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Women and Anemia

Two billion people—over 30% of the world’s population—are anemic, many due to iron deficiency. In resource-poor areas, anemia is frequently exacerbated by infectious diseases.1

 

Women and people with chronic diseases are at increased risk of anemia. Important factors to remember are:2

  • Certain forms of anemia are hereditary, and infants may be affected from the time of birth.
  • Women in the childbearing years are particularly susceptible to iron deficiency anemia because of blood loss from menstruation and increased blood-supply demands during pregnancy.
  • Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions.

  • Women whose menstrual cycles are heavy
  • Women who are pregnant or breastfeeding or those who have recently given birth
  • People who have undergone major surgery or physical trauma
  • People with gastrointestinal diseases, such as celiac disease, inflammatory bowel diseases such as ulcerative colitis, or Crohn’s disease
  • People with peptic ulcer disease
  • People who have undergone bariatric procedures, especially gastric bypass operations
  • Vegetarians, vegans, and other people whose diets do not include iron-rich foods (iron from vegetables, even those that are iron-rich, is not absorbed as well as iron from meat, poultry, and fish)
  • Children who drink more than 16–24 ounces a day of cow’s milk (cow’s milk not only contains little iron, but it can also decrease absorption of iron, and irritate the intestinal lining causing chronic blood loss)
  • Pregnant women in third-world countries, especially suffering from malaria, hookworms, or vitamin A deficiency
  • Women aged 50 and over who suffer from GI bleeding, duodenal or gastric ulcers, or GI cancer

Megaloblastic anemia is usually caused by a deficiency of folic acid or vitamin B12. Other less-common causes are:

  • Alcohol abuse
  • Certain inherited disorders
  • Drugs that affect DNA, such as chemotherapy drugs
  • Leukemia
  • Myelodysplastic syndrome
  • Myelofibrosis
  • The anticonvulsant drug phenytoin (Dilantin)

Pernicious anemia is more common in people of Northern European and African descent than in other ethnic groups. Older people also are at higher risk for the condition. This is mainly due to a lack of stomach acid and intrinsic factor, which prevents the small intestine from absorbing vitamin B12. As people grow older, they tend to make less stomach acid.

 

Pernicious anemia also can occur in younger people and other populations. People at risk for pernicious anemia include those who:

  • Have a family history of the condition
  • Have had part or all of the stomach surgically removed. The stomach makes intrinsic factor. This protein helps the body absorb vitamin B12.
  • Have an autoimmune disorder that involves the endocrine glands, such as Addison's disease, type 1 diabetes, Graves' disease, or vitiligo. Research suggests a link may exist between these autoimmune disorders and pernicious anemia that is caused by an autoimmune response.
  • Have had part or all of the small intestine surgically removed. The small intestine is where vitamin B12 is absorbed.
  • Have certain intestinal diseases or other disorders that may prevent the body from properly absorbing vitamin B12. Examples include Crohn's disease, intestinal infections, and HIV.
  • Take medicines that prevent the body from properly absorbing vitamin B12. Examples of such medicines include antibiotics and certain seizure medicines.
  • Do note eat any animal or dairy products and do not take a vitamin B12 supplement, or those who eat poorly overall.

1 WHO website [Internet]. [cited 2013 Mar 12] Available from: http://www.who.int/nutrition/topics/ida/en/index.html

2 Website [Internet]. Available from: http://www.webmd.com/a-to-z-guides/understanding-anemia-basics

3 Website [Internet]. Available from: http://www.hematology.org/Patients/Blood-Disorders/Anemia/5263.aspx

4 Website [Internet]. Available from: http://health.nytimes.com/health/guides/disease/folate-deficiency-anemia/overview.html

5 Website [Internet]. Available from: http://www.nhlbi.nih.gov/health//dci/Diseases/prnanmia/prnanmia_who.html

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