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What is iron deficiency anemia?


Anemia occurs when you have a level of red blood cells (RBCs) in your blood that is lower than normal. Iron deficiency anemia is the most common type of anemia, and it occurs when your body doesn’t have enough of the mineral iron. Your body needs iron to make a protein called hemoglobin. This protein is responsible for carrying oxygen to your body’s tissues, which is essential for your tissues and muscles to function effectively. When there isn’t enough iron in your blood stream, the rest of your body can’t get the amount of oxygen it needs.

While the condition may be common, a lot of people don’t know they have iron deficiency anemia. It’s possible to experience the symptoms for years without ever knowing the cause.

In women of childbearing age, the most common cause of iron deficiency anemia is a loss of iron in the blood due to heavy menstruation or pregnancy. A poor diet or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anemia. Doctors normally treat the condition with iron supplements or changes to diet.


CAUSES

What causes iron deficiency anemia?


According to the American Society of Hematology, iron deficiency is the most common cause of anemia. There are many reasons why a person might become deficient in iron. These include:

  • Inadequate iron intake

Eating too little iron over an extended amount of time can cause a shortage in your body. Foods such as meat, eggs, and some green leafy vegetables are high in iron. Because iron is essential during times of rapid growth and development, pregnant women and young children may need even more iron-rich foods in their diet.

  • Pregnancy or blood loss due to menstruation

In women of childbearing age, the most common causes of iron deficiency anemia are heavy menstrual bleeding and blood loss during childbirth.

  • Internal bleeding

Certain medical conditions can cause internal bleeding, which can lead to iron deficiency anemia. Examples include an ulcer in your stomach, polyps in the colon or intestines, or colon cancer. Regular use of pain relievers, such as aspirin, can also cause bleeding in the stomach.

  • Inability to absorb iron

Certain disorders or surgeries that affect the intestines can also interfere with how your body absorbs iron. Even if you get enough iron in your diet, celiac disease or intestinal surgery, such as gastric bypass, may limit the amount of iron your body can absorb


Who is at risk for iron deficiency anemia?


Anemia is a common condition and can occur in both men and women of any age and from any ethnic group. Some people may be at greater risk for iron deficiency anemia than others. These include:

  • women of childbearing age
  • pregnant women
  • people with poor diets
  • people who donate blood frequently
  • infants and children, especially those born prematurely or experiencing a growth spurt
  • vegetarians who don’t replace meat with another iron-rich food

If you’re at risk for iron deficiency anemia, talk to your doctor to determine if blood testing or dietary changes could benefit you.

What is osteoporosis?


Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

What are osteoporosis causes and risk factors?


The following are factors that will increase the risk of developing osteoporosis:

  • Female gender
  • Caucasian or Asian race
  • Thin and small body frame
  • Family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture)
  • Personal history of fracture as an adult
  • Cigarette smoking
  • Excessive alcohol consumption
  • Lack of exercise
  • Diet low in calcium
  • Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
  • Malabsorption (nutrients are not properly absorbed from the gastrointestinal system) from bowel diseases, such as celiac sprue that can be associated with skin diseases, such as dermatitis herpetiformis
  • Low estrogen levels in women (which may occur in menopause or with early surgical removal of both ovaries)
  • Low testosterone levels in men (hypogonadism)
  • Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
  • Amenorrhea (loss of the menstrual period) in young women is associated with low estrogen and osteoporosis; amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat (for example, women with anorexia nervosa)
  • Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
  • Immobility, such as after a stroke, or from any condition that interferes with walking
  • Hyperthyroidism, a condition wherein too much thyroid hormone is produced by the thyroid gland (as in Grave's disease) or is ingested as thyroid hormone medication
  • Hyperparathyroidism is a disease wherein there is excessive parathyroid hormone production by the parathyroid gland, a small gland located near or within the thyroid gland. Normally, parathyroid hormone maintains blood calcium levels by, in part, removing calcium from the bone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis.
  • When vitamin D is lacking, the body cannot absorb adequate amounts of calcium from the diet to prevent osteoporosis. Vitamin D deficiency can result from dietary deficiency, lack of sunlight, or lack of intestinal absorption of the vitamin such as occurs in celiac sprue and primary biliary cirrhosis.
  • Certain medications can cause osteoporosis. These medicines include long-term use of heparin (a blood thinner), antiseizure medicine such as phenytoin (Dilantin) and phenobarbital, and long-term use of oral corticosteroids (such as prednisone).
  • Inherited disorders of connective tissue, including osteogenesis imperfecta, homocystinuria, osteoporosis-pseudoglioma syndrome and skin diseases, such as Marfan syndrome and Ehlers-Danlos syndrome (These causes of hereditary secondary osteoporosis each are treated differently.
  • What are osteoporosis symptoms and signs?

    Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone breaks (fractures). Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture. The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.Fractures of the spine (vertebra) can cause severe "band-like" pain that radiates from the back to the sides of the body. Over the years, repeated spinal fractures can lead to chronic lower back pain as well as loss of height and/or curving of the spine due to collapse of the vertebrae. The collapse gives individuals a hunched-back appearance of the upper back, often called a "dowager hump" because it commonly is seen in elderly women.

    A fracture that occurs during the course of normal activity is called a minimal trauma, or stress fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb.

    Hip fractures typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial slip-and-fall accidents. Hip fractures also may heal slowly or poorly after surgical repair because of poor healing of the bone.

  • Calcium supplementation in pregnant women

Poor maternal and newborn health and nutrition

remain significant contributors to the burden of disease and mortality.

Calcium supplementation has the potential to reduce adverse gestational outcomes, in particular by decreasing the risk of developing hypertensive disorders during pregnancy, which are associated with a significant number of maternal deaths and considerable risk of preterm birth, the leading

cause of early neonatal and infant mortality.

Recommendation


In populations where calcium intake is low, calcium supplementation as part of the antenatal care is recommended for the prevention of preeclampsia in pregnant women, particularly among those at higher risk of developing hypertension.