What causes iron deficiency anemia in elderly

what causes iron deficiency anemia in elderly

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Sep 26, The major causes of this type are iron deficiency (low level iron) anemia and thalassemia (inherited disorders of hemoglobin). If the red blood cells size are normal in size (but low in number), this is called normocytic anemia, such as anemia that accompanies chronic disease or anemia related to kidney disease. Iron deficiency, or sideropenia, is the state in which a body lacks enough iron to supply its needs. Iron is present in all cells in the human body and has several vital functions, such as carrying oxygen to the tissues from the lungs as a key component of the hemoglobin protein, acting as a transport medium for electrons within the cells in the form of cytochromes, and facilitating oxygen.

Even though anemia is fairly prevalent among elderly persons, the underlying cause is not so easily defined. Symptoms of fatigue, pale skin, decreased cognitive ability are easily attributed to getting older. Some physicians feel that mildly lowered hemoglobin is normal for an older patient. This may not always be the case. In healthy older persons, hemoglobin levels are generally normal. When anemia is present in older persons it is likely due to some underlying condition that requires further investigation or therapy.

Key to understanding anemia in the elderly is the distinction between anemia caused by elddrly deficiency or anemia caused by inflammationoften called anemia of chronic disease. Anemia of inflammation chronic disease is the most common cause of anemia in the elderly.

Numerous diseases have inflammation as a consequence; in the elderly some of the more common include acute or chronic infections, arthritis or malignancy. Often in many older cases the underlying disease may not be identified right away.

Physicians can mistake the transient condition of inflammation for iron-deficiency anemia and incorrectly prescribe iron pills. Iron-deficiency is the second most common cause of anemia in the elderly. The most foremost reasons for iron deficiency in this age group are blood elderl, nutritional deficiencies, medications, cancer therapies and poor absorption. Long-term use of aspirin and nonsteroidal anti-inflammatory drugs NSAIDs can cause significant bleeding from anemka digestive tract.

Many physicians recommend that patients take one baby aspirin per day as a cquses measure against heart disease. Usually the blood loss from this practice is minute. In cases where aspirin-based drugs are taken several times a day, a person can lose up to a half-cup or more of blood per month. Since a cup of blood contains about to milligrams of iron, an estimated 50 to 60 milligrams of iron can be lost per month in persons with prolonged use of these drugs. Other causes of blood loss include esophageal varices, ulcers, tumor, colon cancer, diverticular bleeding, ccauses intestinal lesions.

Without blood loss, iron-deficiency anemia takes several years to develop. Inadequate intake or inadequate absorption of iron defficiency occur in older anwmia who have poor diets, ironn not eat much meat, or who have subnormal levels of stomach acid. Stomach acid is hydrocloric acid or HCl and is vital to absorption of iron. What are reliable ticket websites HCl is low hypochlorhydria or absent achlorhydriain time the patient will develop iron-deficiency anemia or pernicious anemia due to B12 deficiency.

Locating the source of bleeding is successful in many patients, but in as many as 40 percent of cases, the anrmia of bleeding is not found. Elderly people who consume diets limited in variety are at risk for various nutritional deficiencies that can contribute to anemia. The defciiency most common nutritional anemia seen in the elderly are the B vitamins, especially B12, or folate; zinc and iron. Lack of hydrochloric acid stomach acid can affect nutrient absorption as nutrients need irkn acidic environment to be absorbed.

Taking medications that reduce stomach acidity or the surgical removal of portions of the stomach or small intestine can impair absorption. Other contributors to anemia in the elderly include alcohol abuse, prolonged Helicobacter pylori infection, chemotherapy, medications such as anticonvulsants, celiac sprue disease, poor kidney function, cancer, hypo or hyperthyroidism. In our book Iron Disorders Institute Guide to Anemia discussed more fully are diseases or conditions that can lead to iron deficiency with or without anemia or complicated iron balance such as: myelodysplastic syndromes, cancer or cancer treatment, kidney disease, hormone imbalances, bone marrow failure, autoimmune disease, infection, bleeding disorders, alcohol abuse, drug abuse, drug interference, inherited or acquired diseases that interfere with blood cell jn or management, anemia of inflammation or chronic wyat.

