Iron deficiency anemia natural history, complications and prognosis
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- Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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Overview
Natural History
- The symptoms of iron deficiency are similar as in any other case of anemia.
- The stage of anemia develops when there is chronic deficiency of iron and all the iron stores of body are used up.
- Initially in iron defiicency, no symptoms develop as body has sufficient store of iron in the form of ferritin.
- Normal ferittin levels are 20 to 300 ng/mL. This level denotes suffiicient iron levels in the body.
- Ferittin levels between 20-40 ng/ml denotes iron deficiency without anemia.
- Ferittin levels <20 ng/ml denotes iron deficency with anemia and signs and symptoms of anemia develop at this stage.
- Iron deficiency anemia has age specific presentations:
- Infants (age 0-12 months) and Preschool Children (age 1-5 years)
- Iron-deficiency anemia is defined as a Hb concentration of less than or equal to 10.0 g/dL .
- Developmental delays.
- Behavioral disturbances (e.g., decreased motor activity, social interaction, and attention to tasks)
- Iron-deficiency anemia also contributes to lead poisoning in children by increasing the gastrointestinal tract's ability to absorb heavy metals, including lead.
- Psychiatric illnesses such as unipolar disorder, bipolar disorder and autism spectrum disorder in adolescense.
- Adults (persons aged greater than or equal to 18 years)
- Decreased functional capacity
- Signs of hypoxia due to low oxygen delivery to the tissues.
- Pregnant Female
- Increased chances of pre term labor
- Low birth weight baby
- Infants (age 0-12 months) and Preschool Children (age 1-5 years)
Complications
- Iron deficiency anemia can lead to severe complications if not treated.
- Severe iron deficiency (ferittin <10 ng/mL (<10 mcg/L; <22.5 picoM/L) can lead to severe complications.
- Exercise:
- Fatigue
- Low stamina
- Muscle atrophy
- Decreased aerobic capacity
- Decreased endurance ability
- Heart
- Irregular heart beat
- Cardiac failure
- Dilated cardiomyopathy
- Systolic flow murmur
- Myocardial ischemia
- Angina pectoris
- Haemodynamic instability
- Lungs
- Pulmonary edema
- Dyspnea
- Development delay in children
- Mental retardation
- Behavioral differences
- Psychiatric illness
- Shortened attention span
- Neurocognitive delay
- Pregnancy
- Preterm labor
- Low birth weight baby
- Postpartum depression
- Restless leg syndrome
- Atrophic glossitis
- Alopecia
- Immune system weakness
- Syncope
- Plummer Vinson syndrome
Prognosis
- With treatment, the outcome is likely to be good. In most cases, the blood counts will return to normal in 2 months. It is essential to determine the cause of the iron deficiency.
- You should continue taking iron supplements for another 6 to 12 months after blood counts return to normal, or as your health care provider recommends. This will help the body rebuild its iron storage.
- Iron supplementation improves learning, memory, and cognitive test performance in adolescents who have low levels of iron. Iron supplementation also improves the performance of athletes with anemia and iron deficiency.