How does iron-deficiency anemia develop?
Normally, a well-balanced diet brings in plenty of iron to make hemoglobin and keep your iron stores full. Iron deficiency anemia occurs when there’s not enough iron in your diet, or your body exhausts your iron storage before they can be replenished. This doesn’t happen all at once, but progresses in three stages:
First stage: Lowered total-body iron stores. Early on, the supply of iron to produce hemoglobin and healthy red blood cells is reduced but you’re probably not yet feeling any physical symptoms.
Second stage: Iron storage is low, and so is red blood cell production. The supply of iron isn’t enough to make new red blood cells, but the body tries to compensate by using other methods which is sometimes called latent iron deficiency.
Third stage: Iron-deficiency anemia develops. Hemoglobin concentration drops below the normal range, and you’ll likely begin to notice iron deficiency anemia symptoms like fatigue, chest pain, headaches, or cold hands and feet.
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Anemia is sometimes caused by deficiencies of vitamin B12
In addition to iron, anemia can also be caused by deficiencies of vitamin B12 or folate. Vitamin B12 and folate are essential for the production of red blood cells. Incidentally, vitamin B12 deficiency has also been associated with the development of Alzheimer’s and vascular dementia (5).
Vitamin B12 deficiency is most common in older adults, as it can be more difficult to absorb this nutrient as we age. Vitamin B12 deficiency can also be caused by certain medications, such as metformin and long-term use of proton pump inhibitors or acid blocking drugs which treat GERD or reflux.
Folate deficiency is more common in pregnant women and people with chronic illness, and these groups have an increased need for this nutrient.
It’s important to note however that current studies do not prove that either low iron, excessive iron, or anemia directly cause Alzheimer’s or other forms of dementia—only that there is a link between them. More research is needed to fully understand the mechanisms that drive the development of cognitive decline, and whether hemoglobin levels could be used as a biomarker for various types of dementia.
Diagnosing iron deficiency anemia
There are several tests that can be used to diagnose iron deficiency anemia (6):
Complete blood count (CBC): A very common test for measuring the number and types of cells in your blood.
Hemoglobin level: This test measures the amount of hemoglobin in your blood, which is the protein in red blood cells that carries oxygen to organs and tissues, including the brain.
Serum iron level: A measurement of iron available in your body. Low iron level indicates iron deficiency anemia.
Ferritin: This test measures iron stores in your body. A low ferritin level usually indicates iron deficiency anemia.
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Increase iron intake to prevent iron deficiency & iron deficiency anemia
Anemia can be treated with iron supplements and by eating foods that are high in iron, such as:
- Red meat, poultry, or pork
- Grass-fed beef or chicken liver
- Oysters, mussels, and clams
- Dark leafy greens
When consuming plant-based sources of iron (non-heme iron), eating vitamin C-rich foods at the same time can help improve absorption. Some people with anemia may also need IV therapy to improve iron levels.
Who should be concerned about iron status?
Iron-deficiency anemia is most common in pregnant women, young children, and people with chronic illnesses. Women over the age of 65 may also be at increased risk for iron deficiency.
If you’re at increased risk for iron deficiency anemia, your doctor may recommend that you boost iron intake daily with iron supplements or consume foods that are high in iron.
What conditions make it hard for my body to absorb iron?
For some people, even though iron intake is sufficient, the body isn’t able to properly absorb it. There are several reasons for this, including:
- A digestive condition like celiac disease, autoimmune gastritis, or inflammatory bowel disease like ulcerative colitis, or Crohn’s disease.
- H. pylori infection.
- Weight loss surgery such as gastric bypass.
- Certain genetic conditions.
If you’re struggling with digestive issues, don’t wait to contact an integrative physician to identify and treat root cause issues.
Protect against dementia with integrative medicine
Research has shown that integrative medicine approaches, including diet and lifestyle changes, can help improve risk factors for cognitive decline and dementia. To reduce your risk:
- Eat a well-balanced diet with plenty of quality proteins, fruits and vegetables, and healthy fats. Limit processed carbohydrates and sugar.
- Talk to your doctor about testing iron levels, plus any other preventative screenings for cognitive function.
- Stay active to increase blood flow to the brain and other tissues.
While there is still much to learn about the relationship between iron deficiency and cognitive decline, there are some things you can do to reduce your risk. One of these is ensuring that you have a healthy intake of iron and other essential nutrients. If you’re experiencing any symptoms of low iron, be sure to speak with your doctor—early diagnosis and treatment is key in preventing cognitive decline. By taking steps now to keep your brain healthy and well-nourished, you’ll be doing everything possible to protect yourself from these devastating diseases down the road.