Older people male or female are not prone to accumulating what game can we play iron from a balanced healthy diet, moderate supplementation or alcohol consumption.

This age group can potentially have toxic levels of iron deficieency their organs and glands, if they abuse alcohol, consuming excessively of nicotine products to stop smokingon hormone replacement therapy, have B12 deficiencies, or are receiving repeated blood transfusion.

Iron is particularly dangerous and can catalyze these processes even in small amounts less than a few extra grams when eldefly with other risk factors such as obesity, family history of diabetes or heart disease, inadequate consumption of antioxidants fruits and vegetableshormone replacement therapy, unhealthy cholesterol levels, smoking and regular alcohol consumption and for women who no longer menstruate. Individual symptoms and degree of expression will vary between people as will the amounts of stored iron.

Too much iron should be suspect in the presence of any of these symptoms. In deficoency, the greatest risk for deficisncy indicator of suspect iron overload is when the monthly period stops for whatever reason: taking birth control pills, hysterectomy or menopause. With the monthly blood loss from a period iron is also lost, keeping excess iron under control. Fortunately for most, iron metabolism is tightly regulated by their genes. Those lucky ones are similar to people who seem to be able to deeficiency as much as they want and not get fat.

Some people can consume plenty of iron-packed red meat and even imbibe whaat some potentially unhealthy habits, and yet not be further harmed by qnemia invisible what does bine mean in romanian of adding too much iron to that potentially unhealthy mix.

For older people with genetic hemochromatosis who also have a tendency or condition causing blood loss, the extra ansmia of stored iron may protect them from iron dfficiency and anemia. This iron blood test panel measures the hemoglobin, ferritin, fasting serum iron, TIBC total iron binding capacity and transferrin levels.

In keeping with the Iron Disorders Institute governing policy, our sponsors have been selected based on their defiiciency with defjciency mission and vision.

Copyright Iron Disorders Institute. All Rights Reserved. Privacy Policy. Iron out-of Balance in The Elderly. Too Little Iron Even though anemia is fairly prevalent among elderly persons, the underlying cause is not so easily defined. Anemia of inflammation or chronic disease Anemia of inflammation chronic disease is the most common cause of anemia in the elderly.

Iron-deficiency anemia Iron-deficiency is the second most common cause of anemia in the elderly. Nutritional deficiencies Elderly people who consume diets limited in variety are at risk for various nutritional deficiencies that can contribute to anemia. Diseases or conditions that can lead to iron deficiency Lack of hydrochloric acid stomach acid can affect nutrient absorption defjciency nutrients need an acidic environment to be absorbed.

Too Much Iron in the Elderly Older people male or female are not prone to accumulating excess iron from a balanced healthy diet, moderate supplementation or alcohol consumption. Diseases or conditions that can produce too much iron in the elderly include: Menopause females Genetic: hemochromatosis HHC or iron overload; for whites: type I classic hemochromatosis caused by mutations of HFE; four rarer non-HFE related what does a bichon poodle look like include irkn 2 A and B hemochromatosis juvenile hemochromatosis onset before age 30type 3 hemochromatosis transferrin receptor 2 hemochromatosistype 4 A and B hemochromatosis ferroportin diseaseand a hypo ceruloplasminemia Genetic how to re paint a bike loading for non-whites: not fully known what causes iron deficiency anemia in elderly suspect is for mutations of genes that regulate hepcidin, transferrin receptor 2 or the ferroportin gene; Note: these mutations may also occur in white females as modifiers of HFE.

Genetic or acquired chronic hemolytic anemia mechanical heart valve, blood cell disorders, enzyme deficiencies and rare cases autoimmune disease Acquired sideroblastic anemia Acquired iron overload from blood transfusion, excessive alcohol consumption, excessive use of iron supplements, hormone replacement how to make safety rope bracelet chronic use how to be an aerospace engineer at nasa nicotine products to stop smoking Detection iron tests Diet Therapy.

