Anaemia explained: how to recognise and treat iron deficiency

In South Africa alone, over 17.8 million individuals were diagnosed with anaemia in 2018. Picture: Charlie-Helen Robinson/Pexels

In South Africa alone, over 17.8 million individuals were diagnosed with anaemia in 2018. Picture: Charlie-Helen Robinson/Pexels

Published 15h ago

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Imagine awakening each day burdened by an unseen weight, a fatigue that lingers like a shadow before the day has even begun.

This is the reality for many living with anemia, particularly iron-deficiency anaemia, a condition that goes far beyond the occasional tiredness.

With an estimated 2 billion people worldwide affected, it manifests as a daily struggle, robbing individuals of energy and joy.

The World Health Organization (WHO) reports that around 38% of the global population suffers from low iron levels, affecting everyone from newborns to the elderly.

Without enough iron, your body struggles to produce healthy red blood cells, leading to reduced oxygen delivery to tissues and organs. This lack of oxygen manifests as fatigue, cognitive impairment, and an overall decline in physical and mental health.

In severe cases, iron deficiency anaemia can lead to life-threatening complications, including heart failure and organ damage. For those recovering from surgery or childbirth, iron deficiency can significantly slow recovery, making it essential to address it early.

In South Africa alone, over 17.8 million individuals were diagnosed with anaemia in 2018, and the prevalence continues to rise, particularly among vulnerable populations.

People with chronic conditions such as autoimmune diseases, kidney disorders, and gastrointestinal issues can affect iron levels. 

Children under five, menstruating and pregnant women, the elderly and those with chronic health conditions are disproportionately affected.

What does anaemia feel like?

The symptoms of anaemia can feel overwhelming, transforming daily tasks into Herculean challenges. Common signs include:

Physical fatigue: Persistent tiredness despite adequate rest.

Shortness of breath: Difficulty catching your breath during minor activities.

Paleness: Noticeable changes in skin tone, particularly around the face and hands.

Headaches and dizziness: A constant feeling of fogginess.

Cold intolerance: A heightened sensitivity to temperature.

Hair loss and brittle nails: Fragile nails can signal more than just beauty concerns.

Pica: Unusual cravings for non-food substances like ice or soil.

Additionally, mental well-being can suffer, with many reporting heightened anxiety and depressive symptoms. This combination can deteriorate an individual's quality of life, making it crucial to understand anaemia and its effects.

Diagnosing anaemia

Early diagnosis is key to managing anaemia effectively. According to Sister Karin Davidson, the head of the Cape Town Infusion Centre: "If you catch your iron levels before they are too low, you may be able to correct them with oral supplements."

Sr Karin Davidson is an Inflammatory Bowel Disease Nurse Specialist. She heads up the Cape Town Infusion Centre in Mowbray, Cape Town. Picture: Supplied

She stresses the importance of requesting a full iron study, which provides a more comprehensive picture of your iron status than just a haemoglobin or ferritin test.

Davidson added: "Think iron. Check iron. Take iron." It speaks to the importance of proactive healthcare. By identifying and addressing iron deficiency early, many of the debilitating effects of anaemia can be prevented.

Treating anaemia

Contrary to popular belief, correcting anaemia is not as simple as eating more iron-rich foods. However, it's important to focus on foods that are rich in iron, as well as nutrients that help with the absorption of iron.

Here are some types of foods that can be made staples in the diet:

Iron-rich foods

Heme Iron (from animal sources):

  • Red meat (beef, lamb, pork)
  • Poultry (chicken, turkey)
  • Fish and seafood (salmon, tuna, sardines, shellfish)
  • Liver and organ meats

From plant sources

  • Leafy greens (spinach, kale, Swiss chard)
  • Legumes (lentils, beans, chickpeas)
  • Tofu and tempeh
  • Fortified cereals and grains
  • Pumpkin seeds, sesame seeds, quinoa
  • Dried fruits (raisins, apricots, figs)

Vitamin C-rich foods

Vitamin C helps improve the absorption of non-heme iron, so including these foods with meals can be beneficial:

  • Citrus fruits (oranges, grapefruits)
  • Bell peppers
  • Strawberries, kiwi, guava
  • Tomatoes, broccoli, Brussels sprouts

Foods high in folate (Vitamin B9)

Folate is essential for red blood cell production:

  • Leafy greens (spinach, collard greens)
  • Asparagus
  • Avocado
  • Fortified cereals
  • Beans and lentils
  • Eggs

Vitamin B12-rich foods

Vitamin B12 helps in the production of red blood cells and is found in animal-based products:

  • Meat, poultry, fish, and seafood
  • Eggs and dairy products (milk, cheese, yoghurt)
  • Fortified plant-based milk or cereals

Iron-boosting tips

Avoid drinking tea or coffee during meals as they can inhibit iron absorption.

Treatment options include:

1. Oral Iron supplements: Effective but slow-acting; requires consistency and proper timing to maximise absorption.

2. Intravenous (IV) Iron Therapy: A faster, more effective option for those who cannot tolerate oral iron or need immediate intervention (e.g., before surgery or during pregnancy).

3. Lifestyle adjustments: Addressing underlying causes like heavy menstrual bleeding or improving nutrition.

Anaemia may be common, but it’s not something you have to live with. Take control of your health, check your iron levels, consult your doctor, and explore treatment options. When it comes to your well-being, every ounce of energy matters.