Adequate iron intake crucial to fight anemia

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

Anemia, one of the most common health problems in Asia, is a condition in which there are not enough healthy red blood cells to carry adequate oxygen to the body's tissues.

Blood consists of a liquid called plasma and there are three types of blood cells floating within plasma; red, white and platelets.

White blood cells fight infection. Platelets help blood to clot after a cut. Red blood cells (erythrocytes) give blood its red color and carry oxygen from lungs via the blood stream to the brain and other organs and tissues in the body.

The body needs oxygenated blood to function. Red blood cells contain hemoglobin (a red iron-rich protein), which enables red blood cells to carry oxygen. Most blood cells, including red blood cells, are produced regularly in your bone marrow (a red, spongy material found within the cavities of many of your large bones). Your body needs iron and vitamins to produce sufficient numbers of red blood cells and hemoglobin.

When you're anemic, there are three possible reasons for it: the body produces too few healthy red blood cells; loses too many of them; or destroys them faster than they can be replaced.

What causes anemia?

Iron or vitamin deficiency, blood loss, chronic illness, or a genetic or acquired defect or disease can cause anemia. It may also be a side effect of medication.

Anemia can be temporary or chronic. It can range from mild to severe.

Since women lose blood each month during menstruation, they are at greater risk of iron deficiency anemia. Iron is recycled from old red blood cells, which means blood contains iron and if you lose blood you lose iron. The body also gets iron from the food you eat.

In vitamin deficiency anemia, the body needs folic acid and vitamin B12 to produce sufficient numbers of healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production.

Aplastic anemia is a life-threatening anemia caused by a decrease in the bone marrow's ability to produce all three types of blood cells. Hemolytic anemia develops when red blood cells are destroyed faster than bone marrow can replace them, such as in genetic diseases like sickle cell anemia or thalassemia.

What are the signs and symptoms of anemia?

The main symptom is fatigue, other symptoms are weakness, pale skin (decreased pinkness of the lips, gums, lining of the eyelids, nail beds and palms), rapid heartbeat, shortness of breath with mild exertion, dizziness, lightheadedness, irritability in children, or growth failure.

Initially, anemia can be so mild it can go unnoticed but signs and symptoms increase as the condition progresses.

Treatment for anemia depends on the cause. Iron supplements are for iron deficiency anemia. You can help avoid iron deficiency anemia and vitamin deficiency anemia by eating a healthy, varied diet that includes foods rich in iron, folic acid and vitamin B12.

Foods rich in iron include clams, oysters, meat (red and white), beans and peas, iron-fortified cereals, whole-grain breads and pastas, dark green, leafy vegetables, dried fruit, nuts and seeds. Folic acid is found in fresh fruits and vegetables, meat, dairy products, fortified breakfast cereals and beans. Vitamin B-12 is plentiful in meat and dairy products.

Eating plenty of iron-rich foods is particularly important for people who have high iron requirements, such as children. Iron is needed during growth spurts and pregnant and menstruating women.

Adequate iron intake is also crucial for infants, strict vegetarians and people following weight-reduction diets.

Doctors may prescribe iron supplements or multivitamins containing iron for people with high iron requirements. But iron supplements are appropriate only when you need more iron than a balanced diet can provide. Remember, overloading your body with iron can also be serious. So, check with your doctor to find out the cause and take medication as prescribed.

If you have a family history of anemia, such as sickle cell anemia, thalassemia, talk to your doctor and possibly a genetic counselor about the risk posed to you and what risks you may pass onto your children.