If you have been feeling fatigued or have any other signs of iron deficiency such as paleness, dizziness or a racing heart, you may want to speak to your doctor. It could be that you are iron deficient but there may be another condition causing your symptoms. To get the most out of your visit it is useful to think about the information that the doctor might need in order to work out what is causing your symptoms. You could also plan the questions that you would like to ask. This section expands on the points that you might want to mention to your doctor.
Testing for iron deficiency
If you are concerned about fatigue or other symptoms, it is important that you find out for certain if iron deficiency is the reason. As well as discussing your symptoms and your medical history, your doctor may want to take a blood sample from you. Different analyses can then be performed on your blood sample. These analyses include a complete blood count to identify if you are anaemic, and other tests that check your iron levels. Different values may be used to define anaemia and iron deficiency depending on your age and gender. Click here to learn more about the tests that might be performed and what the results mean.
How is Iron Deficiency Treated?
You don’t have to accept your fatigue and/or other symptoms and adjust the way that you live; iron deficiency can be treated. Once your doctor has understood your symptoms and looked at the results of your blood tests, he will be able to confirm if you are iron deficient or have iron deficiency anaemia and recommend the best treatment for you. It may take different lengths of time for you to feel better, depending on the treatment. It is best to find out from your doctor when you can expect to notice a positive effect. One treatment option may be to increase the amount of iron in your diet by eating more iron-rich foods like red meat, liver, enriched cereals and leafy greens.1 When planning meals, this guide may help you choose food that is rich in iron.
Your doctor may also decide that you need extra iron given through:
Some treatments may be more suitable for you than others, depending on your level of iron deficiency and any other medical conditions that you may have. Your doctor will be able to discuss the treatment options available with you and advise you on the most suitable treatment option for your condition.3,5 It may take different lengths of time for you to feel better, depending on the treatment. It is best to find out from your doctor when you can expect to notice a positive effect.3,6,7 If you are having problems with your treatment and experiencing side effects, or finding that your symptoms are not improving, go to see your doctor again for advice.
Talking to your doctor
Your doctor will try to understand what is causing your symptoms. You might want to talk to your doctor about:
- How long you have felt fatigued (if applicable) and whether it is better or worse after sleeping or exercise
- Any other symptoms, including when they started, how long they last, anything that makes them better or worse and if they affect your daily life8
- Whether you have been to see another doctor or healthcare specialist or had to stay in hospital recently and if so, what was the cause of your visit8
- What (if any) medications you are on8?
- Whether you have any of the risk factors that make iron deficiency more likely, for example if you are pregnant, have coeliac disease, inflammatory bowel disease, heart disease, kidney disease, cancer, or have had bariatric surgery.
- Whether your symptoms appeared after a certain event or change in your life9
- What your everyday habits are, including whether you smoke or not, how much alcohol you drink and how much exercise you do8
- How extreme your tiredness or fatigue feels and how much it affects your daily life8
What happens next?
Depending on their assessment of your symptoms, your doctor may ask you to adjust your lifestyle and return to them for a follow up visit. Your doctor may also ask you to have a blood test.
咨询您的医生
如果您一直感到疲乏,或者有任何其他缺铁体征,例如苍白、头晕或者心跳加速,那么您可能想要咨询您的医生。这可能是您缺铁,但也可能是另一种病症引起您的症状。为了最大限度地利用您的访视,思考医生可能需要的信息非常有用,以便找出引起您的症状的原因。您也可以计划好您想问的问题。本节将对您可能想要向您的医生提及的要点进行扩展。
缺铁检查
如果您担心疲乏或其他症状,重要的是您需要确定其是否由缺铁所致。除了讨论您的症状和病史之外,您的医生可能还想从您身上采集血液样本。然后可能会对您的血液样本进行不同的分析。这些分析包括用于确定您是否贫血的全血细胞计数,以及其他检测您的铁水平的检查。可能会使用不同的值来定义贫血和缺铁,具体取决于您的年龄和性别。点击此处了解有关可能进行的检查以及结果含义的更多信息。
如何治疗缺铁?
