Interesting Facts

• First documented mention of iron deficiency anemia dates back to 1554. In those days, this disease mainly affected girls aged 14 to 17 years, and therefore the disease was called “de morbo virgineo”, which translated means “disease of virgins”.
• The first attempts to treat the disease with iron preparations were made in 1700.
• Latent ( hidden) iron deficiency can occur in children during periods of intensive growth.
• A pregnant woman's iron requirement is twice that of two healthy adult men.
• During pregnancy and childbirth, a woman loses more than 1 gram of iron. With a normal diet, these losses will be restored only after 3 to 4 years.

What are red blood cells?

Erythrocytes, or red blood cells, are the largest population of cellular elements in the blood. These are highly specialized cells lacking a nucleus and many other intracellular structures ( organelles). The main function of red blood cells in the human body is to transport oxygen and carbon dioxide.

Structure and function of red blood cells

The size of a mature red blood cell ranges from 7.5 to 8.3 micrometers ( µm). It has the shape of a biconcave disk, which is maintained due to the presence of a special structural protein in the erythrocyte cell membrane - spectrin. This form ensures the most efficient process of gas exchange in the body, and the presence of spectrin allows red blood cells to change as they pass through the smallest blood vessels ( capillaries) and then restore its original shape.

More than 95% of the intracellular space of an erythrocyte is filled with hemoglobin - a substance consisting of the protein globin and a non-protein component - heme. The hemoglobin molecule consists of four globin chains, each of which has heme at the center. Each red blood cell contains more than 300 million hemoglobin molecules.

The non-protein part of hemoglobin, namely the iron atom that is part of the heme, is responsible for the transport of oxygen in the body. Enrichment of blood with oxygen ( oxygenation) occurs in the pulmonary capillaries, when passing through which each iron atom attaches to itself 4 oxygen molecules ( oxyhemoglobin is formed). Oxygenated blood is carried through the arteries to all tissues of the body, where oxygen is transferred to the cells of the organs. In exchange, carbon dioxide is released from the cells ( byproduct of cellular respiration), which attaches to hemoglobin ( carbhemoglobin is formed) and is transported through the veins to the lungs, where it is released into environment along with exhaled air.

In addition to transporting respiratory gases, additional functions of red blood cells are:

• Antigenic function. Red blood cells have their own antigens, which determine membership in one of the four main blood groups ( according to the AB0 system).
• Transport function. TO outer surface The membranes of red blood cells can attach antigens of microorganisms, various antibodies and some medications, which are carried through the bloodstream throughout the body.
• Buffer function. Hemoglobin takes part in maintaining acid-base balance in organism.
• Stop bleeding. Red blood cells are included in the thrombus that forms when blood vessels are damaged.

Formation of red blood cells

In the human body, red blood cells are formed from so-called stem cells. These unique cells are formed during the embryonic development stage. They contain a nucleus in which the genetic apparatus is located ( DNA – deoxyribonucleic acid), as well as many other organelles that ensure the processes of their vital activity and reproduction. Stem cells give rise to all cellular elements of the blood.

For the normal process of erythropoiesis, the following are necessary:

• Iron. This microelement is part of heme ( non-protein part of the hemoglobin molecule) and has the ability to reversibly bind oxygen and carbon dioxide, which determines the transport function of erythrocytes.
• Vitamins ( B2, B6, B9 and B12). They regulate the formation of DNA in hematopoietic cells of the red bone marrow, as well as differentiation processes ( maturation) red blood cells.
• Erythropoietin. A hormonal substance produced by the kidneys that stimulates the formation of red blood cells in the red bone marrow. When the concentration of red blood cells in the blood decreases, hypoxia develops ( lack of oxygen), which is the main stimulator of erythropoietin production.

Formation of red blood cells ( erythropoiesis) begins at the end of the 3rd week of embryonic development. In the early stages of fetal development, red blood cells are formed mainly in the liver and spleen. At approximately 4 months of pregnancy, stem cells migrate from the liver into the cavities of the pelvic bones, skull, vertebrae, ribs and others, resulting in the formation of red Bone marrow, which also takes an active part in the process of hematopoiesis. After the birth of a child, the hematopoietic function of the liver and spleen is inhibited, and the bone marrow remains the only organ that ensures the maintenance of the cellular composition of the blood.

In the process of becoming a red blood cell, a stem cell undergoes a number of changes. It decreases in size, gradually loses its nucleus and almost all organelles ( as a result of which its further division becomes impossible), and also accumulates hemoglobin. The final stage of erythropoiesis in the red bone marrow is the reticulocyte ( immature red blood cell). It is washed out of the bones into the peripheral bloodstream, and within 24 hours it matures to the stage of a normal red blood cell, capable of fully performing its functions.

Destruction of red blood cells

The average lifespan of red blood cells is 90 – 120 days. After this period, their cell membrane becomes less plastic, as a result of which it loses the ability to reversibly deform when passing through capillaries. “Old” red blood cells are captured and destroyed by special cells of the immune system - macrophages. This process occurs mainly in the spleen, as well as ( to a much lesser extent) in the liver and red bone marrow. A slightly small proportion of red blood cells are destroyed directly in the vascular bed.

When a red blood cell is destroyed, hemoglobin is released from it, which quickly breaks down into protein and non-protein parts. Globin undergoes a series of transformations, resulting in the formation of a yellow pigment complex - bilirubin ( unbound form). It is insoluble in water and highly toxic ( is able to penetrate the cells of the body, disrupting their vital processes). Bilirubin is quickly transported to the liver, where it binds to glucuronic acid and is excreted along with bile.

The non-protein part of hemoglobin ( heme) is also subject to destruction, resulting in the release of free iron. It is toxic to the body, so it quickly binds to transferrin ( transport protein of blood). Most of the iron released during the destruction of red blood cells is transported to the red bone marrow, where it is reused for the synthesis of red blood cells.

What is iron deficiency anemia?

Anemia is a pathological condition characterized by a decrease in the concentration of red blood cells and hemoglobin in the blood. If the development of this condition is caused by insufficient supply of iron to the red bone marrow and the associated disturbance of erythropoiesis, then anemia is called iron deficiency.

The adult human body contains about 4 grams of iron. This figure varies depending on gender and age.

The concentration of iron in the body is:

• in newborns – 75 mg per 1 kilogram of body weight ( mg/kg);
• in men – more than 50 mg/kg;
• in women – 35 mg/kg ( what is associated with monthly blood loss).

The main places where iron is found in the body are:

• erythrocyte hemoglobin – 57%;
• muscles – 27%;
• liver – 7 – 8%.

In addition, iron is part of a number of other protein enzymes ( cytochromes, catalase, reductase). They participate in redox processes in the body, in the processes of cell division and in the regulation of many other reactions. Iron deficiency can lead to a lack of these enzymes and the appearance of corresponding disorders in the body.

Absorption of iron in the human body occurs mainly in the duodenum, while all iron entering the body is usually divided into heme ( divalent, Fe +2), found in the meat of animals and birds, fish, and non-heme ( trivalent, Fe +3), the main sources of which are dairy products and vegetables. An important condition necessary for normal absorption of iron is a sufficient amount of hydrochloric acid included in the composition. gastric juice. When its amount decreases, iron absorption slows down significantly.

Absorbed iron binds to transferrin and is transported to the red bone marrow, where it is used for the synthesis of red blood cells, as well as to storage organs. Iron reserves in the body are represented mainly by ferritin, a complex consisting of the protein apoferritin and iron atoms. Each ferritin molecule contains on average 3–4 thousand iron atoms. When the concentration of this microelement in the blood decreases, it is released from ferritin and used for the needs of the body.

The rate of iron absorption in the intestine is strictly limited and cannot exceed 2.5 mg per day. This amount is only sufficient to restore the daily loss of this microelement, which is normally about 1 mg in men and 2 mg in women. Consequently, in various pathological conditions accompanied by impaired absorption of iron or increased iron losses, a deficiency of this microelement may develop. When the concentration of iron in the plasma decreases, the amount of hemoglobin synthesized decreases, as a result of which the resulting red blood cells will be smaller. In addition, the growth processes of red blood cells are disrupted, which leads to a decrease in their number.

Causes of iron deficiency anemia

Iron-deficiency anemia can develop both as a result of insufficient intake of iron into the body, and when the processes of its use are disrupted.

