What is iron deficiency and how does it occur?
Iron deficiency is a common nutritional disorder when the body lacks sufficient iron.
It can occur due to several reasons. One of the most common causes is insufficient iron intake, which can be due to a diet low in iron or poor absorption of iron from food. Rapid growth, especially in children, can also lead to iron deficiency as the body needs more iron to support growth [1].
Blood loss is another significant cause of iron deficiency. Blood loss can occur due to heavy periods, childbirth, uterine fibroids, stomach ulcers, colon cancer, and urinary tract bleeding. In these cases, the body loses more iron than it can replace, leading to a deficiency [2].
Certain medical conditions and surgeries can also lead to poor absorption of iron. For example, intestinal disorders such as inflammatory bowel disease and celiac disease or surgeries like gastric bypass can affect the body's ability to absorb iron from food [2].
Issues caused by iron deficiency
Iron deficiency anaemia: Iron deficiency can lead to a variety of health problems. One of the most common issues is iron deficiency anaemia, symptoms of which include:
- fatigue,
- weakness,
- and headaches [3, 4].
- In severe cases, iron deficiency anaemia can lead to heart problems. The heart has to pump more blood to compensate for the low amount of oxygen, which can result in heart failure or an enlarged heart muscle [3].
Delayed development in children: Iron deficiency can also lead to growth and developmental delays in infants and children. They may also be more susceptible to infections [4].
Multitude of issues in adults and pregnant women: In adults, iron deficiency can lead to shortness of breath, decreased exercise tolerance, palpitations, tachycardia, angina, congestive heart failure, orthopnea, and oedema [5]. In pregnant women, severe cases of iron deficiency can cause a child to be born prematurely or with a low birth weight [4]. Iron deficiency can also cause severe psychomotor disorders in children, pregnant women, and adults in general [6].
Does iron deficiency cause dizziness when standing up?
Lack of Haemoglobin: Iron deficiency anaemia can indeed contribute to feelings of dizziness when standing up. This condition occurs when your body doesn't have enough iron to produce haemoglobin, the part of your red blood cells that carries oxygen to your body's tissues. Lack of haemoglobin could result in your body not getting the oxygen it needs, leading to dizziness or lightheadedness, especially when changing positions such as standing up [7, 8].
Postural control disorder: A study involving young women with iron deficiency anaemia found that they had worse postural control than their healthy peers. This was indicated by significantly higher values of centre of pressure velocity in various postures and conditions. The study also found that these young women had higher respiratory rates, attentional capacity, physical performance, and fatigue, which could explain the postural control disorder [8].
In another case, a 61-year-old woman with neurodegeneration with brain iron accumulation (NBIA) showed improvement in her gait and a reduction in choreic dyskinesias after six months of iron chelating treatment with deferiprone. Her gait returned to normal after an additional two months of therapy, indicating that iron levels can indeed affect balance and movement [9].
However, it's essential to note that dizziness when standing up can also be caused by various other factors, like dehydration, low blood sugar, low blood pressure, heart problems, certain medications, and more [7].
Therefore, if you're experiencing dizziness when standing up, it's essential to consult with a healthcare provider to determine the underlying cause and appropriate treatment.
Preventing and treating iron deficiency
Iron deficiency affects an estimated 2 billion people worldwide. Therefore it is considered a leading risk factor for disability and death [10]. A significant public health goal is to prevent and treat this condition [11].
Prevention
Preventing iron deficiency often involves changes in diet and food fortification. In developed countries, strategies such as dietary diversification and food fortification have shown significant results in controlling iron deficiency anaemia [12]. Fortifying food products with iron is one way to prevent iron deficiency anaemia in developing countries [13]. Biofortification, a cultivation technique that increases bioavailable iron content in local produce, is also a promising strategy against iron deficiency [14].
Treatment
The treatment of iron deficiency involves finding and addressing the underlying cause and selecting an iron replacement product that meets the patient's needs [11]. The first line of treatment usually involves oral iron supplementation, with ferrous sulphate being the most commonly prescribed drug [15].
However, oral iron supplementation can lead to potential gastrointestinal side effects that reduce compliance. Intermittent oral iron supplementation has been considered to mitigate the possible side effects. This approach improves overall compliance and alleviates side effects [16]. A study comparing oral iron replacement therapy daily and every other day in women of reproductive age with iron-deficiency anaemia found that both approaches significantly improved haemoglobin, serum iron, transferrin saturation, and ferritin levels [17].
When oral iron supplementation is contraindicated, intravenous iron therapy can rapidly achieve therapeutic targets without gastrointestinal complications [15].
In conclusion, preventing and treating iron deficiency involves dietary changes, food fortification, and supplementation. The choice of treatment depends on the individual's needs and the underlying cause of the deficiency.