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Causes of anemia. Different types of anemia have different causes. They include: Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. Iron-deficiency is the second most common cause of anemia in the elderly. The most foremost reasons for iron deficiency in this age group are blood loss, nutritional deficiencies, medications, cancer therapies and poor absorption. Doctors should also assess for other causes of anemia, since its very common for older adults to simultaneously experience multiple causes of anemia (e.g. iron deficiency and vitamin B12 deficiency). If an iron deficiency is confirmed, be sure the doctors have tried to check for any causes .

Iron deficiency , or sideropenia , is the state in which a body lacks enough iron to supply its needs. Iron is present in all cells in the human body and has several vital functions, such as carrying oxygen to the tissues from the lungs as a key component of the hemoglobin protein, acting as a transport medium for electrons within the cells in the form of cytochromes , and facilitating oxygen enzyme reactions in various tissues. Too little iron can interfere with these vital functions and lead to morbidity and death.

Total body iron averages approximately 3. In blood plasma , iron is carried tightly bound to the protein transferrin. There are several mechanisms that control iron metabolism and safeguard against iron deficiency. The main regulatory mechanism is situated in the gastrointestinal tract. The majority of iron absorption occurs in the small intestine called duodenum. A number of dietary factors may affect iron absorption.

When loss of iron is not sufficiently compensated by intake of iron from the diet, a state of iron deficiency develops over time. When this state is uncorrected, it leads to iron-deficiency anemia , a common type of anemia. Anemia is a condition characterized by inadequate red blood cells erythrocytes or hemoglobin. When the body lacks sufficient amounts of iron, production of the protein hemoglobin is reduced.

Hemoglobin binds to oxygen, enabling red blood cells to supply oxygenated blood throughout the body. Women of child-bearing age, [2] children, and people with poor diet are most susceptible to the disease. Most cases of iron-deficiency anemia are mild, but if not treated can cause problems like an irregular heartbeat , pregnancy complications , and delayed growth in infants and children that could affect their cognitive development and their behavior.

Symptoms of iron deficiency can occur even before the condition has progressed to iron deficiency anemia. Symptoms of iron deficiency are not unique to iron deficiency i. Iron is needed for many enzymes to function normally, so a wide range of symptoms may eventually emerge, either as the secondary result of the anemia, or as other primary results of iron deficiency. Symptoms of iron deficiency include:. Continued iron deficiency may progress to anemia and worsening fatigue.

Thrombocytosis , or an elevated platelet count, can also result. A lack of sufficient iron levels in the blood is a reason that some people cannot donate blood. Though genetic defects causing iron deficiency have been studied in rodents, there are no known genetic disorders of human iron metabolism that directly cause iron deficiency.

Possible reasons that athletics may contribute to lower iron levels includes mechanical hemolysis destruction of red blood cells from physical impact , loss of iron through sweat and urine, gastrointestinal blood loss, and haematuria presence of blood in urine. Exercise-induced gastrointestinal bleeding is most likely to occur in endurance athletes. Haematuria in athletes is most likely to occur in those that undergo repetitive impacts on the body, particularly affecting the feet such as running on a hard road, or Kendo and hands e.

Conga or Candombe drumming. Additionally, athletes in sports that emphasize weight loss e. However, subgroups like infants, young children, teenaged girls, pregnant women, and premenopausal women are at risk of obtaining less than the EAR. Iron is needed for bacterial growth making its bioavailability an important factor in controlling infection.

As a comparison, in cow's milk, this is only 2 percent. As a result, breast fed babies have fewer infections. To reduce bacterial growth, plasma concentrations of iron are lowered in a variety of systemic inflammatory states due to increased production of hepcidin which is mainly released by the liver in response to increased production of pro-inflammatory cytokines such as interleukin This functional iron deficiency will resolve once the source of inflammation is rectified; however, if not resolved, it can progress to anaemia of chronic inflammation.

