IRON DEFICIENCY ANEMIA ---is due to insufficient iron.

Without enough iron, your body can't produce enough hemoglobin, a substance in red blood cells that enables them to carry oxygen. Causes: Blood loss. Blood contains iron within red blood cells. So if you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer can cause iron deficiency anemia. A lack of iron in your diet. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine's ability to absorb nutrients from digested food, can lead to iron deficiency anemia. If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients. Pregnancy. Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of hemoglobin for the growing fetus. Symptoms:

Feeling grumpy Feeling weak more often than usual

Headaches Problems concentrating or thinking

As the anemia gets worse, symptoms may include:

Blue color to the whites of the eyes Brittle nails Light-headedness when you stand up

Pale skin color Shortness of breath Sore tongue

Symptoms of the conditions that cause iron deficiency anemia include:

Dark, tar-colored stools or blood Heavy menstrual bleeding

Pain in the upper belly (from ulcers)

Weight loss (people with cancer) Who are at risk? Infants and Young Children. The iron that full-term infants have stored in their bodies is used up in the first 4 to 6 months of life. Premature and low-birth-weight babies are at even greater risk for iron-deficiency anemia. These babies don't have as much iron stored in their bodies as full-term infants. Teens. Teens are at risk for iron-deficiency anemia if they're underweight or have chronic (ongoing) illnesses. Teenage girls who have heavy periods also are at increased risk for the condition. Women. Women of childbearing age are at higher risk for iron-deficiency anemia because of blood loss during their monthly periods. About 1 in 5 women of childbearing age has iron-deficiency anemia. Pregnant women also are at higher risk for the condition because they need twice as much iron as usual. The extra iron is needed for increased blood volume and for the fetus' growth. Adults Who Have Internal Bleeding. Adults who have internal bleeding, such as intestinal bleeding, can develop iron-deficiency anemia due to blood loss. Certain conditions, such as colon cancer and bleeding ulcers, can cause blood loss. Some medicines, such as aspirin, also can cause internal bleeding. Other At-Risk Groups. People who get kidney dialysis treatment may develop iron-deficiency anemia. This is because blood is lost during dialysis. People who have gastric bypass surgery also may develop irondeficiency anemia. This type of surgery can prevent the body from absorbing enough iron. Diagnostic Tests Red blood cell size and color. With iron deficiency anemia, red blood cells are smaller and paler in color than normal. Hematocrit. This is the percentage of your blood volume made up by red blood cells. Hemoglobin. Lower than normal hemoglobin levels indicate anemia

 Ferritin. This protein helps store iron in your body, and a low level of ferritin usually indicates a low level of stored iron. Additional diagnostic tests Endoscopy. Doctors often check for bleeding from a hiatal hernia, an ulcer or the stomach with the aid of endoscopy. This allows your doctor to view your esophagus and your stomach to look for sources of bleeding. Colonoscopy. To rule out lower intestinal sources of bleeding, your doctor may recommend a procedure called colonoscopy. A colonoscopy allows your doctor to view inside some or all of your colon and rectum to look for internal bleeding. Ultrasound. Women may also have a pelvic ultrasound to look for the cause of excess menstrual bleeding, such as uterine fibroids. Treatment and Prevention Treatments may include dietary changes and supplements, medicines, and surgery. Severe iron-deficiency anemia may require a blood transfusion, iron injections, or intravenous (IV) iron therapy. Dietary Changes and Supplements Iron supplements can correct low iron levels within months. Supplements come in pill form or in drops for children. Large amounts of iron can be harmful, so take iron supplements only as your doctor prescribes. Iron supplements can cause side effects, such as dark stools, stomach irritation, and heartburn. Iron also can cause constipation. Your doctor may advise you to eat more foods that are rich in iron. The best source of iron is red meat, especially beef and liver. Chicken, turkey, pork, fish, and shellfish also are good sources of iron. The body tends to absorb iron from meat better than iron from nonmeat foods. However, some nonmeat foods also can help you raise your iron levels. Examples of nonmeat foods that are good sources of iron include:

Iron-fortified breads and cereals Peas; lentils; white, red, and baked beans; soybeans; chickpeas

Tofu Dried fruits, such as prunes, raisins, and apricots Spinach and other dark green leafy vegetables

Prune juice

Vitamin C Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits. Citrus fruits include oranges, grapefruits, tangerines, and similar fruits. Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones. Other fruits rich in vitamin C include kiwi fruit, strawberries, and cantaloupes. Vegetables rich in vitamin C include broccoli, peppers, Brussels sprouts, tomatoes, cabbage, potatoes, and leafy green vegetables like turnip greens and spinach. Preventing iron deficiency anemia in infants To prevent iron deficiency anemia in infants, feed your baby breast milk or ironfortified formula for the first year. Cow's milk isn't a good source of iron for babies and isn't recommended for infants under one year. Iron from breast milk is more easily absorbed than the iron found in formula. Nursing Management Asses for fatigue, activity intolerance, and other sings of impaired tissue oxygenation Promote an adequate intake of iron-rich foods (iron fortified formula and cereals, liver, egg yolk, and organ meats Emphasize to family members or care givers proper administration of oral iron supplements. Give supplements in two or three divided doses in small amount of Vitamin C-containing liquid. (This enhances absorption) Explain the potential adverse effects of iron which includes nausea and vomiting, diarrhea or constipation or black stools and tooth discoloration. Instruct care givers to keep iron supplements out of reach of children since it is toxic when overdosed. Discuss pace of activities and allow periods of rest.