What's The Difference Between Being Anemic And Being Iron Deficient?

When you’re pregnant, you hear a lot about iron deficiency, but what does it really mean? OBGYN Dr. Gleaton explains anemia and iron deficiency, with an emphasis on how these conditions affect pregnant women.

By Dr. Kenosha Gleaton

Increasing societal demands involving work and family can often lead to overexertion, excessive fatigue, and inadequate energy levels. But when exhaustion is also associated with ice cravings (e.g. pica), headaches, or dizziness, it’s time to check in with your doctor. These all represent common signs of anemia, which affects more than twelve percent of US women and 25% of women worldwide.

The difference between being anemic and being iron deficient

Anemia is a condition where the blood doesn't have enough healthy red blood cells. Although iron deficiency anemia is the most common type of anemia, it is only one of many. It occurs when the body doesn't have enough iron to make red blood cells. For simplicity, let's use a football analogy where our red blood cells contain hemoglobin, which functions as a sure-handed running back, carrying oxygen (football) to the desired tissues.

However, three anemia-causing scenarios interfere with oxygen delivery to tissues and will lead to a very undesired fumble.

1. Decreased blood cell production: usually due to nutritional deficits, including iron deficiency anemia, or those related to deficiencies in vitamin B12 or vitamin B9 (folate). 
2. Blood cell loss from bleeding: typically related to heavy or prolonged menstrual cycles. 
3. Blood cell destruction: often seen with Sickle Cell Anemia or infection. 

Can you be iron deficient without being anemic and vice versa?

It is possible to have iron deficiency prior to developing a diagnosis of iron deficiency anemia. 

Over time, however, iron deficiency will always lead to anemia if supplementation is not initiated. This occurs as the body exhausts its iron stores, often termed ferritin. 

And just as individuals can have iron deficiency before anemia develops, many anemias occur independent from iron deficiency.

Anemia and iron deficiency in women of reproductive age

Anemia is most common in nonpregnant women of reproductive age with a prevalence of one in three worldwide and one in eight in the United States. During pregnancy, up to 40% of women will become anemic and 25% of those will be related to iron deficiency. 

During pregnancy, up to 40% of women will become anemic and 25% of those will be related to iron deficiency.

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When to get tested for anemia

The American College of OBGYNs (ACOG) recommends universal anemia screening for all pregnant women. For those who are not pregnant, your doctor may test for anemia if you have signs and symptoms. Additionally, if your diet is consistently low in iron rich foods, you are nursing, or have heavy or frequent menstrual cycles, you should consider testing.

Diagnosing anemia

If you’ve noticed symptoms suggesting anemia, there's good news. It's easily diagnosed through a simple blood test, and treatment makes a huge difference! Although anemia is often suspected due to symptoms and physical exam findings (pale skin or eyelids), confirmation of the diagnosis occurs via a simple finger stick in the office or official testing of the blood stream. 

Several smartphone apps now allow individuals to assess for anemia by taking a photo of the inner eye-lid or fingernails. These apps have been studied and found to have an accuracy of 97% when compared to standard hemoglobin levels in a CBC laboratory result.

Treating anemia

Once the diagnosis is confirmed, an appropriate treatment regimen should involve correction of the underlying cause. Occasionally, referral to a hematologist is required if the anemia is genetically linked, severe, or unexplained. 

For iron deficiency anemia, it's important to take an iron supplement that's easily digested and well absorbed. Our vegan iron supplements offer a high absorption, high purity formula which is easy on the digestion and nearly 100% bioavailable, unlike most other iron supplements. Pregnant women with iron deficiency anemia require iron supplementation in addition to prenatal vitamin supplementation. At Natalist, we also offer convenient options like prenatal gummies with iron, providing essential nutrients to support reproductive health during pregnancy.

When severe iron deficiency anemia is present, intravenous iron infusion or red blood cell transfusion may be required. Early, consistent oral iron supplementation can often prevent these more invasive, costly treatments.

Iron as a preventative supplement

For prevention, the U.S. Food and Drug Administration (FDA), CDC, and the World Health Organization recommend that, from the beginning of pregnancy to three months postpartum, all pregnant women receive oral iron supplementation. 

Prompt diagnosis and treatment of anemia is imperative for proper body function and prevention of pregnancy-associated complications, including preterm birth and low birth weight infants. 

The addition of an iron supplement to your regimen can potentially increase fertility success and lower pregnancy risk. In doing so, you’ll ensure your oxygen-carrying running backs are always on the winning team—TOUCHDOWN!