The underlying inflammation can be caused by fever , [18] inflammatory bowel disease , infections, chronic heart failure CHF , carcinomas, or following surgery. There have been concerns regarding parenteral iron being administered whilst bacteremia is present, although this has not been borne out in clinical practice.

A moderate iron deficiency, in contrast, can provide protection against acute infection, especially against organisms that reside within hepatocytes and macrophages, such as malaria and tuberculosis. This is mainly beneficial in regions with a high prevalence of these diseases and where standard treatment is unavailable.

As always, laboratory values have to be interpreted with the lab's reference values in mind and considering all aspects of the individual clinical situation.

Serum ferritin can be elevated in inflammatory conditions; so a normal serum ferritin may not always exclude iron deficiency, and the utility is improved by taking a concurrent C-reactive protein CRP. The level of serum ferritin that is viewed as "high" depends on the condition. For example, in inflammatory bowel disease the threshold is , where as in chronic heart failure CHF the levels are Before commencing treatment, there should be definitive diagnosis of the underlying cause for iron deficiency.

This is particularly the case in older patients, who are most susceptible to colorectal cancer and the gastrointestinal bleeding it often causes. Upon diagnosis, the condition can be treated with iron supplements. The choice of supplement will depend upon both the severity of the condition, the required speed of improvement e.

Examples of oral iron that are often used are ferrous sulfate , ferrous gluconate , or amino acid chelate tablets. Recent research suggests the replacement dose of iron, at least in the elderly with iron deficiency, may be as little as 15 mg per day of elemental iron. Mild iron deficiency can be prevented or corrected by eating iron-rich foods and by cooking in an iron skillet.

Because iron is a requirement for most plants and animals, a wide range of foods provide iron. Good sources of dietary iron have heme -iron, as this is most easily absorbed and is not inhibited by medication or other dietary components. Three examples are red meat , poultry , and insects. Examples are lentils , beans , leafy vegetables , pistachios , tofu , fortified bread, and fortified breakfast cereals.

Iron from different foods is absorbed and processed differently by the body; for instance, iron in meat heme-iron source is more easily absorbed than iron in grains and vegetables "non-heme" iron sources.

Because iron from plant sources is less easily absorbed than the heme-bound iron of animal sources, vegetarians and vegans should have a somewhat higher total daily iron intake than those who eat meat, fish or poultry. However, spinach and Swiss chard contain oxalates which bind iron, making it almost entirely unavailable for absorption. This is due to a hypothesised "meat factor" which enhances iron absorption. Following are two tables showing the richest foods in heme and non-heme iron.

Children at 6 months should start having solid food that contains enough iron, which could be found in both heme and non-heme iron [33]. Iron deficiency can have serious health consequences that diet may not be able to quickly correct; hence, an iron supplement is often necessary if the iron deficiency has become symptomatic.

Blood transfusion is sometimes used to treat iron deficiency with hemodynamic instability. From Wikipedia, the free encyclopedia. State in which a body lacks enough iron to supply its needs. For other uses, see Iron deficiency disambiguation. Medical condition. Morbidity and Mortality Weekly Report. Recommendations and Reports. PMID Centers for Disease Control and Prevention.

Archived from the original on 8 September Retrieved 12 August World Health Organization. Annals of Nutrition and Metabolism. April Sleep Medicine. Mayo Clinic. Retrieved 26 April J Biol Chem.

PMC Sports Med. Retrieved 7 July Fact Sheet for Health Professionals. Office of Dietary Supplements. National Institutes of Health. February New York. Physiological Reviews. Wilkinson; Supaj Rajagoplan Oxford Handbook of Clinical Medicine 6th ed. Oxford University Press. ISBN N Engl J Med. Low-dose iron therapy is effective in octogenarians". Am J Med. Crop Protection. Iron in the vegan diet. The Vegetarian Resource Group. Rich Foods.

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