The cause of iron deficiency in the body may be:

• insufficient intake of iron from food;
• increasing the body's need for iron;
• congenital iron deficiency in the body;
• iron absorption disorder;
• disruption of transferrin synthesis;
• increased blood loss;
• application medicines.

Insufficient intake of iron from food

Malnutrition can lead to the development of iron deficiency anemia in both children and adults.

The main reasons for insufficient iron intake in the body are:

• prolonged fasting;
• monotonous diet with little animal products.

In newborns and children infancy Iron requirements are fully met by breastfeeding ( provided that the mother does not suffer from iron deficiency). If you switch your baby to formula feeding too early, he may also develop symptoms of iron deficiency in the body.

Increased body needs for iron

Under normal physiological conditions, an increased need for iron may occur. This is typical for women during pregnancy and breastfeeding.

Despite the fact that a certain amount of iron is retained during pregnancy ( due to lack of menstrual bleeding), the need for it increases several times.

Reasons for increased iron requirements in pregnant women

Cause	Approximate amount of iron consumed
Increase in circulating blood volume and red blood cell count	500 mg
Iron transferred to the fetus	300 mg
Iron, which is part of the placenta	200 mg
Blood loss during childbirth and the postpartum period	50 – 150 mg
Iron lost in breast milk over the entire feeding period	400 – 500 mg

Thus, during the period of bearing and breastfeeding one child, a woman loses at least 1 gram of iron. These numbers increase during multiple pregnancies, when 2, 3 or more fetuses can develop simultaneously in the mother’s body. If we consider that the rate of iron absorption cannot exceed 2.5 mg per day, it becomes clear that almost any pregnancy is accompanied by the development of an iron deficiency state of varying severity.

Congenital deficiency of iron in the body

The child's body receives all the necessary nutrients from the mother, including iron. However, if there are certain diseases in the mother or fetus, the birth of a child with iron deficiency is possible.

The cause of congenital iron deficiency in the body can be:

• severe iron deficiency anemia in the mother;
• multiple pregnancy;
• prematurity.

In any of the above cases, the concentration of iron in the blood of a newborn is significantly lower than normal, and symptoms of iron deficiency anemia may appear from the first weeks of life.

Iron malabsorption

Absorption of iron in the duodenum is possible only with normal functional state mucous membrane of this section of the intestine. Various gastrointestinal diseases intestinal tract can damage the mucous membrane and significantly reduce the rate at which iron enters the body.

A decrease in iron absorption in the duodenum can result from:

• Enteritis – inflammation of the mucous membrane of the small intestine.
• Celiac disease – a hereditary disease characterized by gluten protein intolerance and associated malabsorption in the small intestine.
• Helicobacter pylori – an infectious agent that affects the gastric mucosa, which ultimately leads to a decrease in the secretion of hydrochloric acid and impaired iron absorption.
• Atrophic gastritis – disease associated with atrophy ( reduction in size and function) gastric mucosa.
• Autoimmune gastritis – a disease caused by a disruption of the immune system and the production of antibodies to the own cells of the gastric mucosa with their subsequent destruction.
• Removal of the stomach and/or small intestine – at the same time, both the amount of hydrochloric acid formed and the functional area decrease duodenum where iron absorption occurs.
• Crohn's disease - autoimmune disease, manifested by inflammatory damage to the mucous membrane of all parts of the intestine and, possibly, the stomach.
• Cystic fibrosis – a hereditary disease manifested by a violation of the secretion of all glands of the body, including the gastric mucosa.
• Cancer of the stomach or duodenum.

Impaired transferrin synthesis

Impaired formation of this transport protein may be associated with various hereditary diseases. The newborn will not have symptoms of iron deficiency, since he received this microelement from the mother’s body. After birth, the main way iron enters the child’s body is absorption in the intestines, however, due to a lack of transferrin, the absorbed iron cannot be delivered to the depot organs and the red bone marrow and cannot be used in the synthesis of red blood cells.

Since transferrin is synthesized only in liver cells, its various lesions ( cirrhosis, hepatitis and others) can also lead to a decrease in the concentration of this protein in plasma and the development of symptoms of iron deficiency anemia.

Increased blood loss

A one-time loss of a large amount of blood usually does not lead to the development of iron deficiency anemia, since the body's iron reserves are sufficient to replace the losses. At the same time, with chronic, long-term, often unnoticeable internal bleeding, the human body can lose several milligrams of iron daily, over several weeks or even months.

The cause of chronic blood loss may be:

• nonspecific ulcerative colitis ( inflammation of the colon mucosa);
• intestinal polyposis;
• decaying tumors of the gastrointestinal tract ( and other localization);
• hernia hiatus diaphragms;
• endometriosis ( proliferation of cells in the inner layer of the uterine wall);
• systemic vasculitis ( inflammation blood vessels various localizations );
• blood donation by donors more than 4 times a year ( 300 ml donated blood contain about 150 mg iron).

If the cause of blood loss is not promptly identified and eliminated, there is a high probability of the patient developing iron deficiency anemia, since the iron absorbed in the intestines can only cover physiological needs in this microelement.

Alcoholism

Long-term and frequent consumption of alcohol leads to damage to the gastric mucosa, which is associated primarily with the aggressive effects of ethyl alcohol, which is part of all alcoholic beverages. Besides, ethanol directly inhibits hematopoiesis in the red bone marrow, which can also increase the manifestations of anemia.

Use of medications

Taking certain medications can interfere with the absorption and utilization of iron in the body. This usually occurs with long-term use of large doses of medications.

Drugs that can cause iron deficiency in the body are:

• Nonsteroidal anti-inflammatory drugs ( aspirin and others). The mechanism of action of these drugs is associated with improved blood flow, which can lead to chronic internal bleeding. In addition, they contribute to the development of stomach ulcers.
• Antacids ( Rennie, Almagel). This group of drugs neutralizes or reduces the rate of secretion of gastric juice containing hydrochloric acid, necessary for normal absorption of iron.
• Iron-binding drugs ( Desferal, Exjad). These drugs have the ability to bind and remove iron from the body, both free and included in transferrin and ferritin. In case of overdose, iron deficiency may develop.

To avoid the development of iron deficiency anemia, these drugs should be taken only as prescribed by a doctor, strictly observing the dosage and duration of use.

Symptoms of iron deficiency anemia

Symptoms of this disease are caused by a lack of iron in the body and impaired hematopoiesis in the red bone marrow. It is worth noting that iron deficiency develops gradually, so at the beginning of the disease the symptoms can be quite sparse. Latent ( hidden) iron deficiency in the body can lead to symptoms of sideropenic ( iron deficiency) syndrome. Somewhat later, an anemic syndrome develops, the severity of which is determined by the level of hemoglobin and red blood cells in the body, as well as the rate of development of anemia ( the faster it develops, the more pronounced the clinical manifestations will be), compensatory capabilities body ( in children and the elderly they are less developed) and the presence of concomitant diseases.

Manifestations of iron deficiency anemia are:

• muscle weakness;
• increased fatigue;
• cardiopalmus;
• changes in the skin and its appendages ( hair, nails);
• damage to mucous membranes;
• tongue damage;
• disturbance of taste and smell;
• penchant for infectious diseases;
• intellectual development disorders.

Muscle weakness and fatigue

Iron is part of myoglobin, the main protein of muscle fibers. With its deficiency, the processes of muscle contraction are disrupted, which will manifest itself as muscle weakness and a gradual decrease in muscle volume ( atrophy). In addition, muscle function constantly requires a large amount of energy, which can only be generated with adequate oxygen supply. This process is disrupted when the concentration of hemoglobin and red blood cells in the blood decreases, which is manifested by general weakness and intolerance physical activity. People get tired quickly when doing everyday work ( climbing stairs, going to work, etc.), and this can significantly reduce their quality of life. Children with iron deficiency anemia are characterized by a sedentary lifestyle and prefer “sedentary” games.

Shortness of breath and rapid heartbeat

An increase in breathing rate and heart rate occurs with the development of hypoxia and is a compensatory reaction of the body aimed at improving blood supply and oxygen delivery to various organs and tissues. This may be accompanied by a feeling of lack of air, chest pain, ( occurring when there is insufficient oxygen supply to the heart muscle), and in severe cases - dizziness and loss of consciousness ( due to impaired blood supply to the brain).

