Contents
Anemia is a low content of functionally complete red cells (erythrocytes) in the blood, this condition is also called low hemoglobin (read more in the article: causes and symptoms of low hemoglobin). Anemia can develop in a person who suffers from many other diseases. Quantitatively, it is expressed by the degree of decrease in the concentration of hemoglobin – the iron-containing pigment of erythrocytes, which gives the blood a red color.
Every adult has come across the term anemia at least once in their life. This pathological condition is popularly called anemia. Most people treat anemia as a minor disorder, and without even realizing the full extent of the harm that it can cause to human health. So what is anemia and what are its main symptoms? This issue needs to be sorted out.
Anemia – what is it?
Human blood is a mixture of a liquid base (plasma) and solid cellular elements that move freely in it. These blood cells are represented by platelets, erythrocytes and leukocytes. Each element performs its own function in the body. Platelets are responsible for normal blood clotting, leukocytes keep the immune system normal, and erythrocytes carry oxygen.
If the level of red blood cells (hemoglobin) decreases, which may be due to various reasons, then anemia develops in a person. Thus, anemia is a disorder that is characterized by a drop in the concentration of hemoglobin in the blood, most often this process is accompanied by a decrease in the number of red blood cells, or their total volume.
Red blood cells are “born” in the red bone marrow from protein compounds and non-protein components. Their growth requires erythropoietin, which is produced by the kidneys. Red blood cells provide transportation of oxygen from the lungs to the tissues and cells of all internal organs. From them, they take carbon dioxide and carry it to the lungs so that it is brought out. Red blood cells live for about 120 days, after which they are sent to the spleen, where they are disposed of. Non-protein fractions are excreted, and the body uses protein fractions to create new red blood cells.
A healthy red blood cell is represented by a protein component, it also contains hemoglobin, which carries iron. It is thanks to hemoglobin that red blood cells have a red color, and it is he who helps to carry out the transport of oxygen and carbon dioxide with the blood stream. Hemoglobin molecules “riding” on erythrocytes are brought with the blood flow to the lungs, they attach oxygen molecules to themselves there and are sent to the organ cells with the same blood flow. Hemoglobin molecules give them an oxygen molecule, and attach a carbon dioxide molecule to themselves. Then red blood cells containing hemoglobin with carbon dioxide are sent to the lungs, where carbon dioxide is detached from hemoglobin and excreted. Therefore, for the proper functioning of all organs, the normal level of red blood cells and hemoglobin in the blood is so important. If for one reason or another there is a decrease in their concentration, then the transportation of oxygen and carbon dioxide is disturbed, anemia develops in a person. Moreover, with anemia, the level of hemoglobin will always decrease, and the level of red blood cells can remain within the normal range.
The main symptoms of anemia are: increased fatigue, pallor of the skin, drowsiness, irritability, dizziness. The more severe the anemia, the more intense its symptoms will be.
There are three degrees of anemia:
Anemia of the first degree or mild severity, when the hemoglobin level is 90 g / l.
Anemia of moderate severity is characterized by a hemoglobin level of 70-90 g / l.
Severe anemia develops in people who have less than 70 g/L of hemoglobin in their blood.
According to statistics, women are more likely to suffer from anemia than men.
Code according to mkb 10
The ICD 10 code assigned to anemia will vary depending on the type of disease:
Iron deficiency anemia, which includes sideropenic and hypochromic anemia, has the code D50.
Secondary iron deficiency anemia (chronic) due to blood loss has the code D50.0.
If the cause of iron deficiency anemia cannot be clarified, then code D50.9 is assigned to it.
Other iron deficiency anemias have the code D50.8.
Code D51 assigned to vitamin B12 deficiency anemia.
Folate deficiency anemia has the code D52/
Hemolytic anemias, depending on the factor that provoked their development, are coded for microbial 10 D55-59.
Aplastic and other anemias have the code D60-64.
Symptoms
Common symptoms of anemia include:
Changes in the skin: the dermis becomes pale, flaky, cold to the touch. Sometimes the skin takes on a yellowish color.
