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7 a.m. (ET) Thursday, June 6, 2002
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For Further Information:
Bess Andrews
Public Affairs
617-355-6420
page 617-355-6369, #1641
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Iron deficiency anemia affects as many as 600-million people worldwide
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Women and young children are most at risk for iron-deficient anemia, but most are unaware they are anemic until diagnosed by a physician, according to Nancy Andrews, M.D., an expert in iron metabolism.
''Iron-deficient anemia develops slowly so those affected do not notice small, day-to-day changes,'' says Dr. Andrews, associate professor of pediatrics at Harvard Medical School and an attending physician in hematology-oncology at Children's Hospital Boston. She spoke today at an American Medical Association media briefing on anemia in New York City.
Iron-deficient anemia reduces the oxygen-carrying capacity of red blood cells, thus decreasing energy and endurance. When there is not enough iron, the red blood cells are not able to produce enough hemoglobin (the oxygen-transporting pigments found in red blood cells). Those affected may have pale skin and be excessively tired and ineffective at work or school. Some may have heart palpitations and frequent headaches. Although rare, spoon-shaped fingernails and difficulty swallowing are also symptoms of anemia.
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''Women are most at risk for iron-deficient anemia because they lose two to three tablespoons of blood each month during their reproductive years, resulting in a substantial loss of iron,'' Dr. Andrews explains. ''Some women have difficulty replacing the lost iron through diet alone.''
''Children are also at risk for iron-deficient anemia, which most frequently affects children between six months and three years of age. Young children need more iron because they are rapidly growing. Iron-fortified foods including formula or supplemental iron can help treat early iron deficiency and prevent resulting anemia,'' states Dr. Andrews.
Iron deficiency affects as many as one in seven premenopausal women in industrialized countries and an even larger proportion of women in developing nations. Worldwide, approximately 600-million people-twice the population of the United States-are iron deficient.
Iron salts are the most common treatment for iron deficiency anemia. Dr. Andrews says iron salts can replace blood iron in a matter of months, but may take six months to restore the body's iron balance. Unfortunately, iron salts are not well tolerated and may cause nausea, abdominal pain, diarrhea and constipation. Dr. Andrews recommends taking iron supplements at night to increase their effectiveness and to prevent side effects.
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''Medicinal iron salts are inexpensive and available without a prescription; however, it is important to check with your doctor before supplementing iron,'' recommends Dr. Andrews. It is important not to ingest too much iron, because excessive amounts can damage the stomach and intestines. A condition called hemochromatosis is associated with too much iron in the body and may lead to liver cancer, diabetes and impotence. Iron supplements should be stored in childproof containers out of the reach of children. An accidental overdose can seriously hurt or kill a child.
There are several medical alternatives to iron salts. Iron polysaccharide complex may be better tolerated. Acute iron-deficient anemia can be remedied with intravenous iron treatments in a hospital or clinic. This is done only in extreme cases because of the risk of severe allergic reaction to intravenous iron, according to Dr. Andrews.
Dietary changes can also help to alleviate iron deficiency. Increasing the amount of iron-rich meat and vitamin C in the diet can be helpful. Vitamin C helps the body absorb iron more efficiently, while antacids, bran and starch can bind to iron and prevent absorption.
Anemia is exacerbated by a number of conditions, including pregnancy, because the amount of iron required by the developing fetus is equivalent to three units of blood. Chronic blood loss from intestinal cancer with bleeding can cause anemia, as can stomach bleeding from large doses of aspirin over a long period of time.
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Lifestyle may also contribute to iron-deficient anemia. Vegetarians are at risk because red meat and poultry are the richest dietary sources of iron. Plus, the iron in vegetables is not well absorbed. Long distance runners are also at increased risk for iron deficiency for reasons that are not well understood. Regular blood donation over a period of years may also create iron deficiency.
''People living in developing countries are at high risk for iron deficiency for several reasons-diets are generally vegetable or starch based with little meat, and there is an increased exposure to intestinal parasites such as hookworm that cause intestinal bleeding. However, scientists are engineering rice plants with increased iron content,'' adds Dr. Andrews.
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Children's Hospital Boston is the nation's premier pediatric medical center. Children's Hospital is the primary pediatric teaching affiliate of Harvard Medical School, home to the world's leading pediatric research enterprise, and the largest provider of health care to the children of Massachusetts. For more information about the hospital visit: www.childrenshospital.org.
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Editor's Note: Dr. Andrews' research is supported by grants from the National Institutes of Health, the Howard Hughes Medical Institute, and the March of Dimes. She is also a consultant for Xenon Genetics Inc. She has received an honorarium from the American Medical Association to speak at this briefing.
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