Changes in the skin and its appendages

As mentioned earlier, iron is part of many enzymes involved in the processes of cellular respiration and division. A deficiency of this microelement leads to skin damage - it becomes dry, less elastic, flaky and cracks. In addition, the usual red or pinkish tint to the mucous membranes and skin is given by red blood cells, which are located in the capillaries of these organs and contain oxygenated hemoglobin. With a decrease in its concentration in the blood, as well as as a result of a decrease in the formation of red blood cells, pale skin may occur.

Hair becomes thinner, loses its usual shine, becomes less durable, breaks easily and falls out. Gray hair appears early.

Nail damage is a very specific manifestation of iron deficiency anemia. They become thinner, acquire a matte tint, flake and break easily. Characteristic is the transverse striation of the nails. With severe iron deficiency, koilonychia can develop - the edges of the nails rise and bend in the opposite direction, acquiring a spoon-shaped shape.

Damage to mucous membranes

Mucous membranes are among the tissues in which cell division processes occur most intensively. That is why their defeat is one of the first manifestations of iron deficiency in the body.

Iron deficiency anemia affects:

• Oral mucosa. It becomes dry, pale, and areas of atrophy appear. The process of chewing and swallowing food is difficult. Also characterized by the presence of cracks on the lips, the formation of jams in the corners of the mouth ( cheilosis). In severe cases, the color changes and the strength of tooth enamel decreases.
• The mucous membrane of the stomach and intestines. Under normal conditions, the mucous membrane of these organs plays an important role in the process of absorption of food, and also contains many glands that produce gastric juice, mucus and other substances. With its atrophy ( caused by iron deficiency) digestion is impaired, which can be manifested by diarrhea or constipation, abdominal pain, as well as impaired absorption of various nutrients.
• The mucous membrane of the respiratory tract. Damage to the larynx and trachea can be manifested by soreness, a feeling of the presence of a foreign body in the throat, which will be accompanied by unproductive ( dry, without phlegm) cough. In addition, the mucous membrane of the respiratory tract normally performs protective function, preventing the entry of foreign microorganisms and chemical substances into the lungs. With its atrophy, the risk of developing bronchitis, pneumonia and other infectious diseases of the respiratory system increases.
• The mucous membrane of the genitourinary system. Violation of its function can manifest itself as pain during urination and during sexual intercourse, urinary incontinence ( more often in children), as well as frequent infectious diseases in the affected area.

Tongue damage

Changes in the tongue are a characteristic manifestation of iron deficiency. As a result atrophic changes in its mucous membrane the patient may feel pain, a burning sensation and distension. The appearance of the tongue also changes - the normally visible papillae disappear ( which contain a large number of taste buds), the tongue becomes smooth, becomes covered with cracks, and irregularly shaped areas of redness may appear ( "geographical language").

Disorders of taste and smell

As already mentioned, the mucous membrane of the tongue is rich taste buds, located predominantly in the papillae. With their atrophy, various taste disturbances may appear, starting with decreased appetite and intolerance to certain types of foods ( usually sour and salty foods), and ending with a perversion of taste, addiction to eating earth, clay, raw meat and other inedible things.

Smell disorders may manifest as olfactory hallucinations ( feeling smells that aren't really there) or addiction to unusual smells ( varnish, paint, gasoline and others).

Tendency to infectious diseases
With iron deficiency, the formation of not only red blood cells is disrupted, but also leukocytes - cellular elements of the blood that protect the body from foreign microorganisms. The lack of these cells in the peripheral blood increases the risk of developing various bacterial and viral infections, which increases even more with the development of anemia and impaired blood microcirculation in the skin and other organs.

Intellectual development disorders

Iron is part of a number of brain enzymes ( tyrosine hydroxylase, monoamine oxidase and others). Violation of their formation leads to impaired memory, concentration and intellectual development. In the later stages of anemia, intellectual impairment worsens due to insufficient oxygen supply to the brain.

Diagnosis of iron deficiency anemia

A doctor of any specialty may suspect that a person has anemia based on external manifestations of this disease. However, establishing the type of anemia, identifying its cause and prescribing appropriate treatment should be done by a hematologist. During the diagnostic process, he may prescribe a number of additional laboratory and instrumental studies, and, if necessary, involve specialists from other fields of medicine.

It is important to note that treatment of iron deficiency anemia will be ineffective if the cause of its occurrence is not identified and eliminated.

In the diagnosis of iron deficiency anemia the following is used:

• interview and examination of the patient;
• bone marrow puncture.

Interview and examination of the patient

The first thing a doctor should do if he suspects iron deficiency anemia is to carefully question and examine the patient.

The doctor may ask the following questions:

• When and in what order did the symptoms of the disease begin to appear?
• How quickly did they develop?
• Are there any similar symptoms family members or immediate relatives?
• How does the patient eat?
• Does the patient suffer from any chronic diseases?
• What is your attitude towards alcohol?
• Has the patient taken any medications during last months?
• If a pregnant woman is sick, the duration of pregnancy, the presence and outcome of previous pregnancies, and whether she is taking iron supplements are clarified.
• If a child is sick, his birth weight is specified, whether he was born full-term, and whether the mother took iron supplements during pregnancy.

During the examination, the doctor assesses:

• Nutritional nature– according to the degree of expression of subcutaneous fat.
• Color of skin and visible mucous membranes– special attention is paid to the oral mucosa and tongue.
• Skin appendages - hair, nails.
• Muscle strength– the doctor asks the patient to squeeze his hand or uses a special device ( dynamometer).
• Arterial pressure - it can be reduced.
• Taste and smell.

General blood analysis

This is the first test prescribed to all patients if anemia is suspected. It allows you to confirm or refute the presence of anemia, and also provides indirect information about the state of hematopoiesis in the red bone marrow.

Blood for general analysis can be taken from a finger or from a vein. The first option is more suitable if the general analysis is the only one laboratory research, prescribed to the patient ( when a small amount of blood is enough). Before taking blood, the skin of the finger is always treated with cotton wool soaked in 70% alcohol to avoid infection. The puncture is made with a special disposable needle ( scarifier) to a depth of 2 – 3 mm. The bleeding in this case is not severe and stops completely almost immediately after taking blood.

In the event that you plan to perform several studies at once ( for example, general and biochemical analysis) – venous blood is taken, since it is easier to obtain in large quantities. Before blood sampling, a rubber tourniquet is applied to the middle third of the shoulder, which fills the veins with blood and makes it easier to determine their location under the skin. The puncture site should also be treated alcohol solution, after which the nurse punctures the vein with a disposable syringe and draws blood for analysis.

The blood obtained by one of the described methods is sent to the laboratory, where it is examined in a hematology analyzer - a modern high-precision instrument available in most laboratories in the world. Part of the obtained blood is stained with special dyes and examined in a light microscope, which allows you to visually assess the shape of red blood cells, their structure, and in the absence or malfunction of a hematological analyzer, to count all the cellular elements of the blood.

In iron deficiency anemia, a peripheral blood smear is characterized by:

• Poikilocytosis – presence of red blood cells in the smear various forms.
• Microcytosis – predominance of red blood cells, the size of which is less than normal ( Normal red blood cells may also be present).
• Hypochromia – the color of red blood cells changes from bright red to pale pink.

