Iron-deficiency Anemia

Iron-deficiency anemia develops when iron stores are too low to support normal red blood cell production. Iron levels can drop due to blood loss, or poor absorption. Red blood cells contain hemoglobin, a protein that uses iron to carry oxygen from the lungs to the rest of the body. Without enough iron, the body produces fewer and smaller red blood cells, limiting oxygen delivery to tissues and organs.

How iron supports red blood cell production

Iron is essential for making hemoglobin, which efficiently transports oxygen. When iron intake or absorption is inadequate, hemoglobin levels drop, leading to anemia. This process can occur gradually, which is why symptoms may be subtle at first. When iron deficiency is due to blood loss from bleeding, it can be gradual and subtle, or more rapid and thus cause symptoms.

Why low iron levels affect overall health

Low iron levels can impact more than just energy. Reduced oxygen delivery may affect concentration, immune function, and physical endurance. Over time, untreated anemia can place additional strain on the heart and other organs as the body works harder to circulate oxygen.

Iron-deficiency anemia may result from inadequate dietary intake, increased iron needs, poor absorption, or blood loss. In adults, blood loss, particularly from the gastrointestinal tract, is one of the most common causes. Conditions such as peptic ulcers, erosive gastritis, H pylori bacteria, celiac disease, colon polyps, colon cancer, inflammatory bowel disease (IBD), or chronic use of NSAIDs can contribute to ongoing iron loss. 

Symptoms of iron-deficiency anemia can vary in severity and may develop gradually. Common signs include persistent fatigue, weakness, shortness of breath with activity, pale skin, dizziness, and headaches. Some people experience cold hands and feet, brittle nails, or difficulty concentrating.

The digestive system plays a key role in both iron absorption and blood loss. Iron is absorbed primarily in the small intestine, and disorders affecting the GI tract can interfere with this process. In addition, slow or hidden gastrointestinal bleeding may go unnoticed while steadily lowering iron levels.

Diagnosis typically begins with blood tests that measure hemoglobin, iron levels, ferritin, and other markers of iron stores. If anemia is confirmed, further evaluation may be needed to determine the cause. This may include an upper endoscopy, colonoscopy, video capsule endosocpy or other diagnostic testing to assess for sources of bleeding or absorption issues.

Treatment depends on the severity of anemia and its underlying cause. Iron supplementation, either oral or intravenous, may be recommended to restore iron levels. Nutritional counseling to increase iron-rich foods can also support recovery. Treating the underlying cause of poor absorption or blood loss will manage the condition.

At NYGA, our gastroenterologists take a comprehensive approach to iron-deficiency anemia, focusing not only on correcting iron levels but also on protecting long-term digestive and overall health.