The patient’s weakness and drowsiness increase, dizziness often occurs. If anemia is severe, then the patient will experience fainting.
The whites of the eyes become yellowish.
Shortness of breath may occur.
Muscles have insufficient tone.
A person begins to sweat more often and more profusely. Sweat cold and clammy.
Digestive disorders are possible: diarrhea and vomiting.
A slight tingling occurs periodically in the lower and upper extremities.
Headaches become more frequent.
Blood pressure is often low in anemia.
The heartbeat quickens, pain in the chest is possible.
The spleen increases in size.
If these symptoms characterize the development of anemia in general, then separately it is necessary to consider the signs specific to different types of anemia:
Iron-deficiency anemia. Iron deficiency anemia is primarily manifested by circulatory-hypoxic syndrome, which develops against the background of tissue hypoxia. A person experiences weakness and fatigue all the time, he is haunted by drowsiness and tinnitus, “flies” often appear before his eyes. Dizziness can turn into fainting if the anemia is not treated and progresses. With physical exertion, the heartbeat increases significantly, shortness of breath develops.
Also, iron deficiency anemia is characterized by sideropenic syndrome, which develops against the background of a lack of iron-containing enzymes in the tissues. This fact causes changes in the skin, which becomes dry. Nails break, hair begins to fall out. Perhaps a distortion of taste when a person wants to eat chalk or earth. Also, the patient develops dyspepsia and dysuria.
All patients who have iron deficiency anemia are characterized by increased irritability, emotional lability. They note a deterioration in memory and other mental abilities.
Anemia entails a violation of the physiological activity of immunoglobulin lgA, so a person begins to get sick with viral infections more often.
More: Iron deficiency anemia: what is it and how to treat it?
Folievodeficitnaya anemia. Folate deficiency anemia refers to megaloblastic anemia, which develops when there is a violation of bone marrow hematopoiesis against the background of a lack of folic acid (vitamin B9).
Folic acid deficiency anemia most often affects young people and pregnant women. The main symptoms are pale skin, which gives off a slight yellowness, increased heart rate, high blood pressure, and frequent dizziness.
Gastrointestinal disorders are observed, but they are not as pronounced as in B12-deficiency anemia. Perhaps the development of anorexia, gastritis, an increase in the liver in size.
Folate deficiency anemia can aggravate the course of certain diseases (schizophrenia, epilepsy, psychosis). During pregnancy, a lack of folic acid can lead to a delay in the development of the fetus, or to the birth of a child with various defects.
More: folate deficiency anemia
B12 deficiency anemia. B12-deficiency anemia develops against the background of a lack of vitamin B12 in the body, which either comes from outside in insufficient quantities or is not absorbed by the body itself.
The disorder is characterized by increased weakness, palpitations, frequent dizziness, shortness of breath against a background of slight physical exertion. Body temperature may remain slightly elevated. The patient’s skin is pale, with a yellowish tinge, the face is slightly swollen. Prolonged course of B12-deficiency anemia can lead to the development of heart failure and myocardial dystrophy.
The patient’s appetite worsens, the stool becomes unstable, the liver increases in size. The hallmark symptom of B12 deficiency anemia is reddening of the tongue, which becomes literally crimson. Also, patients often suffer from glossitis, complain of pain and burning sensation in the tongue.
The patients are haunted by a feeling of stiffness of the legs and arms, their numbness, muscle weakness, which disrupts a person’s gait. Sometimes there is incontinence of feces and urine.
Among mental disorders: insomnia, hallucinations, mental dementia, depression, psychosis.
More: B12 deficiency anemia
Aplastic anemia. Aplastic anemia is a severe disorder of the hematopoiesis system (all its three sprouts).
Anemia develops acutely, a person experiences severe weakness, quickly gets tired, noise appears in the ears. The skin and mucous membranes become pale, there are stitching pains in the chest. With physical effort, shortness of breath develops.
Petechiae appear on the skin in the form of a small red rash. The gums bleed, the patient often has nosebleeds, menstruation becomes profuse and prolonged.
Against the background of a decrease in immunity, a person becomes susceptible to various infections. At the same time, he does not lose weight.