Results of a general blood test for iron deficiency anemia

Indicator under study	What does it mean?	Norm
Red blood cell concentration (R.B.C.)	When iron reserves in the body are depleted, erythropoiesis in the red bone marrow is disrupted, as a result of which the total concentration of red blood cells in the blood will be reduced.	Men (M ) : 4.0 – 5.0 x 10 12 /l.	Less than 4.0 x 10 12 /l.
		Women(AND): 3.5 – 4.7 x 10 12 /l.	Less than 3.5 x 10 12 /l.
Average red blood cell volume (MCV )	With iron deficiency, the formation of hemoglobin is disrupted, resulting in a decrease in the size of the red blood cells themselves. A hematology analyzer allows you to determine this indicator as accurately as possible.	75 – 100 cubic micrometers ( µm 3).	Less than 70 µm 3.
Platelet concentration (PLT)	Platelets are cellular elements of the blood responsible for stopping bleeding. A change in their concentration can be observed if iron deficiency is caused by chronic blood loss, which will lead to a compensatory increase in their formation in the bone marrow.	180 – 320 x 10 9 /l.	Normal or increased.
Leukocyte concentration (WBC)	During development infectious complications the concentration of leukocytes may increase significantly.	4.0 – 9.0 x 10 9 /l.	Normal or increased.
Reticulocyte concentration ( RET)	Under normal conditions, the body's natural response to anemia is to increase the rate of red blood cell production in the red bone marrow. However, with iron deficiency, the development of this compensatory reaction is impossible, which is why the number of reticulocytes in the blood decreases.	M: 0,24 – 1,7%.	Decreased or at the lower limit of normal.
		AND: 0,12 – 2,05%.
Total hemoglobin level (HGB)	As already mentioned, iron deficiency leads to impaired hemoglobin formation. The longer the disease lasts, the lower this indicator will be.	M: 130 – 170 g/l.	Less than 120 g/l.
		AND: 120 – 150 g/l.	Less than 110 g/l.
Average hemoglobin content in one red blood cell ( MCH )	This indicator more accurately characterizes the disruption of hemoglobin formation.	27 – 33 picograms ( pg).	Less than 24 pg.
Hematocrit (Hct)	This indicator displays the number of cellular elements in relation to the volume of plasma. Since the vast majority of blood cells are represented by erythrocytes, a decrease in their number will lead to a decrease in hematocrit.	M: 42 – 50%.	Less than 40%.
		AND: 38 – 47%.	Less than 35%.
Color index (CPU)	The color index is determined by passing a light wave of a certain length through a suspension of red blood cells, which is absorbed exclusively by hemoglobin. The lower the concentration of this complex in the blood, the lower the color index value.	0,85 – 1,05.	Less than 0.8.
Erythrocyte sedimentation rate (ESR)	All blood cells, as well as the endothelium ( inner surface) vessels have a negative charge. They repel each other, which helps maintain red blood cells in suspension. As the concentration of red blood cells decreases, the distance between them increases and the repulsive force decreases, as a result of which they will settle to the bottom of the tube faster than under normal conditions.	M: 3 – 10 mm/hour.	More than 15 mm/hour.
		AND: 5 – 15 mm/hour.	More than 20 mm/hour.

Blood chemistry

During this study, it is possible to determine the concentration of various chemicals in the blood. This provides information about the state of internal organs ( liver, kidneys, bone marrow and others), and also allows you to identify many diseases.

There are several dozen biochemical parameters determined in the blood. This section will describe only those that are important in the diagnosis of iron deficiency anemia.

Biochemical blood test for iron deficiency anemia

Indicator under study	What does it mean?	Norm	Possible changes in iron deficiency anemia
Concentration serum iron	At first, this indicator may be normal, since the iron deficiency will be compensated by its release from the depot. Only with a long course of the disease will the concentration of iron in the blood begin to decrease.	M: 17.9 – 22.5 µmol/l.	Normal or reduced.
		AND: 14.3 – 17.9 µmol/l.
Blood ferritin level	As mentioned earlier, ferritin is one of the main types of iron storage. With a deficiency of this element, its mobilization from depot organs begins, which is why a decrease in the concentration of ferritin in plasma is one of the first signs of an iron deficiency state.	Children: 7 – 140 nanograms in 1 milliliter of blood ( ng/ml).	The longer iron deficiency lasts, the lower the ferritin level.
		M: 15 – 200 ng/ml.
		AND: 12 – 150 ng/ml.
Total iron binding capacity of serum	This analysis based on the ability of transferrin in the blood to bind iron. Under normal conditions, each transferrin molecule is only 1/3 bound to iron. With a deficiency of this microelement, the liver begins to synthesize more transferrin. Its concentration in the blood increases, but the amount of iron per molecule decreases. By determining what proportion of transferrin molecules is in a state unbound with iron, we can draw conclusions about the severity of iron deficiency in the body.	45 – 77 µmol/l.	Significantly higher than normal.
Erythropoietin concentration	As mentioned earlier, erythropoietin is secreted by the kidneys if the body's tissues lack oxygen. Normally, this hormone stimulates erythropoiesis in the bone marrow, but in case of iron deficiency this compensatory reaction is ineffective.	10 – 30 international milliunits in 1 milliliter ( mIU/ml).	Significantly higher than normal.

Bone marrow puncture

This study consists of piercing one of the bones of the body ( usually the sternum) with a special hollow needle and collecting several milliliters of bone marrow substance, which is then examined under a microscope. This allows you to directly assess the severity of changes in the structure and function of the organ.

At the onset of the disease there will be no changes in the bone marrow aspirate. With the development of anemia, there may be an increase in the erythroid lineage of hematopoiesis ( increasing the number of red blood cell precursor cells).

To identify the cause of iron deficiency anemia, the following is used:

• stool test for occult blood;
• X-ray examination;
• endoscopic examinations;
• consultation with other specialists.

Examination of stool for occult blood

The cause of blood in the stool ( melena) may become bleeding from an ulcer, tumor disintegration, Crohn's disease, nonspecific ulcerative colitis and other diseases. Heavy bleeding is easily determined visually by the change in color of stool to bright red ( with bleeding from the lower intestines) or black ( with bleeding from the vessels of the esophagus, stomach and upper intestine).

Massive single bleedings practically do not lead to the development of iron deficiency anemia, as they are quickly diagnosed and eliminated. The danger in this regard is represented by long-term, small-volume blood loss that occurs during injury ( or ulceration) small vessels of the gastrointestinal waste. In this case, it is possible to detect blood in the stool only with the help of a special test, which is prescribed in all cases of anemia of unknown origin.

X-ray studies

To identify tumors or ulcers of the stomach and intestines that could cause chronic bleeding, X-rays with contrast are used. A substance that does not absorb X-rays is used as contrast. This is usually a suspension of barium in water, which the patient must drink immediately before the test begins. Barium coats the mucous membranes of the esophagus, stomach and intestines, as a result of which their shape, contour and various deformations become clearly visible on an x-ray.

Before the study, it is necessary to exclude food intake for the last 8 hours, and when examining the lower intestines, cleansing enemas are prescribed.

Endoscopic studies

IN this group a number of studies are included, the essence of which is to introduce into the body cavities a special apparatus with a video camera at one end connected to a monitor. This method allows you to visually examine the mucous membranes of internal organs, evaluate their structure and function, and also identify tumors or bleeding.

To determine the cause of iron deficiency anemia, the following is used:

• Fibroesophagogastroduodenoscopy ( FEGDS) – insertion of an endoscope through the mouth and examination of the mucous membrane of the esophagus, stomach and upper intestines.
• Sigmoidoscopy – examination of the rectum and lower sigmoid colon.
• Colonoscopy – examination of the mucous membrane of the large intestine.
• Laparoscopy – piercing the skin of the anterior abdominal wall and inserting an endoscope into the abdominal cavity.
• Colposcopy – examination of the vaginal part of the cervix.

Consultations with other specialists

When identifying diseases of various systems and organs, a hematologist can involve specialists from other fields of medicine in order to make a more accurate diagnosis and prescribe adequate treatment.

To identify the cause of iron deficiency anemia, consultation may be necessary:

• Nutritionist - when a nutritional disorder is detected.
• Gastrologist – if you suspect the presence of an ulcer or other diseases of the gastrointestinal tract.
• Surgeon - in the presence of bleeding from the gastrointestinal tract or other localization.
• Oncologist – if you suspect a tumor of the stomach or intestines.
• Obstetrician-gynecologist – if there are signs of pregnancy.

Treatment of iron deficiency anemia

Therapeutic measures should be aimed at restoring the level of iron in the blood, replenishing the reserves of this microelement in the body, as well as identifying and eliminating the cause that caused the development of anemia.

Diet for iron deficiency anemia

One of the important areas in the treatment of iron deficiency anemia is proper nutrition. When prescribing a diet, it is important to remember that iron, which is part of meat, is most easily absorbed. At the same time, only 25–30% of the heme iron supplied with food is absorbed in the intestine. Iron from other animal products is absorbed only by 10–15%, and from plant products by 3–5%.

Approximate iron content in various foods

The product's name	Iron content per 100 g of product
Animal products
Pork liver	20 mg
Chicken liver	15 mg
Beef liver	11 mg
Egg yolk	7 mg
Rabbit meat	4.5 – 5 mg
Lamb, beef	3 mg
Chicken meat	2.5 mg
Cottage cheese	0.5 mg
Cow's milk	0.1 – 0.2 mg
Products plant origin
Dog-rose fruit	20 mg
Sea kale	16 mg
Prunes	13 mg
Buckwheat	8 mg
Sunflower seeds	6 mg
Black currant	5.2 mg
Almond	4.5 mg
Peach	4 mg
Apples	2.5 mg

Treatment of iron deficiency anemia with medications

The main direction in the treatment of this disease is the use of iron supplements. Diet therapy, although an important stage of treatment, is not able to independently compensate for iron deficiency in the body.

