Ironing out the anaemia situation

People with poor diets who cannot afford (money or time) to eat the foods they should, have figured out a way to supply some necessary nutrients to the body - supplementation with vitamins and minerals. One of the most popular nutritional supplements used by Jamaicans is iron.

Iron is needed to make red blood cells. These blood cells contain most of the body's iron and transport oxygen from the lungs to the rest of the body through a protein called haemoglobin. When there is a shortage in the number of these cells or in the haemoglobin they contain, we have anaemia.

Is it anaemia?

Anaemia shows itself by causing weakness, fatigue, light-headedness, headache, paleness and cracks at the sides of the mouth and in the fingernails. In severe cases we may experience difficulty concentrating, shortness of breath, and irregular heart beat.

So, at the first sign of weakness or fatigue, most of us figure we are running low on iron and reach for iron supplements, whether tablets, capsules or liquid tonics. But too much iron is as harmful as too little.

Although iron deficiency is the most common cause of anaemia, medical conditions can also cause it. Pregnancy and breastfeeding, which increase the need for red blood cells, and heavy menstruation, which increases loss of red blood cells, are other common causes.

We cannot know for sure if we are anaemic unless we take the necessary blood tests. Our doctors may request other tests to rule out medical conditions which may cause anaemia.

Iron helps but it can hurt

A good iron supplement (liquid, tablet or capsules) will work wonders in the person with iron-deficiency anaemia. Treatment with iron preparations is justified only when we know for sure that we are iron-deficient. In cases where there is a risk of anaemia (e.g. pregnancy or poor diet) iron preparations are given to prevent anaemia.

The trouble is that many of us who are not anaemic are dosing up with iron regularly. When iron is oversupplied in the body it has the potential to harm us, accumulating in our organs and causing a range of medical problems.

Iron preparations are common sources of accidental overdose and poisoning in children, so they should be kept out of their reach.

The strength of iron

Apart from treating any underlying condition which is causing the anaemia, the doctor will need to increase haemoglobin. Many iron preparations contain vitamin B12 (cyanocobolamin) and folic acid, since these are also required to make red blood cells.

Even after the haemoglobin concentration in the blood rises, treatment with iron is usually continued for several months. The strength of elemental iron in the preparation is important. Each dose should have at least 35 - 65mg. It is often administered two to three times daily after meals.

In pregnancy, iron supplements are usually given throughout and for three months after childbirth to maintain and replenish adequate iron stores in the woman.

Dahlia McDaniel is a pharmacist and final year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.