Iron deficiency anaemia is very common in women of childbearing age, children and the elderly. In fact, it is one of the most common nutrient deficiencies diagnosed but often missed using routine biochemical analysis such as hemoglobin or full blood count. Normal Hb in particular does not rule out iron deficiency meaning that one can be iron deficient without being anaemic.

Most people with iron deficiency present with fatigue. Cuts and scratches that heal slowly and a tendency to bruse easily as well as pallor may also point toward low iron or even just low iron stores.  The latter (pallor) is particularly prevelant in children and older individuals.
Iron deficiency would also affect immunity and cognitive function and has been shown to impact on children’s ability to do mathematics.

Iron deficiency is not an ‘illness’ but it is vital to treat this condition timeously.

Iron deficiency is may be due to a number of different factors:

– Insufficient dietary iron intake as would be the case if red meat, liver and other organ meats are not consumed on a regular basis (3 – 4 times per week)
– Blood loss due to menstruation
– Pregnancy
– Child birth
– Lactation
– Growth spurts in children
– Strenous or competive sports practices
– Injury associated with blood loss
– Genetic predisposition for reduced iron absorbtion
– Chronic Illness
– Inflammatory conditions
– Chronic Medication e.g. ant-acids
– Achlorhydria (reduced stomach acid) associated with ageing

Treating Iron Deficiency

Treatment of iron anaemia should always be accompanied by a clear diagnosis of the cause of the anaemia. Once the cause has been established, treatment can be planned accordingly.

Poor diet may contribute to the development of anaemia. If poor diet is not the cause of the deficiency, it could certainly aggravate the deficiency. Low intake of protein and the nutrients folic acid, vitamin C, B12 and B6 could aggravate an iron deficiency.

Instead of focusing on individual foods that contain iron, one should look at all the foods one eats and ensure that one selects a varied diet.

Foods to include that will help ensure adequate iron intake:

– Lean red meat, liver, kidney, oysters
– Sardines, pilchards, mussels
– Eggs
– Dried fruit: apricots, prunes, raisins, figs and dates
– Nuts: cashew nuts and almonds – always keep a packet ready to nibble on instead of “empty calorie snacks”
– Fortified breakfast cereals. (This is not an ideal “healthy food” – but may be included occasionally).

Absorption of iron from food may be influenced by various factors. Take into account that:

1. Iron found in meat, fish and poultry is better absorbed than iron found in plant foods.

2. Include a wide variety of fresh fruit and vegetables rich in Vitamin C in the diet. The vitamin C aids absorption of iron found in both animal and plant foods.

Fruit rich in vitamin C:

guavas
strawberries
kiwi fruit
paw-paw
citrus fruit

Vegetables rich in vitamin C:

broccoli
cauliflower
brussels sprouts
tomatoes

The tannins found in tea may effect iron absorption. Therefor, it is advisable to not have strong tea with meals as a rule.

Rather have a glass of milk with a meal that contains iron. Some of the proteins in milk may support iron absorption. The calcium in milk may also inhibit some food components, such as tannins found in tea and oxalates found in green leafy vegetables e.g. spinach, that may reduce iron absorption in susceptible individuals.

When a prescription for an iron supplement is required, this should still be accompanied by increased intake of foods with high iron content and Vitamin C.

Iron is not a harmless nutrient and supplements should not be taken routinely.

Prevention is better that cure – adequate dietary intake of iron from food sources remains the best day to day option