The method of choice is tablet forms of drugs. Parenteral ( intravenous or intramuscular) iron administration is prescribed if it is impossible to fully absorb this microelement in the intestine ( for example, after removal of part of the duodenum), it is necessary to quickly replenish iron reserves ( with massive blood loss) or during development adverse reactions from the use of oral forms of the drug.

Drug therapy for iron deficiency anemia

Drug name	Mechanism therapeutic effect	Directions for use and doses	Monitoring the effectiveness of treatment
Hemophere prolongatum	A ferrous sulfate preparation that replenishes the reserves of this microelement in the body.	Take orally, 60 minutes before or 2 hours after meals, with a glass of water. children – 3 milligrams per kilogram of body weight per day ( mg/kg/day); adults – 100 – 200 mg/day. The break between two subsequent doses of iron should be at least 6 hours, since during this period the intestinal cells are immune to new doses of the drug. Duration of treatment – ​​4 – 6 months. After normalization of hemoglobin levels, they switch to a maintenance dose ( 30 – 50 mg/day) for another 2 – 3 months.	Treatment effectiveness criteria are: An increase in the number of reticulocytes in peripheral blood analysis on days 5–10 after starting iron supplementation. Increased hemoglobin level ( usually observed after 3–4 weeks of treatment). Normalization of hemoglobin levels and red blood cell counts at 9–10 weeks of treatment. Normalization of laboratory parameters - serum iron levels, blood ferritin, total iron-binding capacity of serum. The gradual disappearance of iron deficiency symptoms occurs over several weeks or months. These criteria are used to monitor the effectiveness of treatment with all iron preparations.
Sorbifer Durules	One tablet of the drug contains 320 mg of ferrous sulfate and 60 mg of ascorbic acid, which improves the absorption of this trace element in the intestine.	Take orally, without chewing, 30 minutes before meals with a glass of water. adults for the treatment of anemia – 2 tablets 2 times a day; for women with anemia during pregnancy – 1 – 2 tablets 1 time per day. After normalization of hemoglobin levels, they switch to maintenance therapy ( 20 – 50 mg 1 time per day).
Ferro foil	A complex medicine that contains: ferrous sulfate; vitamin B12. This drug is prescribed to women during pregnancy ( when the risk of developing iron deficiency increases, folic acid and vitamins), as well as for various diseases of the gastrointestinal tract, when the absorption of not only iron, but also many other substances is impaired.	Take orally, 30 minutes before meals, 1 – 2 capsules 2 times a day. Treatment period – 1 – 4 months ( depending on the underlying disease).
Ferrum Lek	Iron preparation for intravenous administration.	Intravenously, drip, slowly. Before administration, the drug must be diluted in sodium chloride solution ( 0,9% ) in a ratio of 1:20. The dose and duration of use are determined by the attending physician individually in each specific case. With intravenous administration of iron, there is a high risk of overdose, so this procedure should only be performed in a hospital setting under the supervision of a specialist.

It is important to remember that some medications ( and other substances) can significantly accelerate or slow down the rate of iron absorption in the intestine. They should be used with caution in combination with iron supplements, as this can lead to an overdose of the latter, or, conversely, to a lack of therapeutic effect.

Substances affecting iron absorption

Medicines that promote iron absorption	Substances that interfere with iron absorption
ascorbic acid; succinic acid ( drug that improves metabolism); fructose ( nourishing and detoxifying agent); cysteine ​​( amino acid); sorbitol ( diuretic); nicotinamide ( vitamin).	tannin ( Contains tea leaves); phytins ( found in soy, rice); phosphates ( found in fish and other seafood); calcium salts; antacids; tetracycline antibiotics.

Red blood cell transfusion

If the course is uncomplicated and the treatment is carried out correctly, there is no need for this procedure.

Indications for red blood cell transfusion are:

• massive blood loss;
• decrease in hemoglobin concentration less than 70 g/l;
• persistent decrease in systolic blood pressure ( below 70 millimeters of mercury);
• upcoming surgical intervention;
• upcoming birth.

Red blood cells should be transfused for the shortest possible period of time until the threat to the patient's life is eliminated. This procedure may be complicated by various allergic reactions, therefore, before it begins, it is necessary to carry out a number of tests to determine the compatibility of the blood of the donor and recipient.

Prognosis for iron deficiency anemia

At the present stage of medical development, iron deficiency anemia is a relatively easily treatable disease. If the diagnosis is made in a timely manner, comprehensive, adequate therapy is carried out and the cause of iron deficiency is eliminated, there are no residual effects will not be.

The cause of difficulties in treating iron deficiency anemia may be:

• incorrect diagnosis;
• unknown cause of iron deficiency;
• late treatment;
• taking insufficient doses of iron supplements;
• violation of medication or diet regimen.

If there are violations in the diagnosis and treatment of the disease, various complications may develop, some of which may pose a danger to human health and life.

Complications of iron deficiency anemia may include:

• Retarded growth and development. This complication typical for children. It is caused by ischemia and associated changes in various organs, including in brain tissue. Reported as a delay physical development, as well as a violation of the child’s intellectual abilities, which, with a long course of the disease, may be irreversible.
into the bloodstream and body tissues), which is especially dangerous in children and the elderly.

Of greater interest to most people are deficiency anemias, which can occur in almost anyone. Therefore, we will dwell in more detail on this type of anemia.

Iron-deficiency anemia- causes, symptoms, diagnosis and treatment

The iron content in the human body is 4–5 g or 0.000065% of body weight. Of these, 58% of iron is part of hemoglobin. Iron can be deposited (stored in reserve) in the liver, spleen and bone marrow. At the same time, physiological losses of iron occur through feces, urine, sweat, menstruation and during breastfeeding, so it is necessary to include iron-containing foods in the diet.

Causes of iron deficiency anemia

Iron deficiency anemia occurs in the following cases:

1. lack of iron in the body (premature babies, children under 1 year of age, pregnant women)
2. increased need for iron (pregnancy, breastfeeding, period increased growth)
3. disturbances in the absorption of iron from the gastrointestinal tract and its subsequent transportation
4. chronic blood loss

Symptoms of iron deficiency anemia

Clinically, iron deficiency anemia is manifested by three main syndromes - hypoxic, sideropenic and anemic. What are these syndromes? How is each of them characterized? A syndrome is a stable set of symptoms. So, hypoxic syndrome is characterized by shortness of breath, headaches, tinnitus, fatigue, drowsiness and tachycardia; anemic syndrome is expressed in a decrease in the number of red blood cells and hemoglobin. Sideropenic syndrome is directly related to a decrease in the amount of iron in the body and manifests itself as follows: impaired nutrition of the skin, nails, and hair - “alabaster” skin, dry and rough skin, brittle hair and nails. Then a perversion of taste and smell is added (the desire to eat chalk, inhale the smell of washed concrete floors, etc.). Complications from the gastrointestinal tract may occur - caries, dysphagia, decreased acidity of gastric juice, involuntary urination (in severe cases), sweating.

Diagnosis of iron deficiency anemia

In the blood, there is a decrease in hemoglobin content to 60 - 70 g/l, red blood cells to 1.5 - 2 T/l, and the number of reticulocytes is also reduced or completely absent. Red blood cells of various shapes and sizes appear. Serum iron concentration is below normal.

Treatment of iron deficiency anemia

The treatment of iron deficiency anemia is based on the principles of eliminating the cause of its occurrence - treatment of diseases of the gastrointestinal tract, as well as the introduction of a balanced diet. The diet should contain foods high in iron (liver, meat, milk, cheese, eggs, cereals, etc.). However, the main means of restoring the amount of iron in the body at the initial stage is iron medications. In most cases, such medications are prescribed in tablet form. In severe cases, intramuscular or intravenous injections are used. In the treatment of this anemia, for example, the following drugs are used: sorbifer, ferrum-lek, tardiferon, totema and others. Choice of different medicines, including combined ones, is very wide.

