Pat Elliott, ND
- anemia - anemia means a reduced number of red blood cells in the blood and is revealed on screening blood work as a reduced number of red blood cells (reduced RBC count and/or reduced hematocrit) In this type of anemia, the red blood cells are often microcytic (meaning the cells are smaller, which shows on bloodwork as a reduced "MCV") and/or hypo chromic (meaning the cells have low hemoglobin content per cell, which shows on bloodwork as a low "MCHC" or "MCH") Often the MCV and MCH/MCHC values begin to fall before the actual anemia begins to develop; these changes represent the body's final attempts to continue producing red blood cells without an adequate supply of iron.
- poor physical endurance
- excessive sleepiness
- pale skin of face or hands, pale or bluish fingernails, pale inner eyelids
- sore, inflamed tongue
- lightheadedness or dizziness
- feeling cold, easily chilled
- depression, unhappiness or withdrawal
- poor concentration and/or attention span
- nervousness or fearfulness
- poor coordination
- itching, localized or generalized
- shortness of breath
- heavy menstrual flow
- menstrual cramps
- racing heart or heart skipping beats
- poor appetite
- poor nails: brittle, thin, flattened, ridged, or spoon-shaped
- hair loss
- frequent infections
- desire to chew ice, sunflower seeds, raw noodles etc. or to eat inedible substances such as paint, dirt, or paper
- inadequate response to thyroid hormone therapy
- whites of eyes can have a blue hue
Diagnosis - An iron deficient state exists for quite some time before it begins to cause anemia. Unfortunately, iron deficiency is often not screened for if a patient is found to not be anemic, even if the patient is feeling fatigued.. This common practice makes it one of the most commonly missed diagnoses. If iron deficiency is suspected but anemia is not present, then specific blood tests for iron deficiency (including serum iron, TIBC, %saturation, and ferritin) are used for diagnosis. The most sensitive early indicator for iron deficiency is a low or borderline low ferritin level. One's ferritin level is representative of the amount of stored iron present and will be abnormal before anemia symptoms appear. Many laboratory reference ranges report ferritin values between 15 and 40 as being within the normal range; however, many experts believe that ferritin levels below 40 indicate depleted iron stores and a need for iron supplementation for optimal health.
Causes - The most common cause of iron depletion is bleeding such as that which occurs with heavy menstrual periods or stomach and intestinal disorders. Digestive tract disturbances which impair digestion or absorption of iron can also contribute as can the demands of pregnancy and breastfeeding.
Treatment - It is usually necessary to treat iron deficiency with supplemental iron especially in the case of menstruating women. The dosage used can depend on the type used and the tolerance of the patient (iron can cause digestive upset and/or constipation in some) but is usually in the range of 50-150 mg of iron per day. It often takes 6 months to a year to bring ferritin levels up above 40. When each dose of iron is taken with a dose of vitamin C, iron absorption is significantly enhanced.
Food sources - The best food sources for iron are all meats (especially liver), eggs, clams, oysters, shrimp, dark green leafy vegetables, lima beans, navy beans, soy beans, kidney beans, split peas, green peas, dried peaches and apricots, raisins, potato, the cabbage/broccoli/cauliflower family of vegetables, nuts including peanuts, and blackstrap molasses.
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Pat Elliott, ND
Elliott Health Care
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Bellingham, WA 98225
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