Iron Deficiency Anemia

What is iron deficiency anemia?

The most common cause of anemia is iron deficiency. Iron is needed to form hemoglobin. Iron is mostly stored in the body in the hemoglobin. About 30 percent of iron is also stored as ferritin and hemosiderin in the bone marrow, spleen and liver.


Iron deficiency anemia can be caused by:

  • Diets low in iron — Iron is obtained from foods in our diet, however, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested. A child unable to have a balanced iron-rich diet may suffer some degree of iron deficiency anemia.
  • Body changes — An increased iron requirement and increased red blood cell production is required when the body is going through changes such as growth spurts in children and adolescents.
  • Gastrointestinal (GI) tract abnormalities Malabsorption of iron is common after some forms of gastrointestinal surgeries. Most of the iron taken in by dietary route is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and result in iron deficiency anemia.
  • Blood loss Loss of blood can cause a decrease of iron and result in iron deficiency anemia. Sources of blood loss may include GI bleeding, menstrual bleeding, or injury.

Signs and symptoms

Each child may experience different symptoms or varying severity of symptoms from iron deficiency anemia. Symptoms may include:

  • Abnormal paleness or lack of color of the skin
  • Irritability
  • Lack of energy or tiring easily (fatigue)
  • Increased heart rate (tachycardia)
  • Sore or swollen tongue
  • Enlarged spleen
  • A desire to eat peculiar substances such as dirt or ice (also called pica)

Testing and diagnosis

Diagnosing iron deficiency anemia begins with a complete medical history and physical examination of your child. A physician may order additional diagnostic tests or procedures for iron deficiency anemia, including:

  • Blood tests to measure the amount of hemoglobin (number of red blood cells) that are present; and measure the amount of iron in your child's blood
  • Bone marrow aspiration and/or biopsy, a procedure where a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, is examined for the number, size, and maturity of blood cells and/or abnormal cells.


Specific treatment for iron deficiency anemia will be determined by your child's physician based on:

  • Your child's age, overall health and medical history
  • Extent of the anemia
  • Cause of the anemia
  • Your child's tolerance for specific medications, procedures or therapies
  • Expectations for the course of the anemia
  • Your opinion or preference

Treatment may include:

An iron-rich diet

Eating a diet with iron-rich foods can help treat iron deficiency anemia. Good sources of iron include the following:

  • Meats — beef, pork, lamb, liver, and other organ meats
  • Poultry — chicken, duck, turkey, liver (especially dark meat)
  • Fish — shellfish, including clams, mussels, and oysters, sardines, anchovies
  • Leafy greens of the cabbage family — broccoli, kale, turnip greens, and collards
  • Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
  • Yeast-leavened whole-wheat bread and rolls
  • Iron-enriched white bread, pasta, rice, and cereals

Iron supplements

Iron supplements can be taken over several months to increase iron levels in the blood. Iron supplements can cause irritation of the stomach and discoloration of bowel movements. They should be taken on an empty stomach or with orange juice to increase absorption. Always consult your child's physician regarding the recommended daily iron requirements for your child. Iron-Rich Foods listed by Quantity/Approximate Iron Content in milligrams:

  • Oysters — 3 ounces/13.2 mg
  • Beef liver  3 ounces/7.5 mg
  • Prune juice — 1/2 cup/5.2 mg
  • Clams — 2 ounces/4.2 mg
  • Walnuts — 1/2 cup/>3.75 mg
  • Ground beef — 3 ounces/3.0 mg
  • Chickpeas — 1/2 cup/3.0 mg
  • Bran flakes — 1/2 cup/2.8 mg
  • Pork roast — 3 ounces/2.7 mg
  • Cashew nuts — 1/2 cup/2.65 mg
  • Shrimp — 3 ounces/2.6 mg
  • Raisins — 1/2 cup/2.55 mg
  • Sardines — 3 ounces/2.5 mg
  • Spinach — 1/2 cup/2.4 mg
  • Lima beans — 1/2 cup/2.3 mg
  • Kidney beansTurkey, dark meat — 3 ounces/2.0 mg
  • Prunes — 1/2 cup/1.9 mg
  • Roast beef — 3 ounces/1.8 mg
  • Green peasPeanuts — 1/2 cup/1.5 mg
  • Potato — 1 potato/1.1 mg
  • Sweet potato — 1/2 cup/1.0 mg
  • Green beans — 1/2 cup/1.0 mg
  • Egg — 1 egg/1.0 mg

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