Severe aplastic anemia is associated with a risk of death due to hemorrhage in the internal organs. Congenital aplastic anemia, for example, Fanconi’s anemia, is accompanied by hypoplasia of kidney tissue, abnormalities in the development of the upper limbs, hearing loss, etc.
More: Aplastic anemia
Hemolytic anemia. Hemolytic anemia is characterized by a shortening of the life cycle of erythrocytes, which leads to their rapid death, when new erythrocytes have not yet had time to mature. Hemolytic anemia can be congenital or acquired.
Among hereditary anemias, Minkowski-Choffard disease is most often diagnosed. The disease can manifest itself at any age, but most often they learn about it during puberty. During an exacerbation, a person’s body temperature rises, dizziness and weakness appear. The acute period is characterized by abdominal pain, yellowing of the skin. The feces become dark brown in color. Possible attacks of biliary colic against the background of the formation of stones in the gallbladder.
As for acquired hemolytic anemias, anemias caused by autoimmune diseases are more often found than others. Such anemia develops suddenly, characterized by fever, shortness of breath, pain in the lower back and abdomen. Weakness increases sharply, the skin can turn yellow very quickly. Sometimes patients with autoimmune hemolytic anemia cannot be in the cold, as they develop urticaria and Raynaud’s syndrome. The capillaries receive less blood, which leads to the formation of gangrene of the fingers and toes.
More: Hemolytic anemia
Posthemorrhagic anemia. This type of anemia develops with bleeding (acute and chronic). In the first 24 hours after acute blood loss, the victim’s weakness increases, the skin retains a pale shade, shortness of breath develops, dizziness, body temperature decreases, and cold sweat appears. The pressure decreases, the pulse quickens, but becomes very weak. All internal organs suffer from anemia. Such anemia is especially dangerous for children under one year old.
If the bleeding was massive, then signs of anemia will develop very quickly, the pressure drops sharply, the pulse becomes thready, consciousness is inhibited. Vomiting and convulsions may occur, up to the development of coma and cardiac arrest.
If the bleeding is chronic, then the symptoms of anemia increase slowly, its manifestations are blurred, as the body has time to use compensatory mechanisms.
More: Posthemorrhagic anemia
Anemia in pregnant women. If anemia develops in a pregnant woman, then she will suffer from insomnia, she will be haunted by frequent dizziness, nausea, shortness of breath, and weakness. The condition of the hair and nails worsens, the skin becomes dry and pale. Taste distortion is often observed.
More: Anemia during pregnancy
Causes
A variety of factors can lead to a decrease in the level of hemoglobin in the blood. The most common of these is the lack of trace elements that the body needs to carry out normal erythropoiesis. Regardless of the age group of patients and their gender, anemia in them is caused mainly by iron and folic acid deficiency, less often anemia develops with a lack of vitamin B12. However, other factors that affect the development of this disorder cannot be ruled out:
Anemia due to genetic abnormalities. Anemia can be caused by inherited diseases, including:
Hemoglobinopathies associated with pathological changes in the structure of hemoglobin molecules.
Fanconi anemia, which develops against the background of a deficiency of stem cells and a deficiency in the DNA repair system in fibrinoblasts.
Violation of the production of enzymes in red blood cells.
Damage to the cellular framework of erythrocytes.
Violations in the process of formation of erythrocytes.
Bassen-Kornzweig syndrome, in which there is a deficiency of lipoprotein in the cells of the intestine. This entails a violation in the process of assimilation of nutrients.
Minkowski-Choffard disease, characterized by a defect in the membrane of red blood cells, which gives them the shape of a ball.
Anemia associated with dietary errors. If a person receives less nutrients from the foods included in his diet, then he develops anemia. A deficiency of such substances as iron, folic acid, ascorbic acid, vitamin B12, riboflavin, copper, cobalt is able to start disorders. Often anemia develops in starving people who tend to stick to a diet without medical advice.
Anemia due to physical factors. Anemia can be triggered by severe burns, injuries resulting in internal or external bleeding, and frostbite.
