In this issue of Grazia International, Doctor William Buxton MBBS, FRCA & CEO of Effect Doctors educates our readers on iron deficiency
Are you a woman? Are you constantly exhausted, lethargic, and feeling grey? Many chalk it up to living a busy work and home life, but very often it is due to iron deficiency. You may be a potential candidate for a private or NHS iron infusion. You can book privately in London using Effect Doctors, a Consultant-led boutique medical prac- tice based in the heart of Soho. First, your blood sample will be taken at your home, office, or our clinic and we will turn around results as fast as within 24 hours then if you are suffering from ferritin under 30, we can design a bespoke iron infusion to correct the deficiency alongside any other areas of deficiency identified (such as Vitamin D or B12). Iron deficiency which can lead to iron deficiency anaemia (IDA) is sadly a very common condition affecting millions of people (predominantly women) worldwide. Some studies have demonstrated up to 30% of the world population is affected by it. In the UK, 10% of women are deficient, 1% severely so.
Sadly, despite the symptoms, for women experiencing low iron the most important blood test to check for is ferritin and it is often not requested by doctors in primary health care. Another important point to note is that laboratory reference ranges often list ferritin of >15 as normal even though symptoms described can occur even with ferritin in the low normal range i.e. between 30-80. Effect Doctors are there to help.
Being iron deficient can severely reduce the quality of life for patients with symptoms such as thinning hair, low mood/ depression, and low energy levels (more on this later). In this read, I will delve into these symptoms further, causes, investigations required, and treatment options for iron deficiency.
Who knows, acting on what you read could change your life?
CAUSES OF IRON DEFICIENCY:
1. Menstrual Blood Loss: Women are at a higher risk of developing iron deficiency anaemia due to menstrual blood loss. Heavy menstrual bleeding can deplete iron stores over time.
2. Pregnancy: Iron requirements sig- nificantly increase during pregnancy to support the growing fetus and placenta. If dietary intake doesn’t meet these increased demands, iron deficiency anaemia can develop.
3. Poor Diet: Inadequate intake of iron-rich foods such as red meat, poultry, fish, lentils, beans, and leafy green vegetables can lead to iron deficiency.
4. Gastrointestinal Disorders: Conditions such as celiac disease, inflammatory bowel disease (IBD), and gastrointestinal bleeding can impair iron absorption, leading to iron deficiency.
5. Blood Loss: Any form of chronic blood loss, such as from ulcers, polyps, or fre- quent blood donation, can contribute to iron deficiency leading to iron deficiency anaemia in women.
SYMPTOMS THAT OUR TEAM OF DOCTORS COMMONLY NOTE IN- CLUDE:
1. Fatigue: The hallmark of iron deficiency anaemia is persistent fatigue due to re- duced oxygen supply to tissues.
2. Irritability and mood swings: Changes in neurotransmitter levels due to iron defi- ciency can affect mood regulation, leading to increased irritability, mood swings, and emotional instability.
3. Depression: Research suggests a link be- tween iron deficiency and depression. Low iron levels may disrupt the functioning of brain regions involved in mood regulation, increasing the risk of depressive symptoms.
4. Anxiety: Iron deficiency may exacerbate symptoms of anxiety or contribute to the development of anxiety disorders. Changes in neurotransmitter levels and altered brain function associated with iron deficiency can contribute to feelings of anxiety and nervousness.
5. Poor concentration and cognitive func- tion: Iron deficiency can impair cognitive function, attention, and memory. Difficulty concentrating and cognitive fog may con- tribute to feelings of frustration, stress, and decreased overall well-being.
6. Weakness: Women with IDA may expe- rience weakness, especially during physical exertion.
7. Pale skin and nail beds: Reduced hemo- globin levels can result in pale skin and nail beds.
8. Shortness of breath: Insufficient oxygen supply to tissues can lead to shortness of breath, particularly during activities.
9. Headaches and dizziness: Some women may experience headaches, dizziness, or lightheadedness due to inadequate oxy- genation of the brain.
10. Hair-related issues including:
• Increased hair shedding: Women with iron deficiency may notice excessive hair shed- ding, often characterized by more hair fall during brushing, washing, or styling.