When choosing, you should consult your doctor. Usually, daily dose for the prevention and treatment of mild anemia is 50-60 mg of iron, for the treatment of moderate anemia - 100-120 mg of iron per day. Treatment of severe anemia is carried out in a hospital and iron supplements are used in the form of injections. Then they switch to tablet forms. Iron supplements cause darkening of the stool, but this is normal in this situation. If an iron supplement causes discomfort in the stomach, it must be replaced.

Iron refractory anemia causes, symptoms, diagnosis and treatment

Cause of iron refractory anemia

Iron refractory anemia is also called sideroblastic or sideroachristic. Iron-refractory anemia develops against the background normal content iron in the blood serum and a lack of enzymes that are involved in the synthesis of hemoglobin. That is, the main cause of iron-refractory anemia is a violation of the processes of “absorption” of iron.

Symptoms of iron-refractory anemia, what is hemosiderosis?

Iron-refractory anemia manifests itself as shortness of breath, headaches, dizziness, tinnitus, fatigue, drowsiness, sleep disturbances and tachycardia. Due to the high iron content in the blood tissues, hemosiderosis Hemosiderosis is the deposition of iron in organs and tissues due to its excess. With hemosiderosis, heart failure develops. vascular system due to iron deposition in the heart muscle, diabetes, lung damage and an increase in the size of the liver and spleen. The skin takes on an earthy tint.

Diagnosis of iron-refractory anemia, what are sideroblasts?

The blood color index is reduced to 0.6 - 0.4, red blood cells of various shapes and sizes are present, the amount of hemoglobin and red blood cells is below normal. There are changes in the bone marrow - cells appear - sideroblasts. Sideroblasts are cells that have a rim of iron around their nucleus. Normally, such cells in the bone marrow are 2.0–4.6%, and in iron-refractory anemia their number can reach up to 70%.

Treatment of iron-refractory anemia

To date, there is no treatment that could eliminate it completely. It is possible to use replacement therapy - infusion of red blood cells and blood substitutes.

B12 deficiency anemia, causes of the disease, diagnosis and treatment.

What is B12? Where is this vitamin found?

Firstly, what is B12? AT 12 is a vitamin that also has the name cyanocobalamin . Cyanocobalamin is found mainly in products of animal origin - meat, liver, kidneys, milk, eggs, cheese. The level of vitamin B12 must be constantly maintained by consuming appropriate foods, since its natural physiological loss occurs in feces and bile.

Causes of B12 deficiency anemia

So, B12 deficiency anemia is anemia that occurs due to a deficiency of vitamin B12. Vitamin B12 deficiency can be caused by insufficient dietary intake or impaired absorption in the gastrointestinal tract. Insufficient intake of cyanocobalamin from food is possible in strict vegetarians. Also, a deficiency of B12 can occur when the need for it increases in pregnant women, nursing mothers, and cancer patients. Failure to absorb vitamin B12, supplied with food in sufficient quantities, occurs in diseases of the stomach, small intestine (diverticula, worms) and treatment with anticonvulsants or oral contraceptives.

Symptoms of B12 deficiency anemia

Symptoms of B12 deficiency anemia are characterized by disorders in the central nervous system and gastrointestinal tract. So, let's look at these two large groups of symptoms:

1. from the central nervous system. There is a decrease in reflexes, paresthesia (“goosebumps”), numbness of the limbs, a feeling of wobbly legs, gait disturbance, memory loss
2. from the gastrointestinal tract. There is increased sensitivity to acidic foods, glossitis, difficulty swallowing, atrophy of the gastric mucosa, an increase in the size of the liver and spleen

Diagnosis of B12 deficiency anemia

In the blood system there is a transition to the megaloblastic type of hematopoiesis. This means that giant red blood cells with a shortened life span, brightly colored red blood cells without clearing in the center, pear-shaped and oval red blood cells with Jolly bodies and Cabot rings appear in the blood. Giant neutrophils also appear, the number of eosinophils decreases (up to complete absence), basophils and total number leukocytes. The concentration of bilirubin in the blood is increased, and therefore, slight yellowing of the skin and sclera of the eyes may occur.

Treatment of B12 deficiency anemia

First of all, it is necessary to cure diseases of the gastrointestinal tract and establish a balanced diet with sufficient vitamin B12. The use of a course of injections of vitamin B12 quickly normalizes hematopoiesis in the bone marrow, and then a constant, regular intake of sufficient amounts of vitamin B12 with food is necessary.

Folate deficiency anemia, causes, symptoms and treatment

Vitamin B9 – folic acid . It enters the body with food - beef and chicken liver, lettuce, spinach, asparagus, tomatoes, yeast, milk, meat. Vitamin B9 can accumulate in the liver. Thus, B9 - deficiency anemia occurs due to a lack of folic acid in the human body. Lack of folic acid is possible when children are fed goat's milk, during long-term heat treatment of food, in vegetarians, or with insufficient or unbalanced diet. Also, folic acid deficiency is observed with an increased need for it in pregnant, lactating, premature children, adolescents, and cancer patients. Sun-deficiency anemia is caused by the presence of diseases such as chronic renal failure and liver disease. The occurrence of folic acid deficiency is also possible when the absorption of this vitamin is impaired, which occurs with alcoholism, taking oral contraceptives and B12 deficiency.

Symptoms of folate deficiency anemia

With folate deficiency anemia, the gastrointestinal tract suffers, and therefore the manifestations of this anemia are associated with disturbances in the functioning of the gastrointestinal tract. There is an appearance hypersensitivity to sour foods, glossitis, difficulty swallowing, atrophy of the gastric mucosa, enlargement of the liver and spleen.
The same changes occur in the blood system as with B12 deficiency anemia. This is a transition to the megaloblastic type of hematopoiesis, the appearance of giant neutrophils, a decrease in the number of eosinophils, basophils and the total number of leukocytes.

Treatment of folate deficiency anemia

To treat this type of anemia, folic acid tablets are used and the diet is normalized, which should include foods containing sufficient amounts of folic acid.

Hypoplastic anemia, causes, diagnosis, treatment

Hypoplastic anemia is characterized by a decrease in the content of all cells in the blood ( pancytopenia ). Pancytopenia is associated with the death of progenitor cells in the bone marrow.

Symptoms of hypoplastic anemia

Hypoplastic anemia can be hereditary or acquired, but all subtypes of this type of anemia are characterized by the same manifestations. Consider these symptoms:

1. Bleeding, bleeding gums, fragility of blood vessels, bruises on the skin, etc. These phenomena occur due to low platelet levels in the blood.
2. Ulcerative-necrotic lesions of the mouth, pharynx, nose, skin. Attachment of infections. This occurs due to the low number of white blood cells in the blood.
3. Dizziness, headaches, tinnitus, drowsiness, fatigue, fainting, sleep disturbances, shortness of breath, increased heart rate, etc.
4. In a general blood test, a decrease in the content of all blood cells - red blood cells, leukocytes, platelets. In the bone marrow there is a picture of desolation, as the foci of hematopoiesis are replaced by adipose tissue.

Causes causing the development of hypoplastic anemia

What reasons can cause such bone marrow damage? Hereditary anemias, accordingly, are inherited, but acquired ones? All factors that can lead to the development of hypoplastic anemia are divided into exogenous (external) and endogenous (internal). The table shows the main exogenous and endogenous causes that can cause the development of hypoplastic anemia.

External factors	Internal factors
Physical – radiation, high-frequency currents, vibration	Genetic – mutations due to unknown causes
Mechanical – injuries	Endocrine diseases thyroid gland, diabetes mellitus, ovarian diseases in which their function is enhanced
Chemical – industrial poisons, some medicines	Systemic diseases connective tissue– systemic lupus erythematosus, rheumatoid arthritis
Biological – viruses, mainly the herpes group, fungi, intracellular bacteria	Malnutrition - lack of substances necessary for hematopoiesis

Principles of treatment of hypoplastic anemia

Treatment of hypoplastic anemia is strictly within the competence of the hematologist. Various methods of stimulating hematopoiesis or bone marrow transplantation can be used.

So, we have looked at all the main types of anemia. Of course, there are many more of them, but we cannot comprehend the immensity. If any signs of anemia appear, you should consult a doctor promptly. And regularly take a blood test for hemoglobin levels.

A lack of red blood cells in the blood leads to a condition called anemia. Symptoms and treatment in adult women have their own characteristics due to physiology.

