Anaemia is a condition in which there is decrease in Red Blood Cell count, haemoglobin and/or haematocrit values resulting in a lower ability for the blood to carry oxygen to body tissues.
Normal range for women is 12.1 to 15.1 gm%, in pregnant women more than 11 gm%.
Nutritional anaemia is of 3 types-iron deficiency anaemia, foliate deficiency,B12 deficiency and protein deficiency
Iron deficiency anaemia-in India is 50%.Prevalence is higher in reproductive age women
Causes: diminished iron stores in the body, decreased iron intake, decreased absorption, increased demand, defective metabolism
Who gets iron-deficiency anaemia ?
Iron-deficiency anaemia affects more women than men. The risk of iron-deficiency anaemia is highest for women who:
are pregnant. Iron-deficiency anaemia affects one in six pregnant women.
Have heavy menstrual periods: Up to 5% of women of childbearing age develop iron-deficiency anaemia because of heavy bleeding during their periods.
What are the symptoms of iron-deficiency anaemia ?
Fatigue, weakness, dizziness, headache, irregular menses and pale skin.
If you think you have anaemia , talk to your doctor
Women can have low iron levels for several reasons:
• Iron lost through bleeding. Bleeding can cause you to lose more blood cells and iron than your body can replace. Women may have low iron levels from bleeding caused by:
o Regular, long-term use of aspirin
o Heavier or longer than normal menstrual periods
o Uterine fibroids, which are noncancerous growths in the uterus that can cause heavy bleeding
• Increased need for iron during pregnancy. During pregnancy, your body needs more iron than normal to support your developing baby.
• Not eating enough food that contains iron. Low socioeconomic status. Vegetarians or vegans, who eat little or no animal-based foods, need to choose other good sources of iron to make sure they get enough.
• Problems absorbing iron. Certain health conditions, such as celiac disease, or gastric bypass surgery for weight loss can make it harder for your body to absorb iron from food
• Your doctor will ask you questions about your health history, including how regular or heavy your menstrual periods are. Your doctor may also ask you about any digestive system problems you may have, such as blood in your stool.
• Do a physical exam
• Talk about the foods you eat, the medicines you take, and your family health history.
• Do blood tests. Your doctor will do a complete blood count (CBC). The CBC measures many parts of your blood. If the CBC test shows that you have anaemia , your doctor will likely do another blood test to measure the iron levels in your blood and confirm that you have iron-deficiency anaemia .
• Pelvic ultrasonography to look for fibroids causing menorrhagia
• Blood loss from heavy menstrual periods. Your doctor may give you hormonal birth control to help relieve heavy periods. If your heavy bleeding does not get better, your doctor may recommend surgery. Types of surgery to control heavy bleeding include endometrial ablation, which removes or destroys your uterine lining, and hysterectomy, which removes all or parts of your uterus.
• Increased need for iron. If you have problems absorbing iron or have lower iron levels but do not have severe anaemia , your doctor may recommend:
o Iron pills to build up your iron levels as quickly as possible. Do not take any iron pills without first talking to your doctor.
• Deworming-As hookworm infestation is a common cause.
• Iron supplements to pubertal age girls
• Treat the cause of blood loss. Talk to your doctor if you have heavy menstrual periods or if you have digestive system problems, such as frequent diarrhea or blood in your stool.
• Eat foods with iron. Good sources of iron include lean meat and chicken, dark, leafy vegetables, and beans.
• Eat and drink foods that help your body absorb iron, like orange juice, strawberries, broccoli, or other fruits and vegetables with vitamin C.
• Make healthy food choices. Don’t take iron with antacids.
• Cook food in iron utensils
• Avoid drinking coffee or tea with meals. These drinks make it harder for your body to absorb iron.
• Talk to your doctor if you take calcium pills. Calcium can make it harder for your body to absorb iron. If you have a hard time getting enough iron, talk to your doctor about the best way to also get enough calcium.
Food sources of iron include:
• Fortified breakfast cereals
• Canned white beans
• Dark chocolate
• Beef liver
• Tofu, firm
• Kidney beans
• Canned tomatoes
• Lean beef
• Baked potato
During pregnancy, your body needs more iron to support your growing baby. In fact, pregnant women need almost twice as much iron as women who are not pregnant do. Not getting enough iron during pregnancy raises your risk for premature birth or a low-birth-weight baby (less than 5 ½ pounds). Premature birth is the most common cause of infant death. Both premature birth and low birth weight raise your baby's health risk and developmental problems at birth and during childhood.
If you're pregnant, talk to your doctor about these steps:
• Take a prenatal vitamin with iron every day, or talk to your doctor about taking an iron supplement (pill).
• Testing for iron-deficiency anaemia
• Testing for iron-deficiency anaemia four to six weeks after childbirth
Deworming-as hookworm infestation causes iron deficiency anaemia .
Iron supplements like oral iron tablets and intravenous iron therapy.
• Hormonal birth control, such as the pill, the patch, the shot, or the hormonal intrauterine device (IUD), is often used to treat women with heavy menstrual periods. Lighter menstrual periods may reduce your risk for iron-deficiency anaemia.