• Thinning hair: Iron deficiency can lead
to overall thinning of the hair, making the scalp more visible.
• Brittle hair: Hair may become dry, brittle, and prone to breakage in individuals with iron deficiency.
• Slowed hair growth: Iron deficiency can delay the hair growth cycle, resulting in slower hair growth and difficulty in achiev- ing desired hair length.
• Changes in hair texture: Some women may experience changes in hair texture, such as increased frizziness or loss of shine, due to iron deficiency.
To check for iron deficiency, healthcare providers typically use a combination of blood tests that provide information about various aspects of iron metabolism and blood cell parameters. Here are the com- mon blood tests used to assess iron defi- ciency. You could ask your GP to undertake these for you or private providers such as Effect Doctors can undertake them for you at your earliest convenience.
1. Full Blood Count (FBC) in particular checking the level of hemoglobin
2. Serum Ferritin – this is the most impor- tant test to ask for. Serum ferritin levels reflect the amount of iron stored in the body. Low ferritin levels are indicative of iron deficiency, even before anemia devel- ops. Serum ferritin is considered one of the most sensitive markers for iron deficiency. Ferritin < 30 ng/mL: is the cut-off commonly used to diagnose iron deficiency, particularly in the absence of inflammation or other confounding factor
3. Serum Iron
4. Total Iron-Binding Capacity (TIBC)
5. Transferrin Saturation
6. Red Blood Cell Distribution Width (RDW)
These blood tests are often interpreted together to provide a comprehensive as- sessment of iron status and detect iron deficiency at various stages, from early depletion of iron stores to the development of anaemia. It’s important to consult with a healthcare provider for proper interpreta- tion of blood test results and appropriate management of iron deficiency.
The image below shows the symptoms that patients may experience at different levels of ferritin:
TREATMENT:
1. Oral iron supplementation: Iron sup- plements are commonly prescribed to replenish iron stores. It’s important to take these supplements as directed by a health- care provider to maximize absorption and minimize side effects such as constipation. In certain cases, the iron deficiency is so severe that intravenous iron is required. One issue with oral iron supplementation is the side effects that are sometimes experienced which mean adherence to supplementation is often poor. These include gastrointestinal upset, con- stipation, stomach cramps and pain, heartburn and acid reflux, metallic taste, staining of the teeth or tongue, and black and smelly stools.
2. Intravenous (IV) iron infusions are sometimes prescribed to rapidly re- plenish iron stores in individuals with severe iron deficiency or where oral iron supplementation is ineffective or not feasible. This is not a cheap option (typi- cally prices are around £900) but it will immediately replenish your levels of iron. This also carries risks and side effects and should be done under the direct supervi- sion of a doctor who is an expert in its administration.
3. Dietary changes: Increasing consump- tion of iron-rich foods can help prevent and treat iron deficiency anaemia. Incorporating foods such as lean meats, poultry, fish, beans, lentils, tofu, spin- ach, and fortified cereals into the diet is recommended.
4. Vitamin C intake: Consuming vitamin C-rich foods or supplements alongside iron-rich foods or supplements can enhance iron absorption.
5. Addressing underlying causes: Treat- ing underlying conditions contributing to iron deficiency, such as gastrointestinal disorders or menstrual disorders, is cru- cial for long-term management.
6. Blood transfusion: In severe cases of iron deficiency anaemia, particularly when accompanied by significant symptoms or complications, blood transfusions may be necessary to rapidly increase hemoglobin levels.
Iron deficiency is a common condition that significantly impacts the health and quality of life of women. Recognizing
the causes, symptoms, and treatment options is essential for effective man- agement and prevention of complications. Through a combination of dietary modifications, iron supplementation, and addressing underlying factors, women can overcome iron deficiency anemia and regain optimal health. Regular screening and proactive management are key in ensuring the well-being of women at risk for or affected by this condition.
Effect Doctors undertake iron screening and iron supplementation at their clinic on Greek Street in Soho. If you have any questions do not hesitate to contact us at book@effectdoctors.com
Website: www.effectdoctors.com
Telephone: +44 (0) 207 305 7608
