​Feeling Fatigued All the Time?

If you notice yourself feeling tired more easily, looking pale or suffering from cold hands or feet, you might be experiencing symptoms of anaemia.

Anaemia occurs when you do not have enough healthy red blood cells to carry oxygen to your body's organs. The World Health Organization (WHO) defines it as a haemoglobin level lower than 12.0 and 13.0 g/dL in females and males respectively.

It could arise from many factors ranging from nutritional deficiencies to immune causes to malignant blood disorders. Iron deficiency is the most common cause of nutritional anaemia worldwide, even in developed countries like Singapore, shares Dr Ian Wu, Associate Consultant, Haemotology Service, Department of General Medicine at Sengkang General Hospital.

"Iron-deficiency anaemia can affect anyone, from teenagers to the elderly. In the younger age group, females are more likely to be iron-deficient, accounting for the majority of cases seen in our practice," says Dr Wu.

Younger women are more likely to be iron-deficient due to menstrual blood losses, as well as increased physiological demands during pregnancy. Non-gynaecological sources, such as bleeding from the gastrointestinal tract, could also cause anaemia. Other groups at higher risk of iron deficiency include infants and children, vegetarians, frequent blood donors, and the elderly. 

Are You at Risk of Being Anaemic? 

Check if you tick any boxes on the list:

• Lack of energy or chronic fatigue
• Pale skin
• Reduced tolerance of exercise
• Dizziness
• Fast or irregular heartbeat
• Brittle or grooved nails
• Cold hands and feet
• Cravings for non-nutritive substances that are not food, such as dirt (one of the symptoms of Pica, an eating disorder)

Iron-deficiency anaemia could lead to complications if left unchecked. These include heart problems, pregnancy problems and growth problems in infants and children. Early detection and treatment could prevent these complications from developing. 

Avoid Self-Diagnosis

If you have concerns that you have iron-deficiency, consult a doctor for a proper evaluation. A doctor can help address the cause of the iron-deficiency, as well as advise on how you can increase your iron intake.

Avoid self-diagnosis or taking iron supplements on your own.

"Overloading the body with iron can have detrimental effects as it can cause organ damage, particularly to the liver, as well as other complications," warns Dr Wu.

In cases of mild iron-deficiency, you simply need oral supplements. However, there are instances where patients are unable to tolerate oral ingestion or have trouble with gut absorption. In such cases, this can be treated with intravenous iron formulations. 

"Patients with severe anaemia may sometimes require red blood cell transfusions to bring the haemoglobin to a safe level while investigations are performed," says Dr Wu, adding that the duration of treatment depends on the underlying cause for the iron deficiency and will vary from patient to patient. 

Tips on Adding Iron to Your Diet

For women, the Health Promotion Board recommends:

Take steps to incorporate iron into your daily diet. There are two types of dietary iron:  haem iron (found in animal sources) and non-haem iron (found in vegetables and plant-based sources).

• Haem sources of iron can be found in red meat, pork, poultry and seafood.
• Non-haem sources are found in whole grain foods such as rice, noodles, iron-fortified cereals, dark leafy vegetables like spinach and fruits like berries.
• Vitamin C-rich foods and fruits, like oranges and kiwi, can help improve iron absorption, as well as a combining both haem and non-haem food sources.
• If you need caffeine to keep your energy up, try to have it two hours before or after your meal as caffeine interferes with iron absorption.