Iron deficiency in pre-menopausal women, cause for Anaemia – Haematologista | Sunday Observer

Iron deficiency in pre-menopausal women, cause for Anaemia – Haematologista

1 November, 2020

Iron deficiency anaemia has a substantial effect on the lives of pre-menopausal women and young children, Consultant Haematologist , National Hospital of Sri Lanka Dr. Bhaddika Rasanjalie Jayaratne said. “As the iron deficiency continues to be the top ranking cause of anaemia worldwide including Sri Lanka, the diagnosis, treatment and prevention of this condition could clearly be improved”, she said in an interview with the Sunday Observer.

She said iron deficiency anaemia is a global health problem and a common medical condition seen in every day clinical practice. “Iron is crucial to biological functions including respiration, energy production, DNA synthesis and cell proliferation. The human body has evolved to conserve iron in several ways including recycling of iron after the breakdown of red cells and retention of iron in the absence of an excretion mechanism. Since excess level of iron can be toxic, its absorption is limited to 1 to 2 mgs daily. Most of the iron needed is provided by the body iron store through recycling macrophages that phagocytose senescent red cells. These mechanisms are controlled by a hormone called hepcidin which maintains total body iron level within normal ranges avoiding both iron deficiency and excess.”

To our query on what caused this condition, she said that the causes varied according to the income levels of the communities at risk. “In low income communities iron deficiency anaemia usually results from insufficient dietary intake, loss of blood through gastrointestinal tract or heavy menstrual bleeding and intestinal worm colonization. In high income communities certain eating habits such as vegetarian diet or no intake of red meat and associated morbidities such as chronic blood loss and malabsorption are common causes. These are also the reasons for the high rate of iron deficiency in the aging populations.”

Health impacts

Commenting on the adverse health impacts on those with this condition, she said, “They include weakness, fatigue, difficulty in concentration and poor work productivity are nonspecific symptoms ascribed to low delivery of oxygen to body tissues and decreased activity of iron containing enzymes. Iron deficiency has been reported to decrease cognitive performance and delay mental development in children. Iron deficiency may predispose a person to infections, precipitate heart failure and cause restless leg syndrome. In patients with heart failure iron deficiency has a negative effect on the quality of life irrespective of the presence of anaemia,” she added.


The diagnosis of anaemia is made after confirmation of a reduced blood haemoglobin level as shown by full blood count. “These laboratory investigations are comparatively inexpensive and available at public and private sector hospitals. “However, investigations are incomplete until the cause of the iron deficiency anaemia is found for treatment,” she said.

On the management of this condition she said, “Acute and long term management of iron deficiency anaemia is aimed at supplying enough iron to normalize haemoglobin level and replenish body iron stores in view of relieving symptoms and improving the quality of life.”


Asked what interventions had been initiated to reduce risks of iron deficiency anaemia, she said, “Public health interventions to reduce the burden of iron deficiency anaemia include the increase of iron stores through supplementation and education on increased consumption of food with high iron content and bioavailability.

Fortification of processed and staple food or home food fortification has to be done under careful surveillance studies in suitably identified communities in the country”.

Compiled by Carol Aloysius