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Anaemia is a condition in which the body does not produce enough haemoglobin, a substance in the red blood cells which transports oxygen from the lungs to the rest of the body. This leads to feeling tired and weak, among other symptoms. The most common cause of anaemia is iron deficiency. Iron is needed for the production of haemoglobin.
If you have anaemia, the reason you may lack energy and feel tired is because not enough oxygen is getting to your body and brain. Older people may also get heart pain or angina because their heart has to work harder to supply enough oxygen to the body.
Iron deficiency can be caused by inadequate dietary intake of iron, absorption problems in the gut or increased iron requirements (e.g. pregnancy). Sometimes iron deficiency can result from gastrointestinal blood loss and requires medical investigation.
Symptoms of anaemia
- low energy levels
- reduced exercise capacity
- difficulty concentrating
- difficulty learning new tasks
- being prone to infections
- feeling irritable
- pale skin (looking paler than usual, or ‘washed out’ looking)
Where do we get iron from?
A balanced diet usually contains enough iron for your body’s needs. Iron comes from many foods, including:
- meat and fish: beef, lamb, veal, pork, poultry, mussels, oysters, sardines and tuna
- fruit: dried fruit (prunes, figs, raisins, currants, peaches) and prune and blackberry juice
- vegetables: greens (spinach, silverbeet), beans, peas, pumpkin and sweet potatoes
- grains: oatmeal, iron-fortified breakfast cereals and wholegrain breads
- nuts and eggs
It is best to get iron from a variety of food. Iron in meat, fish and chicken is more easily absorbed than iron in vegetables. To get the most out of these foods remember that eating foods rich in vitamin C, such as citrus fruit and leafy green vegetables, will help your body absorb the iron.
Drinking tea or coffee with meals can stop your body absorbing iron properly.
Breast milk contains enough iron for babies until six months of age. Other foods should then be introduced; check with your doctor or breastfeeding consultant (1800 686 2 686 [1800 mum 2 mum]).
Do you have iron deficiency?
You may develop iron deficiency if you do not eat enough iron-rich foods over a long period of time, or if you have a condition that stops you from absorbing iron from your food properly.
People need more iron at certain times, such as during adolescence, pregnancy or when exercising a lot. Iron deficiency can occur as a result of a long illness, losing blood due to heavy periods or bleeding stomach ulcers. Vegetarians and people with a high dietary alcohol intake may also require iron supplementation.
Some medicines, such as aspirin and non-steroidal anti-inflammatories, can cause bleeding into the gut and lead to anaemia. Patients may need to be investigated with an endoscopy or colonoscopy in hospital to determine the source of the bleeding.
The most common cause of iron deficiency anaemia in developing countries is hookworm infection. The worms live in the gut and feed on blood. It may be the cause of anaemia in people who have travelled overseas.
Increasing iron-rich foods in your diet is not sufficient to correct iron-deficiency anaemia. Once iron stores are restored with treatment it is important to increase dietary iron intake to prevent the deficiency recurring.
See Your Pharmacist or Medical Professional
See your pharmacist or medical professional you have symptoms of anaemia, and particularly:
- if you are pregnant or breastfeeding
- if you have heavy periods
- if you have recently travelled to a developing country
- if you have bleeding haemorrhoids (piles)
- if you have black or tarry stools, or blood in your stools
- if you have stomach pains
- if you are elderly
- if you are taking medication
- if you have a condition affecting your intestines (gut)
- if you have not yet seen a doctor about your condition
- a blood test is needed to confirm anaemia and determine what type it is
- it is important to find out the cause of your anaemia so it can be treated if necessary
- if you have iron deficiency anaemia you will need to take iron tablets or liquid iron medication
- some people who cannot absorb iron properly will need iron injections
- you may need iron treatment for many months to rebuild your body’s iron stores (follow your doctor’s advice on how long to take iron)
- iron treatment is best taken on an empty stomach but it can sometimes cause nausea or indigestion, so take iron with food if this is a problem. Constipation or diarrhoea can also occur
- iron treatment can turn your stools black
- sip liquid iron through a straw to avoid discolouring your teeth
- vitamin C helps your body absorb iron; some iron tablets also contain vitamin C (ascorbic acid)
- take iron tablets with a glass of water or orange juice, not coffee or tea
- iron can interfere with how well other medications are absorbed; ask your pharmacist for advice. Most medicines will need to be taken 2 hours after taking an iron supplement
- iron is dangerous if you take too much, particularly for children
- it is important to only take iron supplementation on advice from your healthcare professional; a blood test is usually required
- always store iron products out of reach of children
e.g. ferrous sulfate (e.g. Ferro-Gradumet, Ferro-Liquid), ferrous fumarate (Ferro-tab), iron polymaltose (e.g. Maltofer)
- Combination products
Iron with vitamin C
e.g. Ferrograd C
- vitamin C, also called ascorbic acid, helps the body to absorb iron
- most iron with other vitamins products contain some level of vitamin C
Iron with folic acid
e.g. Fefol, Elevit, FGF
- folic acid is needed for the production of healthy red blood cells
- folic acid is particularly important during pregnancy
Iron with other vitamins
e.g. Centrum Kids Incremin Iron Mixture (iron, lysine, vitamin B1, B6 and B12), Floradix (herbal food supplement), Spatone, Fab Iron, FabFol Tablets, Fab Iron + B Complex Tablets, Blackmores Bio Iron, Ethical Nutrients Mega Iron, Blackmores Pregnancy Iron, Blackmores Pregnancy and Breastfeeding Gold, Swisse Pregnancy Ultivite, Nature’s Own Iron-Plus, Penta-Vite Liquid Multi-vitamins with Iron, Nature’s Way Kidsmart Iron + Vitamin C
- these products contain other vitamins which may also be lacking in some people’s diets
- iron mixtures may help maintain adequate iron stores in children who are fussy eaters. Always stick to the dosage recommended on the product packaging
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