Anemia that develops against the background of chronic diseases or against the background of the presence of a tumor in the body. The following diseases can lead to the development of anemia:
Pathologies of the kidneys, for example, their tuberculosis or glomerulonephritis.
Liver pathologies, in particular, hepatitis or cirrhosis.
Diseases of the digestive system: ulcers, gastritis, colitis, Crohn’s disease.
Systemic diseases such as rheumatoid arthritis or systemic lupus erythematosus.
Benign and malignant neoplasms: uterine fibroids, intestinal polyps, tumors of the kidneys or lungs.
Anemia that manifests when an infection enters the body. Anemia can be the result of viral, bacterial and parasitic diseases. So, the following viral infections lead to the development of anemia: mononucleosis, hepatitis, cytomegalovirus infection. In terms of the development of anemia, the following bacterial diseases are dangerous: tuberculosis of the internal organs, leptospirosis, obstructive pulmonary disease. Anemia can be caused by malaria, toxoplasmosis, and leishmaniasis.
Anemia caused by taking drugs or poisoning with toxic substances. In terms of the development of anemia, the penetration of the following substances into the body is dangerous:
Benzene, arsenic.
Antibacterial and cytotoxic drugs, NSAIDs, antithyroid drugs, drugs for the treatment of epilepsy.
The effect of radiation on the body.
Separately, you need to consider the causes of anemia, depending on the type of violation:
Causes of iron deficiency anemia. Iron deficiency anemia can be caused by the fact that iron enters the body with certain disorders. For example, if a person is an adherent of a vegetarian cuisine, then he limits himself to products of animal origin. While liver, meat, fish, eggs and dairy products are a source of iron on their own. In addition, they contain components that contribute to its absorption by the body.
Often a person is simply not able to afford to buy products to meet the needs of his body.
Diseases of the stomach and intestines entail malabsorption of many components, including iron.
Sometimes the body experiences an increased need for iron. This occurs during pregnancy, during breastfeeding, during periods of active growth of the child, in the presence of chronic pathologies. If during such periods you do not revise your diet, then anemia will certainly develop and cause damage to health.
Of course, with the development of bleeding, iron will be quickly excreted from the body along with the blood. Its level will decrease the faster, the more massive blood loss.
Causes of folate deficiency anemia. The development of this type of anemia leads to a lack of vitamin B9 in the body due to its insufficient intake with food. With liver cirrhosis and other serious pathologies, folic acid will be excreted from the body in excess quantities.
Celiac disease, alcoholism, and taking medications can interfere with the absorption of folic acid in the intestines. Cancer tumors growing in various organs lead to the formation of folate deficiency anemia. Of course, the body of a pregnant woman will need this microelement especially acutely.
Causes of B12 deficiency anemia. Errors in nutrition can lead to the development of B12-deficiency anemia, when this trace element is not supplied with food in sufficient quantities.
Dangerous in this regard are diseases such as: dysbacteriosis, intestinal infections, atrophic gastritis, stomach cancer, cirrhosis of the liver.
It is imperative to cover the needs of vitamin B12 at a time when the body needs it most urgently, for example, during gestation, during active sports training, during periods of rapid growth.
Causes of aplastic anemia. Aplastic anemia can develop as a result of congenital diseases such as Fanconi anemia or Diamond-Blackfan anemia, or when taking drugs from the NSAID group, during treatment with cytostatics and antibiotics.
All the reasons that were mentioned above may well give rise to aplastic anemia. To a lesser extent, its manifestation is influenced by errors in nutrition. However, with a pronounced deficiency of vitamin B12 and folic acid, aplastic anemia will definitely develop.
Causes of hemolytic anemia. Hemolytic anemia develops with the destruction of red blood cells that have not reached their natural old age. This can occur when their membrane is damaged, when there are disturbances in the process of hemoglobin production, with enzymatic defects, against the background of diseases of the liver and spleen. There are also congenital diseases that can cause hemolytic anemia, among them: Minkowski-Choffard disease, enzymopathies, thalassemia, sickle cell anemia.
