DEAR DOCTOR K:
My teenage daughter recently learned that she has iron deficiency and anemia. Why would her iron be low? What is the treatment?
Anemia means that the blood does not have enough red blood cells. These cells carry oxygen from the lungs to the rest of the body. There are many kinds of anemia. In the United States, iron-deficiency anemia is the most common; it occurs when the body does not have enough iron to make red blood cells.
What’s the connection between iron and red blood cells? Inside every red blood cell is the protein called hemoglobin, which carries oxygen to every cell in your body. Oxygen is an essential source of energy to every cell.
Iron is a part of hemoglobin. Most of the iron in the body is in the hemoglobin (and a similar protein in muscle called myoglobin).
Iron enters our body in food and leaves the body primarily when we bleed. Bleeding causes the loss of red blood cells and a lot of iron. That’s why teenage girls are particularly susceptible to iron-deficiency anemia: They have begun to have monthly menstrual bleeding. Each month they lose blood and iron. If your daughter doesn’t eat enough iron-rich foods, she will gradually develop iron deficiency.
Symptoms of iron-deficiency anemia are not usually obvious unless the problem is severe or long-lasting. If that’s the case, symptoms may include pale skin, tiredness, dizziness, lightheadedness, headaches or ringing in the ears. The condition is diagnosed with a blood test.
Iron-deficiency anemia is usually treated with iron supplements, taken by mouth for several months. The doctor will do follow-up blood tests to make sure the anemia has gone away or at least is improving.
Iron is best absorbed when given between meals. Encourage your daughter to take her iron supplement mid-morning, between breakfast and lunch, or mid-afternoon, between lunch and dinner.
Vitamin C makes it easier for the body to absorb iron. But calcium makes it harder, so your daughter should not take her supplement with milk. It may work best taken with foods or drinks that are high in vitamin C such as fruits, vegetables and orange juice.
Warn your daughter not to take more than the recommended dose of iron, as higher doses can be dangerous. Some people are vulnerable to developing iron overload.
You should also try to increase the amount of iron-rich foods in your daughter’s diet. These include:
- lean meats, poultry and fish
- iron-fortified cereals, breads and pasta
- dried fruits (apricots, raisins, prunes)
- leafy green vegetables (spinach, collard greens, kale)
- whole grains (brown rice, wheat germ, bran muffins)
- beans, peas and nuts
Teenage girls who have begun to have menstrual periods can help prevent iron-deficiency anemia by taking a multivitamin with iron. The Recommended Dietary Allowance (RDA) for iron is 8 milligrams (mg) per day for females ages 9 to 13 years, and 15 mg per day for females ages 14 to 18 years.
Iron deficiency in teenage girls is common, easily diagnosed and easily treated. Your daughter should be fine.