Family Medicine North  
Anemia and Iron-Deficiency

A decreased number of circulating red blood cells, or insufficient hemoglobin in the cells. Anemia is a symptom of other disorders. For proper treatment, the cause must be found. It decreases the oxygen-carrying capacity of the blood which affects all body cells. Iron deficiency is a common cause of anemia, but there are other causes.

Frequent signs and symptoms:

  • Initially there may be no symptoms.

Signs of pronounced anemia include:

  • Tiredness and weakness
  • Paleness, especially in the hands and lining of the lower eyelids

Less common signs include:

  • Tongue inflammation
  • Fainting
  • Breathlessness
  • Rapid heartbeat
  • Unusual quietness or withdrawal in a child
  • Appetite loss
  • Cravings for ice, paint or dirt (pica)
  • Susceptibility to infection


  • Decreased absorption of iron or increased need for iron.

Causes in infants and children include:

  • Poor nutrition. Between 6 months and 2 years of age, children may consume large quantities of milk, to the exclusion of iron-containing foods.
  • Premature birth. Premature babies often have low stores of iron at birth.

Causes in adolescents and adults include:

  • Rapid growth spurts
  • Heavy menstrual bleeding
  • Pregnancy
  • Malabsorption
  • Gastrointestinal disease with bleeding, including cancer

Risk factors:

  • Poverty
  • Adults over 60
  • Recent illness, such as an ulcer, diverticulitis, colitis, hemorrhoids or gastrointestinal tumors

Preventive measures:

  • Maintain an adequate iron intake through a well-balanced diet or iron supplements
  • Provide iron-fortified formula for bottle-fed infants

Expected outcome:

  • Usually curable with iron supplements if the underlying cause can be identified and cured.

Possible complications:

  • Failure to diagnose a bleeding malignancy


  • Diagnostic tests may include laboratory blood studies of serum iron, total iron-binding capacity and ferritin levels.
  • The most important part of treatment for iron-deficiency anemia is to correct the underlying cause. Iron deficiency can be treated well with iron supplements.
  • Blood transfusions are sometimes prescribed, but they should be unnecessary, except in rare instances.
  • Lower your risk of infections.

Medication/ Iron supplements:

  • Take iron on an empty stomach (at least ½ hour before meals) for best absorption. If it upsets your stomach, you may take it with a small amount of food (except milk).
  • If you take other medications, wait at least 2 hours after taking iron before taking them. Antacids and tetracyclines especially interfere with iron absorption.
  • Because liquid iron supplements may discolor the teeth, a child should drink any liquid preparation through a straw. Iron supplements may also cause black bowel movements, diarrhea or constipation.
  • Continue iron supplements until 2 to 3 months after blood tests return to normal.
  • Too much iron is dangerous. A bottle of iron tablets can poison a child. Keep iron supplements out of the reach of children.


  • No restrictions. You may need to pace activities until symptoms of fatigue are gone.


  • Adults should limit milk to 1 pint a day as it interferes with iron absorption.
  • Eat protein and iron containing foods, including meat, beans, and leafy green vegetables.
  • Increase dietary fiber to prevent constipation.

Notify our office if:

  • You or a family member has symptoms of anemia.
  • You develop nausea, vomiting, fever, stomach pain, severe diarrhea or constipation during treatment.

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