Other reasons that can cause such a violation in the body include: infectious diseases, poisoning with poisons, taking medications, DIC, hemolytic-uremic syndrome, thrombocytopenic purpura.
Causes of posthemorrhagic anemia. Posthemorrhagic anemia is caused by acute or chronic blood loss. If acute bleeding is not difficult to detect, since it will be obvious, for example, after an injury, uterine bleeding, rupture of the tube, then chronic bleeding may remain undiagnosed for a long time. It often accompanies a stomach ulcer, a malignant tumor growing in the body, uterine fibroids and other conditions. As a rule, anemia in chronic blood loss can be detected during a laboratory examination.
Causes of anemia in pregnant women. During pregnancy, erythrocyte and hemoglobin levels may decrease slightly, which is a variant of the norm. This process is caused by changes occurring in the body of a woman. However, the development of true anemia, which poses a threat to the health of the mother and child, cannot be ruled out.
It can be provoked by violations in the absorption of iron, severe vomiting against the background of toxicosis. Anemia is more common in women who have more than one child rather than one. Chronic diseases can complicate the course of pregnancy and cause the development of anemia, for example, pathologies such as hepatitis or pyelonephritis.
Is anemia dangerous?
Anemia is dangerous to human health, especially if left untreated for a long time. This condition leads to severe pathological changes in the body, which are often irreversible.
Anemia leads to a weakening of the body’s defenses, so a person begins to get sick more often, he is no longer able to resist viruses, bacteria, parasites and fungi as before.
The body starts compensatory mechanisms, increasing the load on the cardiovascular system. Their tissues wear out quickly, which increases the likelihood of heart failure.
The psycho-emotional sphere suffers, the person becomes irritable, he develops neurological disorders. Attention and memory worsens, smell and taste change.
Anemia affects the work of all organs, including the functioning of the gastrointestinal tract, respiratory system, organs of vision.
Anemia is very dangerous for pregnant women. Iron deficiency in the first 2 trimesters of pregnancy doubles the risk of preterm birth, three times more often children of such mothers are born with underweight. The child is born with anemia. This leads to a delay in its development, which cannot be eliminated until the infant is cured of anemia. In the future, such children will be prone to the occurrence of cardiovascular pathologies.
A severe complication of anemia is hypoxic coma, which can be fatal.
Diagnostics
Examination of the patient in the doctor’s office and taking an anamnesis
Diagnostic method | What does it include? |
Collection of anamnesis | The doctor will clarify the following points with the patient:
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Patient examination | During the examination, the doctor should pay attention to the following points:
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Tests that must be taken to detect anemia:
Name of analysis | Description of the procedure | Evaluation of results |
CBC (general blood test) | Blood is taken for a general analysis in order to determine the hematocrit and calculate the amount of hemoglobin. In the course of the study, the leukocyte formula is calculated. | Indicators that need to be interpreted by the doctor:
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BAC (biochemical blood test) | This study provides information about the state of internal organs. | The study requires the evaluation of the following indicators:
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Fecal occult blood test | This analysis allows you to detect hidden gastrointestinal bleeding. 3 days before the delivery of feces, a person must adhere to a dietary diet with a restriction of foods that contain iron. You also need to stop taking NSAIDs, iron supplements and laxatives. | The reaction to occult blood can be weakly positive, positive or pronounced. |
A bone marrow puncture may be performed to detect anemia. During the procedure, a thin needle is inserted into the iliac crest or sternum crest, with which the bone marrow is taken for examination. It is this spongy substance that is the main organ that is responsible for hematopoiesis. All blood cells are produced in the bone marrow.
To harvest the brain, the patient is placed on a couch on their side, a local anesthetic is injected, and then the needle is advanced to the desired site. The depth of penetration of the needle is equal to 2 cm into the bone cavity. The collected material is applied to glass, which is examined using a microscope.
The doctor will be interested in the index of maturation of neutrophils and erythroblasts, the number of cellular elements in the bone marrow, the level of megacarcytes and myelocarcytes.
During the procedure, a trephine biopsy of the ilium is performed to calculate the ratio of parenchyma, bone tissue and fat cells.
