the inability to absorb iron from your intestines (which can cause risk of allergy), or even blood transfusion in very severe cases. You will have to keep taking the supplements for a few months, even though you will feel better soon after your first few doses. This is because you will need to restore depleted sources of iron. Side effects to oral supplements are diarrhea and nausea. Your doctor will advise you.

In case of no iron deficiency or mild deficiency you can restore lost iron, or work on maintaining constant normal iron levels, simply by following a healthy diet plan with iron rich foods. There are no types of iron – heme and non-heme. Heme iron can be found from all meat sources such as: beef, beef or chicken liver, chicken, and fish (sardines). Non-heme iron can be found from plant sources such as lentils (daal), beans, tofu, apricots and spinach.

See your dietitian for a proper diet plan and always visit your nearest physician for any query that you have. Most importantly, know that it is necessary to find out the underlying cause of iron deficiency before treating it.