Iron deficiency, the most common deficiency in women, can lead to iron deficiency anemia, a condition characterized by inadequate healthy red blood cells due to insufficient iron levels.

For women planning to get pregnant, understanding this deficiency is crucial, as it can have significant implications for pregnancy and the baby’s health.

SYMPTOMS OF IRON DEFICIENCY

Iron deficiency can manifest through various symptoms, most commonly:

• Fatigue
• Headache
• Short of breath on exertion 
• Muscle weakness
• Exercise intolerance
• Restless legs syndrome
  

In some cases, individuals might experience unusual cravings for non-nutritive substances like ice, a condition known as pica.

CAUSES OF IRON DEFICIENCY IN WOMEN

Several factors can contribute to iron deficiency:

1. Dietary insufficiency: A diet low in iron-rich foods like meat, beans, and fortified cereals can lead to a deficiency.
2. Absorption issues: Conditions like IBS, celiac disease, Crohn's disease, or surgical removal of part of the small intestine can impact iron absorption.
3. Blood loss: Menstrual periods or conditions causing internal bleeding, such as ulcers, can deplete iron stores. 
4. Increased need: Pregnancy significantly elevates the body's demand for iron.

DIAGNOSING IRON DEFICIENCY AND ANEMIA

Diagnosing iron deficiency usually involves a series of blood tests:

1. Complete Blood Count (CBC): This checks the levels of red blood cells and hemoglobin. Hemoglobin less than 12.0 signals a trend toward anemia.
2. Ferritin: This assesses the body's iron stores. Under 30 ng/mL is considered to be iron deficiency. Ferritin is also an acute phase reactant, meaning it can be elevated with inflammation. Over 75 ng/mL could be considered elevated, indicating possible inflammation.
3. Transferrin Saturation (TSAT): TSAT is the ratio of the serum iron divided by the transferrin. TSAT normal range is between 25-45%, and less than 20% is diagnostic of iron deficiency.

PRECONCEPTION: THE BEST TIME TO ADDRESS IRON DEFICIENCY

Addressing iron deficiency before conceiving can greatly reduce the risk of future complications. Here's how:

1. Get tested: At least 3 months prior to attempting to conceive, get your complete blood count, ferritin, and iron panel with a transferrin saturation percentage. Then you’ll have a good understanding if you’re low on iron reserves or even anemic.
2. Supplements: Iron supplements can be beneficial, especially for women with a history of anemia or heavy menstrual bleeding. However, it's vital to consult a healthcare professional before starting any supplementation. There are certain conditions where iron supplementation can be detrimental.
3. Lifestyle Adjustments: Certain habits, like consuming tea or coffee with meals, can inhibit iron absorption, while vitamin C-rich foods can enhance it.

PREGNANCY: HOW TO MAINTAIN IRON STORES

Blood volume begins to rise at 6 weeks gestation, initially by retention of water and electrolytes. Then by week 16, the fetus’s demand for blood rises, and new red blood cells are made. The demand continues until the mother’s blood volume rises by 25% or approximately 9 pints to 12 pints.

To keep up with demand, it requires good iron stores at the beginning of pregnancy and ongoing iron supplementation throughout. That’s why most prenatal vitamins have iron.

• Continue testing: Ask for a CBC, ferritin, and iron panel with a transferrin saturation percentage at least every 12 weeks. A CBC will “look” like anemia, especially between week 6-16 because of the rising water retention, but you can rely on a hemoglobin less than 11.0, which is an indication that iron stores are too low.
• Supplements: During pregnancy, most women will take a prenatal that has iron in it. However, some newer research has found it more beneficial to separate the iron from the prenatal and take it every other day at higher doses for best absorption. Some women, especially with digestive issues, will be best served with infusions instead of oral iron.

SUMMARY

Iron deficiency and iron deficiency anemia can have profound implications for mother and baby’s health. By understanding its causes, ensuring diagnosis prior to conception, and taking preventive steps during the preconception phase, women can significantly mitigate the risks associated with this deficiency. A proactive approach to iron stores is not just beneficial but crucial for ensuring a healthy pregnancy and a thriving newborn.

To get a thorough preconception health evaluation and testing, get started with us at Floryn Health! Book your first appointment here. 

FAQs

1. Can iron deficiency affect fertility in women?

   - While iron deficiency itself does not directly impact fertility, it can cause iron deficiency anemia, which in turn can lead to irregular menstrual cycles, fatigue, and other health issues. Addressing this deficiency can improve overall health and wellness, potentially creating a more favorable environment for conception.

2. How can I boost my iron levels naturally?

   - You can increase your iron intake by incorporating more iron-rich foods into your diet. Foods high in iron include red meat, poultry, fish, lentils, beans, tofu, spinach, and fortified cereals. Consuming vitamin C-rich foods like oranges, strawberries, and tomatoes alongside iron-rich foods can enhance iron absorption. Conversely, tea, coffee, and calcium-rich foods may inhibit iron absorption when consumed with meals.

3. Is it safe to take iron supplements during pregnancy?

   - Iron supplements are commonly prescribed during pregnancy to prevent and treat iron deficiency anemia. However, it's crucial to consult with a healthcare professional before starting any supplementation. Taking too much iron can lead to toxicity and adverse side effects.

4. Can iron deficiency anemia affect the baby during pregnancy?

  - Yes, iron deficiency anemia during pregnancy is associated with several risks for the baby, including preterm birth, low birth weight, and developmental delays. Ensuring adequate iron levels is essential for the health and development of the baby. Regular prenatal checkups can help monitor and manage iron levels effectively during pregnancy.