Where does the deficit come from?
During pregnancy, blood volume increases, and the need for iron increases several times: it is needed for the growth of the fetus, placenta and increase in the mass of the mother's red blood cells. If a woman enters pregnancy with low reserves, they are depleted by the end of the term. During childbirth, additional blood volume is lost, and during caesarean section and complications - more. After childbirth, iron consumption continues during breastfeeding. Additionally, the deficiency is aggravated by heavy periods before pregnancy, a short interval between births, an uncontrolled vegetarian diet, and diseases of the gastrointestinal tract.
- Increased need for iron during pregnancy
- Blood loss during childbirth and caesarean section
- Low iron stores before pregnancy
- Multiple pregnancy
- Short interval between births
- Impaired absorption of iron in the intestines
Symptoms
Manifestations increase gradually, so the woman gets used to feeling unwell. Severe weakness, fatigue, dizziness, tinnitus, shortness of breath and palpitations with little exertion, pallor of the skin and inner surface of the eyelids are typical. Signs not directly related to hemoglobin are also characteristic: brittle nails, increased hair loss, dry skin, cracks in the corners of the mouth, strange food cravings, for example, the desire to eat ice or chalk. Irritability, decreased mood and difficulty concentrating are often associated.
- Weakness and fatigue
- Dizziness, tinnitus
- Shortness of breath and palpitations on exertion
- Pale skin and mucous membranes
- Hair loss, brittle nails
- Cracks in the corners of the mouth
- Unusual food cravings
What tests are needed
The basic test is a complete blood count with hemoglobin and red blood cell counts. But hemoglobin shows only the tip of the problem: iron stores can be depleted long before they decline. Therefore, ferritin, which reflects iron reserves in the body, is key. It is important to consider that ferritin increases with inflammation, so it is assessed along with indicators of inflammation. Additionally, serum iron and binding capacity are looked at. If anemia does not respond to treatment or there are unusual findings, the doctor will look for other causes and sources of blood loss.
- General blood test
- Ferritin is an indicator of iron reserves
- Serum iron
- CRP for correct interpretation of ferritin
- Vitamin B12 and folate when indicated
- Finding the source of blood loss in persistent anemia
Treatment
The basis of treatment is iron supplements, which are prescribed by a doctor in a selected dose. It is fundamentally important that the course does not end when hemoglobin normalizes: a few more months are needed to replenish reserves, otherwise anemia will quickly return. Iron supplements are better absorbed on an empty stomach or between meals and together with a source of vitamin C, but tea, coffee, dairy products and calcium supplements impair absorption. Nausea, constipation and darkening of the stool are possible - you should warn your doctor about this in order to adjust the regimen. For severe anemia or intolerance to tablets, intravenous iron supplements are used.
- Iron supplements in the prescribed dose
- Continuation of the course after normalization of hemoglobin
- Take with vitamin C, separately from tea and milk
- Correction of the regimen for side effects
- Intravenous iron for severe anemia
- Control tests on time
Nutrition and breastfeeding
Nutrition by itself rarely compensates for severe deficits, but is necessary to maintain results. Iron is best absorbed from meat, liver and poultry; from plant foods - legumes, buckwheat, greens - it is absorbed worse, but absorption improves when combined with vegetables and fruits rich in vitamin C. Iron supplements are compatible with breastfeeding and do not harm the baby. At the same time, treating the mother’s anemia improves her well-being and ability to cope with workload, which is important for the whole family. The regimen is always agreed upon with the doctor.
- Meat, liver, poultry as the main sources
- Legumes, buckwheat, greens combined with vitamin C
- Avoiding tea and coffee immediately after meals
- Iron supplements are compatible with lactation
- Monitoring adequate drinking and caloric intake
- Discuss the regimen with your doctor if you have any doubts