Anemia and its varieties

Erythrocytes - red blood cells - contain the protein hemoglobin, one of the functions of which is to transport oxygen to organs and tissues.

All types of anemia pose a danger to health, and sometimes life.

Causes of anemia in adult women

Female anemia is not uncommon, unfortunately. It may be due to:

Periodic intestinal bleeding poses a particular danger. They are not abundant and unnoticeable, but regular. Diagnosed by testing stool for occult blood. The person is weaker and “melts” before our eyes, not realizing the causes of anemia. Meanwhile, such phenomena may be symptoms of a malignant process in the intestine;

In addition to the above, there are indirect risk factors that can provoke the development of anemia:

• a diet that includes foods and dishes that are insufficient in folic acid, iron and vitamin B12;
• dysbacteriosis and frequent intestinal disorders, due to which nutrients do not enter the blood in full, which negatively affects hemoglobin levels;
• pregnancy and breast-feeding. During these periods, the body requires more iron and other microelements, because it works “for two”. Monitoring a woman’s health during pregnancy and after childbirth includes a mandatory test of her blood for hemoglobin;
• menopause Hormonal changes caused by the aging of the body and the decline of reproductive functions cause many changes in the condition and well-being of a woman. Anemia can be one of these metamorphoses, although older women often face the opposite problem - high hemoglobin levels, which also relates to health problems;
• severe pathologies of the liver, kidneys and other organs in which a person loses blood;
• genetic predisposition. Some types of anemia can be inherited.

Pregnant women constitute a special category in terms of risks. When discussing the dangers of anemia for women when carrying a child, it is worth noting that the associated lack of oxygen has a detrimental effect, among other things, on the formation of the placenta and the health of the unborn baby. The danger of fetal hypoxia increases, and therefore central nervous system disorders in the future. Among other things, anemia weakens the labor activity of the expectant mother.

A timely visit to a doctor will normalize the condition and avoid complications.

Treatment of anemia in adults

Therapy for anemia begins with normalizing the regimen and diet. It is necessary to eat regularly and nutritiously, be sure to include foods high in iron and vitamin A in the menu. With mild anemia, this is enough to restore health.

When there is no improvement, the doctor may prescribe pharmaceutical drugs that affect the composition of the blood and help normalize hemoglobin levels. IN difficult cases Hormone therapy is also indicated.

Only a doctor knows how to treat anemia. When choosing means and methods of therapy, the specialist takes into account everything related to the woman’s health condition. Sometimes consultations with a gynecologist and endocrinologist are required.

In the posthemorrhagic form, in addition to everything else, blood transfusions are used.

Video

Prevention of anemia

To protect yourself from the risk of anemia, every woman must:

• organize your diet and lifestyle correctly so that the body receives everything it needs for normal functioning. Food should be rich in proteins, vitamins and minerals. Doctors believe that the daily diet of an adult should include at least half a kilogram fresh vegetables and fruits, regardless of the season. This will strengthen the body and avoid many health problems;
• during pregnancy with precision follow medical recommendations regarding diagnosis and prevention pathological conditions, which includes anemia. This will allow you to keep your own body in order, as well as bear and give birth to a healthy baby without any problems;
• when the first ones appear alarming symptoms see a doctor, treat responsibly diagnostic procedures and therapy.

Attentive and careful attitude towards your own body will make your life full, long and happy.

What are the consequences? low hemoglobin in women, and how to treat it.

From this article you will learn

1. Anemia in women, and how to treat it?

• The different types of anemia and their causes include
• Risk factors
• Symptoms of anemia in women

2. How to treat low hemoglobin in women

Anemia in women, and how to treat it?

It is also called anemia - not just a separate disease, it is a whole group of clinical and hematological various syndromes, which are united by one common point - a decrease in the concentration of hemoglobin in a person’s blood, most often everything occurs simultaneously with a decrease in the number of red blood cells. The term “anemia” itself cannot indicate any specific illness or disease; simply put, we should consider anemia as one of the important symptoms of various pathological abnormalities. Ibn Sina wrote a lot about this in his books on medicine.

Note that there are several various types anemia, and each of them has various reasons; Iron deficiency is the most common form of the disease.

Anemia can also be caused by a lack of vitamin B12 or folic acid in the body.

What is responsible for low hemoglobin?

Iron deficiency anemia - the main symptoms are fatigue and lethargy, leading to a lack of energy, and other symptoms include difficulty breathing, or changes in vision (such as a pale complexion and dry nails). If the cause is slow blood loss, there may be no symptoms.

It is also known that iron is part of many other enzymes, without which our body is not able to function normally.

Risk factors

These factors increase the risk of developing anemia:

• Lack of vitamins in the daily diet. You constantly eat foods low in iron, vitamin B-12 and folic acid, which can develop low hemoglobin.
• You suffer from intestinal disorders. Persistent intestinal problems, as well as celiac disease and Crohn's disease, can interfere with the normal absorption of all the nutrients that enter your small intestine from the food you eat.
• Menstruation. In general, women who have not experienced menopause have a greater risk of iron deficiency anemia. Continuous menstruation leads to blood loss, and as a consequence to disease.
• Pregnancy. Pregnant women are often at risk of developing anemia. Therefore, it is imperative to monitor your diet and lifestyle during pregnancy.
• Various chronic diseases. If you suffer from kidney failure, cancer or another chronic disease, you may also be at risk of getting sick. Chronic, slow blood loss from any ulcer or other source in your body can very quickly deplete your iron stores, leading to iron deficiency anemia.
• Your family history. If you have a family member with a family history of sickle cell anemia, you may also be at increased risk of the disease.
• Other factors. Infections, blood disorders and autoimmune disorders, alcoholism, exposure to toxic chemicals, and the use of certain medications can affect the body's production of blood, leading to decreased hemoglobin
• Age. People over 65 years of age are at increased risk of developing anemia.

What is the normal level of hemoglobin in the blood?

The normal concentration of hemoglobin in the blood of women is from 12 to 16 g/dl

Causes of anemia in women

It occurs when the blood does not contain enough red blood cells. This may happen if:

1. Your body does not produce enough red blood cells.
2. Bleeding that results in the loss of red blood cells faster than they can be replaced.
3. Your body destroys red blood cells.

The different types of anemia and their causes include:

1. Iron deficiency. This Anemia occurs when iron (found in meat, nuts and some vegetables) is not enough in the body. If the disease is left untreated, it can make the patient more susceptible to illness and infection, as iron deficiency affects the immune system. In some cases, severe iron deficiency can increase the risk of patients developing complications affecting the lungs, such as tachycardia (irregular beats and rapid heartbeat) and heart failure.
   A pregnant woman also has more high risk development of complications before and after childbirth.
2. Vitamin. The human body needs a variety of vitamins and minerals, including folic acid and vitamin B-12. If your body is deficient in these two components, your diet will be deficient in these and other key nutrients and may result in decreased red blood cell production. In addition, some people consume sufficient amounts of vitamin B - 12, but their body simply is not able to process this vitamin. With this type of disease, pernicious anemia may develop.
3. Active bleeding- Blood loss due to heavy menstrual bleeding or injury can cause the disease.
4. Cancer. Colon cancer and gastrointestinal ulcers can also lead to anemia.
5. Chronic diseases- any long-term disease or disorder can lead to anemia, and the exact mechanism of this process is still unknown, so any medical condition, cancer, or chronic infection can lead to anemia.
6. Kidney diseases- produce the hormone erythropoietin, which helps the bone marrow produce red blood cells. This hormone decreases in people with chronic kidney disease or end-stage kidney disease kidney disease and reduces the production of red blood cells, leading to anemia.
7. Pregnancy- Weight gain due to fluids and water during pregnancy weakens the blood and can be reflected as anemia.
8. Poor nutrition / Vegetarianism, raw food diet- Iron, also necessary for proper production of hemoglobin. Poor diet is one of the main reasons for low levels of folic acid and vitamin B12. Vegan vegetarians who do not get enough vitamins are also at risk of developing vitamin B12 deficiency.
9. Fatal anemia- A problem in the stomach or intestines can lead to poor absorption of vitamin B12, and this can lead to anemia.
10. Sickle cell anemia- may be associated with the production of abnormal hemoglobin molecules, which can cause problems in the integrity of the red blood cell structure. Sickle cell anemia can be quite serious illness and, as a rule, is inherited.

