Ethos Ho, BSc Pharm Student
Feeling Tired All the Time?
How often do you find yourself struggling to get through to the end of the day? Do you find that you have to sleep longer hours than all your friends, yet still feel tired throughout the day? Does it ever feel like you just don’t have the same level of energy as everyone else?
Right now, there’s an incredible number of people experiencing one or more symptoms of chronic fatigue on a daily basis. Needless to say, low energy can interfere with work, life, and the ability to just go out and enjoy the day. In many cases, people write off their symptoms as a result of stress, or lack of sleep. Both of these certainly play a part, but the truth is, it could something else entirely.
In one of our previous articles, we’ve covered hypothyroidism which can contribute to constant fatigue and feeling cold all the time. Another common issue well discuss today is iron deficiency anemia, which often occurs so slowly and gradually that most people don’t realize they’re actually suffering from an easily fixed problem.
What Is Iron Deficiency Anemia?
Iron deficiency anemia (IDA) is the most common nutritional deficiency worldwide, and it occurs most commonly in women of childbearing age (especially pregnant women), young children, elderly hospitalized patients, or patients with gastrointestinal conditions (conditions associated with digestive tract such as blood loss, iron malabsorption, or gastric cancer). It also happens very commonly in individuals that don’t eat very much meat.1,2,3
The most common non – diet related cause of IDA is blood loss, which occurs commonly in the gastrointestinal tract of men and postmenopausal women. Some other causes of IDA include:1,2
- Regular blood donation
- Menstruation (or commonly known as period)
- Iron absorption disorders (celiac disease, inflammatory bowel disease)
- Recent gastric bypass surgery
- Deficiency in dietary intake
What Are the Symptoms of IDA?
Many patients with IDA don’t always experience any symptoms.1,3 However, those who do may experience the following:1,2,3
- Tiredness and fatigue, especially during exercise or walking up the stairs.
- Headaches
- Chest pain
- Trouble breathing
- Depression
- Impaired cognitive function
- Anorexia
Why does iron deficiency lead to anemia? Our bodies require iron to manufacture red blood cells, which are necessary for transporting oxygen throughout our body. Therefore, when we’re chronically low on iron, our bodies eventually lose the ability to transport oxygen and function properly.
The tricky thing with iron deficiencies is the body has a fairly good ability to store iron. Therefore, it takes some time for symptoms to develop, and when they do, it’s usually when the body is moderately to severely deficient. Before that happens, symptoms may occur so gradually over time that they go unnoticed, and the person may begin to feel it’s simply “normal” for them to feel the way they do.
To diagnose IDA, a healthcare provider will order lab tests to measure iron levels that are both stored and being used in the body. In addition, there’s something called a complete blood count, which provides specific information about the components of your blood to ensure an appropriate diagnosis.1,2,3
How Do You Treat IDA?
Depending on the cause of IDA, management may be as simple as ensuring an adequate dietary intake of iron rich foods such as red meat, poultry, fish, beans, dark green vegetables, raisins, apricots, prunes, and iron-fortified breads and cereals.1
Alternatively, iron supplementation is often used as well. Even though oral iron supplements don’t require a prescription, your healthcare provider may write one with specific instructions on its usage. Additionally, they are found behind the counter of a pharmacy depending on the province or state you live in, where a pharmacist may obtain additional information such as medical condition and medication. The following are examples of products available in the market:2
- Ferrous fumarate (PALAFeR®)
- Ferrous gluconate
- Ferrous sulphate
- Polyride-Fe®, FeraMAX® (polysaccharide-iron complex)
- Proferrin® (heme-iron polypeptide)
Based on current evidence, no iron salt is better than the other. However, Proferrin® (heme-iron polypeptide) may be better absorbed and tolerated than other iron salts.2 In the end, consistent use and follow-up with a healthcare provider is the key to correcting IDA.
Tips on Taking Iron Supplements
Unlike some other supplements like vitamins, taking iron supplements is not quite as straightforward. The following are some tips and recommendations that you can follow to ensure that the iron supplements work in your body.
- Iron supplements are usually better absorbed when taken on an empty stomach. However, if you experience side effects such as nausea and pain in the upper abdomen, they can be taken after meals.2
- Vitamin C (ascorbic acid), found in orange juice, may enhance the absorption of iron supplements.2
- Certain drugs such as antacids (Tums®), calcium carbonate (Caltrate®, Diovol®), and sodium bicarbonate may decrease the absorption of iron supplements. So, it’s recommended that you separate the administration time of iron supplements by at least two hours with these drugs.2
- The dose of iron supplement is usually around 60-200 mg/day of elemental iron in three divided doses.1,2
- There is no specific duration for iron supplementation. Some healthcare providers may continue treatment for 3 months after target hemoglobin levels have been reached.2 Therefore, it’s important to follow-up with your healthcare provider to get bloodwork done to measure your body’s response to iron supplementation. In terms of benefits, it usually takes about a month before a correction is seen in the body’s iron levels. 1-3
The Bottom Line
Iron deficient anemia is the most common nutritional deficiency in the world, due to the fact that it can be contributed by various factors as mentioned above. Patient with IDA usually don’t have symptoms; however, some individuals may experience tiredness, fatigue, and impaired exercise tolerance. Along with a dietary approach, the main treatment option for IDA is oral iron-supplementation, which comes in various salt preparations found behind the counter of a pharmacy. There is no evidence that one iron salt is better than the other, however, the heme-polypeptide formulation may be better absorbed and tolerated compared to the salts.
As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
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RESOURCES
- Dynamed
- RxTx
- Lexicomp