Methods of instrumental examination:
Method | How is it carried out | Help in making a diagnosis |
X-ray examination of the lungs | Assessment of the condition of the tissue of the lungs, bones and soft tissues | It is possible to detect tuberculosis and lung cancer, which can lead to anemia |
EGDF | Assessment of the state of the stomach, esophagus and duodenum. During the procedure, you can take a piece of tissue for histological examination. | It is possible to detect varicose veins of the esophagus, gastritis, ulcers, polyps, cancerous tumors. All these pathologies can provoke anemia. |
US | Assessment of the state of internal organs and soft tissues | It is possible to detect cirrhosis of the liver, enlargement of the liver and spleen in size, kidney cancer, the presence of stones in them. Ultrasound can detect uterine fibroids, ectopic pregnancy, cancerous tumors of the uterus. |
Colonoscopy | Assessment of the condition of the large intestine. Anesthesia may be used for the procedure. | It is possible to detect bleeding ulcerative lesions of the intestine, ulcerative colitis, Crohn’s disease, diverticula, cancerous neoplasms. |
CT | Assessment of the state of various organs and tissues. To obtain the most reliable information, it is possible to use a contrast agent. | It is possible to detect cirrhosis and hepatitis of the liver, cancer and tuberculosis of the lungs or kidneys, as well as other organ damage that can cause anemia. |
Treatment of anemia in adults
Treatment of anemia should be based on the causes that provoked it. Taking medications is an indispensable condition that allows you to normalize the level of the missing substance in the blood.
Medications
Therefore, the following drugs can be used in the treatment of anemia:
Ferrous preparations. The advantage is good absorption through the gastrointestinal mucosa, and faster recovery of iron levels in the blood. The disadvantage is high toxicity (the risk of iron overload is high, since the absorption of ferrous iron through the mucosa of the digestive tract is uncontrolled, and it may happen that all transport proteins that must pick up iron and take it either to the depot or to the places of hemoglobin formation are busy ), and the formation of a large number of free radicals.
Trivalent iron preparations. This form is difficult to digest and is more likely to cause constipation and heaviness in the stomach. It will take longer to replenish the supply of iron in the blood. But at the same time, you are less likely to get poisoned from excess iron.
Folic acid. It is prescribed for anemia provoked by radiation exposure or medication.
The patient receives cyanocobalamin for B12 deficiency anemia.
Side effects of iron supplements
The most common side effects of iron supplements are:
Pain, discomfort in the abdomen.
Constipation or diarrhea.
Nausea, vomiting.
Darkening of tooth enamel.
Chair painted black. Nothing wrong with that. Just unabsorbed iron leaves the body naturally.
Food
In addition, the treatment of anemia is impossible without diet. It is selected depending on the type of violation:
Iron deficiency anemia requires the inclusion of animal liver, beef, turkey, fish, mushrooms, legumes, fruits (pears, quinces, apples, plums) in the menu. Be sure the sick should eat persimmons and beets.
B-12 deficiency anemia requires eating pork, beef and chicken liver, mackerel, pork, cod, cheeses, eggs, sour cream.
With folate deficiency anemia, the patient should eat animal liver, fatty fish, butter and sour cream, chicken eggs and chicken meat. Useful asparagus, peanuts, legumes, spinach, parsley, tomatoes, carrots, oranges and white cabbage.
Indications for operation
Surgical treatment can be prescribed for acute or chronic bleeding, in the presence of a cancerous tumor, bleeding polyp, and uterine bleeding. Aplastic anemia can be treated with a bone marrow transplant. Sometimes a blood transfusion, a plasmapheresis procedure is performed.
Which doctor should I contact for anemia?
A doctor who deals with blood diseases is a hematologist. However, first you need to contact a general practitioner if you find signs of anemia, and he, in turn, will send you for a blood test for hemoglobin, and if necessary, to a hematologist.
Anemia prevention
Sometimes the authorities are engaged in the prevention of anemia at the level of the whole country. According to the recommendations of the World Health Organization, if more than 40% of the inhabitants of the region suffer from iron deficiency anemia, it is necessary to carry out fortification. That is, the products that are included in the consumer basket are enriched with iron.