Symptoms of anemia in women

Signs of iron deficiency:

• constant weakness
• increased fatigue during normal exercise
• a sharp decrease in your ability to work
• pale skin
• disturbance, perversion or lack of appetite
• craving for non-food products (chalk)
• depression and stress
• constant bad mood
• tired look
• dry skin
• brittle, dull hair and nails

The insidiousness of anemia in women is that symptoms can increase gradually and unnoticed. The woman partially adapts to them and finds an explanation for her condition through other reasons.

The hemoglobin level and the number of red blood cells can drop catastrophically before she sees a doctor.

How to treat low hemoglobin and anemia in women

1. It is imperative to diagnose the entire body so that the doctor can understand the reasons that led to anemia. Only after eliminating the causes is a cure possible.
2. If a decrease in hemoglobin occurs as a result of a lack of iron, then you just need to change your diet (eat organic meat, lamb and beef, fresh liver, cottage cheese, apples, pomegranate, berries, eggs, honey, meat, beans, pumpkin seeds, a lot of greens, such as spinach, sorrel, nettle, raisins and other dried fruits, iron-fortified cereals).
3. In severe cases, it is necessary to do a blood or red blood cell transfusion, and even iron supplements are administered intramuscularly. Personally, I have not yet met anyone who was able to recover from a severe form of anemia with the help of a transfusion.
4. To prevent iron deficiency, you need to improve your diet. I am against iron in tablets and capsules.

It is important that your body does not receive additional toxicity during the recovery process, so here are some tips:

• Avoid artificial sweeteners.
• Avoid high fructose syrup.
• Don't drink carbonated drinks.
• Avoid fast foods.
• Avoid all canned foods.
• Eliminate regular store-bought dairy products.
• Avoid regular beef. The best beef comes from animals that are fed only organic grass.

Aromatherapy

- Peppermint oil - refreshes and strengthens, has a strong piercing aroma that helps disinfect the air in the body and relieve pain..

— Honey with lemon — has a natural healing smell, refreshes and helps with anemia.

According to statistics, every fourth person has encountered such a problem as anemia. Women are more susceptible to anemia than men. Anemia in females is not considered a separate pathology, but a symptom of another disease or condition human body. Most often it occurs due to a lack of iron in the body. In women with anemia, iron-containing vitamins are used.

If not provided timely treatment anemia, complications may arise that affect the immune and nervous system body.

Anemia can be not only a separate disease, but also a complication of any pathology or its symptom. Consequently, both the reasons for the development of anemia and the type of therapy that will be used in its treatment differ.

Various types of anemia in women

Types of development of anemia, as a pathology or general condition woman's body, maybe.

Iron deficiency. Based on the name, you can understand that the cause of its appearance was a lack of iron in the blood. Also possible reasons The occurrence of this type can be pregnancy, breastfeeding, heavy blood loss with large loss of blood, infectious diseases, etc.

Symptoms of this type include brittle, peeling nails, loss of large amounts of hair, and decreased blood color values. These signs in most cases appear at critical levels of hemoglobin and red blood cells in the blood.

Hemolytic. With this type of anemia, red blood cells are rapidly destroyed, while the bone marrow produces them several times slower. There are hereditary and acquired. During the course of the disease, there is a possibility of jaundice.

Aplastic. Severely slowed production of red blood cells in the body. The causes may be radiation from various chemicals, various infections, or heredity. This type can lead to fatal outcome, therefore, treatment of the pathology should begin immediately.

Folate deficiency. It is a consequence of a lack of vitamin B12. The consequence is the appearance of night. Most often it occurs during pregnancy and breastfeeding, as well as with pathologies and improper use of medications.
Acute posthemorrhoidal. Oxygen of the body due to large blood loss resulting from injury or surgery. The person's skin turns pale, the body becomes stiff.

Chronic posthemorrhagic. The causes and symptoms are similar to the first type on the list.

Medicinal. This type is caused by improper use of medications or drugs contraindicated for human use.

Anemia is also divided into three degrees:

1. Mild with hemoglobin higher than 90 g/l;
2. Average with hemoglobin about 70-90 g/l;
3. Severe when hemoglobin is lower than 70 g/l.

The signs listed above may be symptoms the following diseases: diseases of internal organs, kidney failure, pathology, problems with the spleen, diseases of the gastrointestinal tract.

Anemia in women - main causes

There are several reasons for a lack of hemoglobin in the blood, which most often occurs in women.

• Various diets, on which the girl consumes the wrong daily calorie intake - 1000 or less.
• Anemia can also be caused by heavy bleeding during the menstrual cycle.
• High physical activity.
• During adolescence when there is active growth throughout the body.
• Vegetarianism.
• The inability of a woman's body to absorb iron.
• Pathologies of the gastrointestinal tract.
• Blood donation, transfusion or hemodialysis.
• Pregnancy and period.

Symptoms and signs of anemia in women

Signs of the disease may not show themselves for quite a long time. If you notice several of the symptoms listed below, you should consult a medical specialist.

• Reduced performance.
• Fatigue and constant weakness.
• Fainting.
• Bad feeling.
• Trouble swallowing.
• Shortness of breath.
• Poor condition of the scalp and nail plates.
• I only want to eat salty, sour, spicy foods.
• Constant .
• Painful sensations in the area of ​​the heart.

Diagnostic measures

In order for a medical professional to make a diagnosis, the following must be present: diagnostic measures: specialist examination, general clinical analysis blood. Additional studies are carried out in order to diagnose such types of anemia as: iron deficiency (setting the level of iron in a person’s blood), folate deficiency (determining the level of folic acid in the blood), acquired hemolytic (direct Kubus test, setting erythrocyte osmotic resistance).

Features of treatment

Treatment methods directly depend on the type of disease. Most often, iron-containing drugs are used during therapy. For women, when treating pathology, it is important to take into account not only the consistent intake of medications prescribed by a specialist, but also the correct diet.

Tips for use medical supplies can also be found on the Internet. However, the treatment process should be supervised by a medical specialist.

Medicines and vitamins

You can help the body during the period of rehabilitation therapy with the help of vitamins from a variety of foods, as well as with the help of medications containing vitamins.

For anemia, it is recommended to take the following vitamins: iron, B vitamins, ascorbic acid, copper and zinc, and other vitamins. Are used vitamin complexes or a certain vitamin. The amount of vitamins taken is regulated by the attending physician.

Folk remedies

Another remedy for the treatment of pathology is a variety of folk recipes.
Vegetable juice from radish, beets and carrots. Squeeze the juice from these vegetables and mix in equal proportions. Store in a cool place, avoid direct contact sun rays no more than one week.

Tincture from. Pour 500 ml of boiling water over two teaspoons of berries. Leave to infuse for an hour and a half. Add sugar if necessary. You need to drink the tincture 3-5 times during the day.

Carrot salad. Peel and cut the carrots into strips. Mix with sour cream or vegetable oil.

Diet for anemia

In order to quickly get rid of anemia, you should make up your diet from foods such as meat and liver. It is necessary to consume as many high-calorie foods as possible. Give preference also to fermented milk and dairy products - milk, butter, cream.

Cabbage, zucchini and eggplant are healthy to eat. Which foods contain the most vitamins? In products having yellow: corn, millet porridge, melon.

Consequences of anemia

The consequences of anemia in women who have suffered from this disease during pregnancy can harm not only the health of the mother, but also the health of the child.

The following complications are possible: premature birth of a child; side effects include severe toxicosis; bleeding; weak labor activity; in the period after childbirth, milk deficiency; improper development of the internal organs of the fetus; terrible consequence– the birth of a dead child; a delay in the development of the baby relative to his peers.

What does anemia lead to for women?

It is worth taking this disease seriously. For example, the consequences of long-term iron deficiency can be neurological disorders, anemia of the extremities, and an increase in the size of the liver.

Often, a complication of IDA (iron deficiency anemia) is cardiomyopathy, resulting in heart failure, which often leads to the death of the patient.

Prevention

Preventing anemia from occurring is easier than trying to treat an advanced case of the disease. Preventive methods are especially important for pregnant women, since pathology affects not only the health of the mother, but also the child.

To prevent the occurrence of anemia, you should immediately include sources of iron in your diet: products of animal and plant origin such as chicken, fish, and legumes.

Also, do not come into contact with toxic substances hazardous to health for a long time.