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by EBSCO Medical Review Board
(Reduced Iron in Blood)

Definition

Anemia is a low level of red blood cells (RBCs). RBCs carry oxygen from the lungs to the rest of the body. Lower RBC counts mean the body is not getting enough oxygen.

Red Blood Cells
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Iron makes a critical component of red blood cells.
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Causes

This type of anemia is caused by low levels of iron in the body. Iron is needed to build healthy RBCs. Low iron levels may be caused by one or more of these issues:

  • Problems with iron getting from the stomach or intestines into the blood. This may be due to intestinal diseases or surgery.
  • Chronic bleeding.
  • Not enough iron in the diet. This is a common cause in infants, children, and pregnant women.

Risk Factors

Things that may increase the chance of this anemia are:

  • Growth spurts that can happen in infants, children, and teens
  • Heavy menstrual bleeding
  • Health issues that cause bleeding in the gastrointestinal tract
  • Pregnancy
  • Breastfed infants who have not started on solid food after 6 months of age
  • Babies who are given cow’s milk before 12 months of age
  • Alcohol use disorder
  • Diets that don't have enough iron—rare in the US

Symptoms

People with this type of anemia may have:

  • Fatigue or weakness
  • Pale skin, fingernail changes, or hair loss
  • Headache
  • Decreased work capacity
  • Heart palpitations
  • Infection
  • A craving for things that are not food, such as ice or clay
  • Shortness of breath during or after physical activity
  • Restless legs at night

Mild anemia may not cause problems.

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Blood tests will be used to confirm anemia. It will also show problems with the level of iron. Other tests may be done to look for a cause.

Treatment

The goal of treatment is to bring iron levels back to normal. The body will then be able to make more RBCs and cure the anemia. Ways to do that are:

  • Treat related problems
    • Slow or stop blood loss. This will stop the loss of iron and let iron levels recover.
    • Treat health issues of the intestines. It may help them pass iron to the rest of the body.
  • An iron supplement may be needed. They can increase the volume of iron that gets into the blood. May be given as a pill or through injections.
  • Iron-fortified foods may help. A fortified cereal may be recommended for babies.

Prevention

If you are at risk for anemia:

  • Eat a diet rich in iron. Include iron-rich foods such as
  • Meat
  • Poultry
  • Fish
  • Peas
  • Beans
  • Potatoes
  • Avoid foods that can block or slow iron absorption. Black tea is one common iron blocker.
  • Follow any treatment plan you have been given for related health problems.

Talk to your doctor about your baby’s diet. In general:

  • Breastfed infants may need an iron supplement starting at 4 months of age. Once they are older, they can get iron from other sources, like cereal or fortified formula.
  • Bottle-fed infants should get a formula that is fortified with iron.
  • Premature infants may need extra iron by 1 month of age.

RESOURCES

Healthy Children—American Academy of Pediatrics  https://healthychildren.org 

The American Congress of Obstetricians and Gynecologists  https://www.acog.org 

CANADIAN RESOURCES

Dietitians of Canada  http://www.dietitians.ca 

Health Canada  https://www.canada.ca 

References

How to add foods that are high in iron to your diet. Cleveland Clinic website. Available at: https://health.clevelandclinic.org/how-to-add-more-iron-to-your-diet/. Accessed May 16, 2022.

Iron deficiency anemia in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/iron-deficiency-anemia-in-adults/. Accessed May 16, 2022.

Iron deficiency anemia in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/iron-deficiency-anemia-in-children. Accessed May 16, 2022.

Lopez A., Cacoub P., et al. Iron deficiency anaemia. Lancet, 2016; 387(10021): 907-916.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 03/2022
  • Update Date: 05/16/2022