您不必接受您的疲乏和/或其他症状,也不必调整您的生活方式;缺铁是可以治疗的。在您的医生做了血液检查并确认您是否缺铁之后,他们将就最佳的治疗选择向您提供建议。治疗可能包括通过进食更多富含铁的食物来增加您饮食中的铁含量,或者以口服铁片或静脉铁剂的形式使用铁补充剂。您可能需要不同长度的时间才能感觉好些,具体取决于治疗。最好从您的医生那里了解预期您可在什么时候观察到明显效果。
明智地选择您的食物
如果您感到极度疲倦或有任何其他缺铁症状,重要的是要考虑您的饮食是否含有足够的铁。进食更多的富含铁的食物是提高您的铁水平和减少疲乏的一个简单方法。正常情况下,您可以从健康、均衡的饮食中获取您的身体所需的所有铁。但是,即使您饮食健康,有时您也可能无法进食足够的富含铁的食物。对于那些面临更高缺铁风险的素食者和严格素食主义者,或者如果您的情况发生了变化,例如您已怀孕,情况尤其如此。参见本节了解富含铁的食物列表和需要避免以增加您的铁摄入量的食物列表。
一旦您的医生了解了您的症状并查看了您的血液检查结果,他们就将能够确认您是否缺铁或患有缺铁性贫血,并为您推荐最佳的治疗。一种治疗选择可能是通过进食更多富含铁的食物来增加您饮食中的铁含量,例如红肉、肝脏、强化谷类和叶状蔬菜1。在计划餐食时,本指南可帮助您选择富含铁的食物。
您的医生也可能决定,您需要通过以下方式补充额外的铁
- 口服铁补充剂1,有非处方或处方制剂,或
- 静脉铁剂2,3,4,直接将铁递送至您的血流中。
某些治疗可能比其他治疗更适合您,具体取决于您缺铁的程度和您可能有的任何其他医学病症。您的医生将能够与您讨论可用的治疗选择,并就最适合您情况的治疗选择向您提供建议3,5。
您可能需要不同长度的时间才能感觉好些,具体取决于治疗。最好从您的医生那里了解预期您可在什么时候观察到明显效果3,6,7。如果您对您的治疗存有问题和出现副作用,或者发现您的症状未见改善,则再次去看您的医生以寻求建议。
- Alleyne M, Horne MK, Miller JL.Individualized treatment for iron-deficiency anemia in adults.Am J Med.2008;121(11):943-8. doi:10.1016/j.amjmed.2008.07.012.
- Krayenbuehl P-A, Battegay E, Breymann C, Furrer J, Schulthess G. Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration.Blood.2011;118(12):3222-7. doi:10.1182/blood-2011-04-346304.
- Goddard AF, James MW, McIntyre AS, Scott BB.Guidelines for the management of iron deficiency anaemia.Gut.2011;60(10):1309-16. doi:10.1136/gut.2010.228874.
- Rodgers GM, Becker PS, Blinder M, et al.Cancer- and Chemotherapy- Induced Anemia.J Natl Compr Canc Netw.2012;10:628-653.
- Stein J, Hartmann F, Dignass AU.Diagnosis and management of iron deficiency anemia in patients with IBD.Nat Rev Gastroenterol Hepatol.2010;7(11):599-610. doi:10.1038/nrgastro.2010.151.
- Auerbach M, Ballard H. Clinical use of intravenous iron: administration, efficacy, and safety.Hematology Am Soc Hematol Educ Program.2010;2010:338-47. doi:10.1182/asheducation-2010.1.338.
- Seid MH, Derman RJ, Baker JB, Banach W, Goldberg C, Rogers R. Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia: a randomized controlled clinical trial.Am J Obstet Gynecol.2008;199(4):435.e1-7. doi:10.1016/j.ajog.2008.07.046.
- Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med. 2008;121(11):943-8. doi:10.1016/j.amjmed.2008.07.012.
- Krayenbuehl P-A, Battegay E, Breymann C, Furrer J, Schulthess G. Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration. Blood. 2011;118(12):3222-7. doi:10.1182/blood-2011-04-346304.
- Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60(10):1309-16. doi:10.1136/gut.2010.228874.
- Rodgers GM, Becker PS, Blinder M, et al. Cancer- and Chemotherapy- Induced Anemia. J Natl Compr Canc Netw. 2012;10:628-653.
- Stein J, Hartmann F, Dignass AU. Diagnosis and management of iron deficiency anemia in patients with IBD. Nat Rev Gastroenterol Hepatol. 2010;7(11):599-610. doi:10.1038/nrgastro.2010.151.
- Auerbach M, Ballard H. Clinical use of intravenous iron: administration, efficacy, and safety. Hematology Am Soc Hematol Educ Program. 2010;2010:338-47. doi:10.1182/asheducation-2010.1.338.
- Seid MH, Derman RJ, Baker JB, Banach W, Goldberg C, Rogers R. Ferric carboxymaltose injection in the treatment of postpartum iron deficiency anemia: a randomized controlled clinical trial. Am J Obstet Gynecol. 2008;199(4):435.e1-7. doi:10.1016/j.ajog.2008.07.046.