When you’re low in iron, it could be more than just needing a pill

Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning to talk about iron deficiency and anemia.

Sommer explained, “It just means your blood has a lack of iron and that leads to the reduction in number of red blood cells in your blood. The red blood cells are important because they are what carry oxygen throughout the body. So if you have fewer red blood cells, it could put some stress on your organs and the tissues because they’re not getting the oxygen they need.”

Some symptoms of iron deficiency anemia include tiredness and lack of energy, lethargy and shortness of breath.

Sommer said, “Some people do have palpitations at rest, not with exercise or if they exercise they feel that their heart is beating faster than it normally does. They tend to look pale. So less common side effects are headache, ringing in the ears or tinnitus, altered sense of taste, feeling itchy, a smooth tongue or hair loss.”

Additionally, a lot of people that have low iron or anemia want to eat non-food items, like paper and clay and they tend to want to chew ice.

Sommer continued, “Difficulty swallowing and sometimes you can get ulcers on the corners of your mouth.”

If you have the symptoms, go get checked out. You will probably have to have an EGD (Esophagogastroduodenoscopy).

Sommer said, “An upper endoscopy is the easier term and then our friend the colonoscopy. There are some issues that can cause anemia. It’s associated with malabsorption in the stomach. These are the reasons why you would have an upper or lower scope and it’s Celiac disease, which if anybody’s familiar, that’s usually you don’t tolerate gluten; Crohn’s disease, which is an inflammatory bowel disease, diverticular disease. You can get those little pockets in your colon that can trap bacteria. If you have diverticulosis, they can become inflamed and infected, leading to diverticulitis, and sometimes with irritation with that you can bleed.”

It can also cause a hiatal hernia.

Sommer continued, “Chronic hepatitis or liver conditions. Sometimes surgeries to lose weight like bariatric surgery can cause some type of malabsorption and H. pylori infection, that’s the bacteria, that if left untreated, could cause I think a rare type of lymphoma. So usually when you have an upper scope and you have any type of irritation, there’s always a biopsy for that because it’s easily treated. It’s 10 days of antibiotics, it’s usually eradicated.  We you check again and if it’s gone, you’re good.”

Issues that can cause iron loss include inflammatory bowel disease like Crohn’s disease, ulcerative colitis, bleeding ulcers, gastric or duodenal.

Sommer said, “Colon polyps can cause bleeding, and usually they are the cancerous ones. So that’s usually the number one reason why when you have iron deficiency anemia they want to do a colonoscopy at least to make sure because colon polyps do cause you to bleed and you can become anemic from a bleeding polyp. Gastric polyps, you can have one in your stomach. Not all gastric polyps turn out to be as cancerous as the ones below, but they just can cause irritation and bleeding. So that’s why we need to check the top and the bottom.”

Recommended testing is important.

Chronic use of non-steroidal anti-inflammatories can increase your risk of bleeding and ulcers.

Sommer said, “They can eat your stomach away. NSAIDS, ibuprofen, naproxen, aspirin and I also want to mention because still people don’t realize that Ibuprofen is Motrin and Advil. I think Naproxen is Alieve. Sometimes I’ll just say, oh, you can take something mild for pain, like Tylenol, ibuprofen and they’ll say, well I take Motrin, it’s the same thing.”

That’s why most medications should be taken with food.

Sommer said, “This is more for people that take large doses of these medications daily, usually for pain. Back pain, any type of body aches, arthritis. A lot of times you see people with really bad arthritis, they end up with some type of GI bleed because they are in pain.”

Parasitic infections can also cause anemia.

Sommer said, “Like hookworm, that can cause bleeding. It just it causes irritation. For women who still get their monthly cycle, they too are at risk for iron loss, because sometimes you can bleed heavily.”

Chronic nose bleeds can also bring about anemia.

Sommer continued, “And then urinary blood loss. Sometimes people have chronic UTIs, or kidney infections or kidney stones. It was as one of the ways you can lose your iron. Usually what happens is, if you have blood in your urine, and you have anemia, and they’re ruling everything out, you’ll see the urologist, you’ll see us, you go all over.”

Sometimes, depending on the symptoms, you can choose to have the upper scope or a colonoscopy.

Sommer explained, “We get referrals for anemia a lot. That’s why I wanted to mention that. A lot of times patients don’t understand why one can do with the other. That’s why I wanted to talk about it. We have that cost issue and insurance. So sometimes it’s they can’t afford both. So they usually pick the colonoscopy. Or sometimes they’ll pick the upper scope, depending I guess on their symptoms. But just to know that if one doesn’t show anything, and you’re still losing blood, or you’re still not maintaining your iron, they are going to recommend doing the other one. We just try and do both at the same time, like kill two birds with one stone.”

Remember if you have an iron deficiency, there could be more going on than just needing to pop an iron pill.

Sommer said, “If it’s a malabsorption issue or when it can be ruled out that it’s not any type of cancer or disease process then, treatment will go hopefully with just a pill.”