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Causes of Iron Deficiency Anemia (IDA)
Reviewed By Medical Advisory Board
Iron is needed by the body for many processes, but in particular for the formation of hemoglobin, the pigment in red blood cells that carries oxygen. When there is not enough iron present the body is unable to produce the usual amount of hemoglobin and red blood cells. Instead small pale red blood cells in smaller numbers than usual are made resulting in the condition known as iron deficiency anemia (IDA).


Signs and Symptoms of Iron Deficiency Anemia (IDA)[1-6]

  • Pale skin
  • An elevated platelet count
  • Inflamed tongue (glossitis)
  • Spoon nails
  • Blue sclerae
  • Weakness
  • Restless leg syndrome
  • Fatigue
  • Irritability
  • Pica -A craving for peculiar substances such as soil or clay or an abnormal appetite for foods such as cornstarch, tomatoes, lemons, and ice.

IDA may be caused by dietary deficiency due to poor diet, poor absorption of iron, or loss of iron from bleeding. Dietary sources of iron include meats, fish, poultry, and plant sources. The iron found in meats, fish, and poultry is contained in a molecule called heme which is easily absorbed by the body. The iron in plant sources is nonheme iron and is not as easily absorbed . Absorption of nonheme iron is increased with acid digestion, and decreased by calcium as well as substances found in tea, coffee, and wines.

Causes of IDA in Reproductive-Aged Women

Increased Iron Requirements

  • Increased requirement due to pregnancy and breast feeding.
  • Heavy menstrual periods
  • Frequent blood donation
  • Hookworms
  • Short interval between pregnancies
  • Excessive blood loss at delivery

Inadequate Supply of Iron

  • Impaired absorption
    • Coeliac disease (gluten intolerance).
    • Gastric by pass (Roux-en-Y gastric bypass in particular)
    • Long term antacid therapy.
    • Substances (such as polyphenols or  phytates) found in foods or drinks such as, soybean-protein,  tea, coffee, and wines
  • Poor diet
    • Some vegetarian diets


Diagnosis of Iron Deficiency Anemia in Pregnancy
Sources of Dietary Iron
Iron Therapy



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2. Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep. 1998;21(4):371–377.

3. O’Keeffe ST, et al.. Iron status and restless legs syndrome in the elderly.Age Ageing. 1994;23(3):200–203.

4.Kettaneh A.,et al, Pica and food craving in patients with iron deficiency anemia: a case-control study in France.Am J Med 118.185-188.2005

5.&Mills M.E.Craving more than food: the implications of pica in pregnancy. Nurs Womens Health 11.: 266-273.2007

6. Kathula SK Am J Med - 01-JUL-2008;Craving Lemons: Another Form of Pica in Iron Deficiency<

7 ACOG Practice Bulletin No. 95: anemia in pregnancy.Obstet Gynecol 2008 Jul;112(1):201-7. PMID: 18591330

8. Killip S, et al Iron deficiency anemia.Am Fam Physician 2007 Mar 1;75(5):671-8. PMID: 17375513

9 .Skroubis G, Sakellaropoulos G, Pouggouras K. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Obes Surg. 2002;12:551-558.

10. Sharma VR et al., Effect of omeprazole on oral iron replacement in patients with iron deficiency anemia.South Med J 2004;97(9):887-9PMID: 15455980

11. Zijp IM et al. Effect of tea and other dietary factors on iron absorption.Crit Rev Food Sci Nutr. 2000;40(5):371-98. PMID: 11029010

12. Hallberg L.  Wheat fiber, phytates and iron absorption. Scand J Gastroenterol Suppl. 1987;129:73-9. PMID: 2820048

13. Lynch SR . et al.,  Inhibitory effect of a soybean-protein--related moiety on iron absorption in humans.Am J Clin Nutr. 1994;60(4):567-72. PMID: 8092092

14. Mork Ta et al, Inhibition of food iron absorption by coffee.Am J Clin Nutr. 1983;37(3):416-20. PMID: 6402915

15. Reddy MB et al. Effect of calcium intake on nonheme-iron absorption from a complete diet. Am J Clin Nutr. 1997;65(6):1820-5. PMID: 9174478

16.Cook JD Calcium supplementation: effect on iron absorption. Am J Clin Nutr. 1991;53(1):106-11. PMID: 1984334


CREATED 11/08/2008

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March of Dimes



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