Supplementation is also included in the measures of public prevention. That is, iron preparations are prescribed to people at risk, for example, pregnant women. WHO recommends taking 2 mg per day in the 3nd and 60rd trimester. The drug continues to be taken during lactation (for 3 months). In America, pregnant women are prescribed 30 mg of iron throughout the entire period of bearing a child.
Measures for the primary prevention of anemia include proper and balanced nutrition, regardless of gender and age of the person. A child should receive 0,5-1,2 mg of iron every day, and an adult 1-2 mg of this element. The average diet allows you to get 5-15 mg of iron per day, but no more than 10-15% is absorbed from this component.
Animal products are the main source of iron. Most of it is found in beef, lamb and liver. Less iron in fish, chicken meat, cottage cheese. Iron from meat products is absorbed much better than iron from plant foods. The bioavailability of this element is influenced by the combined intake of iron with vitamin C. Tannic acid, on the contrary, reduces the absorption of this element. There is a lot of it in tea. Phthalates, which are present in many foods, negatively affect the process of iron absorption.
In the modern world, there are clear recommendations for the prevention of anemia in pregnant women, nursing mothers and children.
The American Academy of Pediatrics, gives the following tips for the prevention of anemia in children 1-3 years old:
Full-term breastfed infants should be given iron over the age of 4 months and before the introduction of complementary foods.
Full-term babies who eat breast milk and formula (50% of each type of food) should be given 1 mg of iron per 1 kg of body weight 1 time per day. Supplement at 4 months of age and before complementary foods are introduced.
Formula fed babies get enough iron from formula. They do not recommend iron supplements. Cow’s milk is not allowed to drink to children under the age of one year.
The daily norm of iron for children from six months to a year is 11 mg per day. For complementary foods, be sure to use red meat and vegetables, in which the iron content is high. If this is not enough, then iron is prescribed in drops or syrup.
Children 1-3 years old should receive 7 mg of iron per day. It is good if its source is meat, vegetables and fruits. It is also possible to prescribe iron preparations as part of complex multivitamins or in liquid form.
Premature babies under one year old are prescribed 2 mg of iron per kg of body weight once a day. This is the amount of iron that is included in milk formulas. If a child is breastfed, then from the first month of life, he should receive 1 mg of iron per 2 kg of weight until he is introduced to complementary foods or is transferred to formula milk.
Secondary prevention measures are reduced to early detection of anemia. Therefore, at each examination of the patient, during the medical examination, during routine examinations, one should devote as much time as possible to this issue. The doctor should listen to the patient’s complaints, take an anamnesis, pay attention to the symptoms of anemia and the results of laboratory tests.
In America, for the purpose of secondary prevention of anemia in children, universal (universal) and selective screening is carried out. In the first case, all children under one year old are examined to determine the level of hemoglobin in the blood. They are also assessed by their exposure to risk factors for anemia.
Among those:
Living in socially disadvantaged families.
The birth of a child ahead of schedule and with low body weight.
Intoxication of the child’s body with lead.
Breastfeeding a child over the age of 4 months without the use of iron supplements.
Reception by the child of whole cow’s milk, eating foods with insufficient iron content.
Other risk factors include:
Poor quality food.
Lag in development.
The need for special care for a child due to his health condition.
If children 2-5 years old do not belong to the risk group, then they are examined for anemia once a year. Schoolchildren and adolescents are checked only when anemia has already been diagnosed in the history of his illness, or there are some other prerequisites for a comprehensive examination.
Women, from adolescence until the onset of pregnancy, are subject to examination for anemia every 5-10 years until they enter menopause. Every year, women are examined who belong to risk categories, for example, with too heavy menstruation.
To detect anemia, it is necessary to focus on hemoglobin, hematocrit, color index, MCH and MCV. If the data of the tests carried out indicate the development of anemia, then the patient is prescribed a biochemical blood test with the determination of SF, TIBC, SF and NTZ.
Prophylactic iron supplementation is indicated for people whose diet is limited in the intake of iron from food.