Does iron deficiency anemia cause tiredness?

Written by Zhang Xiao Le
Hematology
Updated on January 15, 2025
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Patients with iron-deficiency anemia can exhibit symptoms of fatigue. Anemia is characterized by red blood cells and hemoglobin levels that are below the normal range. Red blood cells are the main cells responsible for transporting oxygen in the body. Oxygen enters the blood through gas exchange in the lungs and is then delivered throughout the body by red blood cells to supply oxygen. Therefore, patients with anemia will show varying degrees of ischemia and hypoxia. In the nervous system, this can be manifested as lethargy, insomnia, frequent dreaming, tinnitus, blurry vision, fainting, and lack of concentration. As the severity of anemia increases, these symptoms may also worsen. Patients with severe anemia may exhibit significant lethargy and drowsiness.

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Written by He Li Fang
Hematology
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The causes of iron deficiency anemia

The causes of iron deficiency anemia primarily refer to the disruption of the normal dynamic balance between iron absorption and excretion, leading to the consumption of stored iron as well as an increased need for iron and insufficient iron intake, especially in cases of chronic blood loss, resulting in a long-term negative iron balance. The causes of iron deficiency can be divided into two main aspects: insufficient iron intake and excessive iron loss. In the first aspect, decreased iron intake includes dietary insufficiency, meaning inadequate food intake, and reduced absorption, which includes decreased absorption due to lack of stomach acid and reduced absorption following gastric surgery. Excessive iron loss includes the following eight aspects: 1) gastrointestinal bleeding, which includes bleeding caused by tumors, gastrointestinal ulcers, gastritis, as well as bleeding due to parasites and hookworm infections. It also includes bleeding caused by hemorrhoids in men and arteriovenous malformations; 2) excessive menstrual bleeding; 3) frequent blood donations; 4) multiple pregnancies in women; 5) chronic intravascular hemolysis causing hemoglobinuria; 6) hereditary hemorrhagic telangiectasia; 7) primary pulmonary hemosiderosis; and 8) coagulation disorders or the use of anticoagulants leading to iron deficiency. These eight categories all result from excessive loss of iron, causing iron deficiency which leads to iron deficiency anemia.

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Written by He Li Fang
Hematology
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The key to curing iron deficiency anemia

Iron deficiency anemia, a common and frequently occurring disease in the department of hematology, is not difficult to diagnose and treat. The key to treatment lies in addressing the cause of the iron deficiency, and it is essential to eliminate the underlying causes as much as possible. Using iron supplements alone can only restore blood counts; neglecting the primary disease will not lead to a complete cure of the anemia and can easily lead to recurrence. Treatment consists of two phases: first, the supplementation with iron supplements. After taking iron supplements for three to four days, an increase in reticulocytes will occur, reaching a peak around seven days, and hemoglobin will significantly rise after two weeks of medication, returning to normal levels after one to two months. However, after hemoglobin levels normalize, some patients may stop taking the medication. It is important to note that continuing to take iron supplements for three months is necessary to replenish the body's iron stores completely.

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Written by Hu Qi Feng
Pediatrics
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What are the symptoms of iron deficiency anemia in children?

Iron deficiency anemia can manifest as: 1. Gradual pallor of the skin and mucous membranes, especially noticeable on the lips, oral mucosa, and nail beds. Older children may experience dizziness, darkening before the eyes, and tinnitus. Additionally, anemia can lead to extramedullary hematopoiesis, and enlargement of the liver, spleen, and lymph nodes can occur. The younger the age and the longer the duration of the disease, the more severe the anemia and the more prominent the enlargement of the liver and spleen. 2. In terms of gastrointestinal tract: reduced appetite, pica, vomiting, diarrhea, and stomatitis may occur. 3. Nervous system manifestations include: restlessness or lethargy, lack of concentration, reduced memory, and intelligence often lower than peers of the same age. 4. Cardiovascular system: an increased heart rate may be observed, and in severe cases, cardiac enlargement and even heart failure can occur. 5. Immune system: Iron deficiency can affect hematopoietic function, often leading to reduced cell-mediated immune function and combined infections.

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Written by He Li Fang
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Characteristics of iron deficiency anemia blood picture

The clinical manifestations of iron deficiency anemia are due to the specific characteristics of anemia caused by iron deficiency and the underlying disease causing the iron deficiency. Its hematological characteristics present as typical microcytic hypochromic anemia. What does this concept mean? It refers to the values in a complete blood count where MCV is less than 80 femtoliters, MCH is less than 27 picograms, and MCHC is less than 30%. MCV refers to the average red blood cell volume, MCH refers to the mean corpuscular hemoglobin concentration, and MCHC refers to the mean corpuscular hemoglobin concentration of red blood cells. The extent of changes in red blood cell indices correlates with the duration and severity of anemia. The blood smear typically shows pale-stained red blood cells with an enlarged central pallor and varying sizes. Platelet count often tends to be high when there is concurrent bleeding and generally tends to be low in infants and children. White blood cell count is usually normal or slightly reduced, with normal differential. These are the hematological characteristics of iron deficiency anemia.

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Hematology
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Hazards of Iron Deficiency Anemia in Women

The harm of iron deficiency anemia in women is related to the severity of the anemia. Mild anemia generally has no obvious clinical symptoms; moderate anemia often presents with fatigue, palpitations and shortness of breath after activity, dizziness, tinnitus, insomnia, frequent dreams, reduced appetite, and poor digestive function; severe anemia can affect the quality of life, with symptoms of palpitations and shortness of breath even with slight activity, and can severely impact the quality of life. The most common cause of iron deficiency anemia in women is due to increased menstrual flow. Additional examinations, such as gynecological ultrasound, are necessary to clarify the presence of conditions like uterine fibroids or adenomyosis, and to provide targeted treatment.