anaemia / CPD
COMBATING NUTRIENT DEFICIENCY ANAEMIA
A
Normal level of red blood cells
Anaemia level of red blood cells
naemia is not a disease but rather a symptom
CAUSES OF IRON-DEFICIENCY ANAEMIA
of various diseases. Anything that causes a
Iron deficiency refers to the reduction in iron stores
deficiency in the formation of red blood cells
that either precedes overt iron-deficiency anaemia
or that leads to the accelerated destruction
or persists without progression. Low iron levels in
of red blood cells can result in anaemia. Anaemia can be
iron-deficiency anaemia result in anaemia with the
an early indicator of arthritis, infection, or certain major
presence of microcytic hypochromic red cells.4 The
illnesses like cancer.1,2
reported prevalence of iron deficiency in the absence
Drug use, hormonal disorders, chronic inflammation in
Anaemia is a very common blood disorder that results from a reduction in either the number of red blood cells or the amount of haemoglobin in the blood. The oxygen-carrying capacity of blood is decreased, and less oxygen is available to cells of the body to perform their functions
of dietary fortification is estimated to be 40% in
the body, surgery, infections, peptic ulcers, haemorrhoids,
preschool children, 30% in menstruating girls and
diverticular disease, heavy menstrual bleeding, repeated
women, and 38% in pregnant women. These high rates
pregnancies, liver damage, thyroid diseases, rheumatoid
reflect the increased physiological demands during
arthritis, bone marrow disease, hereditary disorders, and
particular life-stages and according to gender. A further
dietary deficiencies (especially deficiencies of iron, folate,
critical period is the growth spurt of adolescence.4
Anastasia Dobson Du Toit, Managing Director and Pharmacist, Anastellar
and vitamins B6 and B12) can all lead to anaemia. Severe anaemia is associated with fatigue, weakness,
DIETARY IRON SUPPLEMENTATION
dizziness, and drowsiness. The risk for anaemia increases
Once iron deficiency has been diagnosed and the
because of poor diet, intestinal disorders, chronic diseases,
physician has identified and, where possible, addressed
infections, and other conditions. Women who are
the underlying cause, it is important to restore iron levels
menstruating or pregnant, people with chronic medical
through supplementation. A dietary assessment should
conditions, and children have a higher risk profile of
be conducted, and appropriate advice provided. Although
developing anaemia. The risk of anaemia also increases
dietary changes and counselling are important, dietary
in the elderly. Nutritional interventions can have a positive
changes alone are not usually adequate and medicinal
impact on micronutrient deficiencies and undernutrition,
iron supplementation should be considered.5
Caragh Cooper, Consultant Medical Writer and Pharmacist
as well as on acute infections like diarrhoea, malaria, HIV/AIDS, and tuberculosis.1,2
REFERENCES
IRON DEFICIENCY AND ITS ROLE IN ANAEMIA Iron deficiency and iron-deficiency anaemia are global health problems and common medical conditions seen in everyday clinical practice. The classic textbook symptoms of iron-deficiency such as koilonychia (spoon nails), glossitis, or dysphagia are not commonly seen in developed countries.3 Iron plays a crucial role in biologic functions, including energy production, respiration, cell proliferation, and DNA synthesis. Due to the absence of an excretion mechanism and the potential for iron levels to become toxic, daily absorption is
1. Organisation, World Health. Anaemia. Health Topics. [Online] [Cited: January 24, 2020.] https://www.who.int/topics/ anaemia/en/. 2. Royal Pharmaceutical Society of Great Britain. Dietary Supplements. [ed.] P Mason. 4th. London: The Pharmaceutical Press, 2012. 3. Iron Defiency Anaemia. Killip, Shersten, Bennett, John M and Chambers, Mara D. 5, 2007, American Family Physician, Vol. 75,
Michelle Dateling, Sales and Marketing Director, Anastellar
pp. 671-678. 4. Iron-Deficiency Anaemia. Camaschella, Clara. [ed.] Dan L Longo. 19, 2015, The New England Journal of Medicine, Vol. 372, pp. 1832-1843. 5. Individualized Treatment for Iron-deficiency Anaemia in Adults.
limited as the body has developed mechanisms to recycle the
Alleyne, Michael, Horne, McDonald K and Miller, Jeffery L. 11,
iron which is released after the breakdown of red blood cells.
2008, The American Journal of Medicine, Vol. 121, pp. 943-948.
This is a condensed version of the full CPD-accredited article which first appeared in the Medical Chronicle in February 2020. CPD points cannot be guaranteed as they are awarded at the South African Pharmacy’s discretion. FOR THE FULL ARTICLE AND TO COMPLETE THE CPD QUESTIONS VISIT WWW.MEDICALCHRONICLE.CO.ZA INSTRUCTIONS: 1. Go to www.medicalchronicle.co.za 2. Click the tab labelled ‘CPD Portal’ on the far-right tab near the top of the page to access this and other CPD accredited articles. Pharmacy Magazine MARCH 2020 |
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