Talk:Iron-deficiency anemia

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This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 November 2018 and 14 December 2018. Further details are available on the course page. Student editor(s): Sciande. Peer reviewers: Brittanylauren120.

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 January 2021 and 16 April 2021. Further details are available on the course page. Student editor(s): Student3665.

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Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Amole90. Peer reviewers: Anderclamusc.

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Signs and Symptoms

This is a very long list that is almost totally devoid of citations. While I know many of these things to be associated with iron deficiency and iron deficiency anemia, we really need references here. Does anyone have any suggestions? --Rhombus (talk) 08:54, 25 May 2012 (UTC)

What

what does "seeing bright colours" mean? im a person with iron deficiency anaemia and im wondering if its what im thinking it is. 80.178.179.90 18:43, 7 December 2006 (UTC)

Merge

Merging is a bad idea

I really don't think merging this with iron deficiency is appropriate; even though iron deficiency anaemia can result from iron deficiency, it is still a clinically discrete diagnosis. --Rhombus 18:24, 9 February 2006 (UTC)

merging is a good idea

On the other hand, "iron deficiency anemia" and "iron deficiency" are so tightly interlinked. Besides the BMJ paper talking about iron supplementation for fatigue, I'm not aware (perhaps someone could clarify) of iron deficiency without anemia as being a clinically important entity. Andrew73 18:51, 9 February 2006 (UTC)

I think that one is a subset of the other and can be included on the same page, as long as the

topics "iron deficiency" and "iron deficiency anamia" are included. Snowman 11:37, 13 March 2006 (UTC)

Is there any difference between "Iron deficiency anemia" and "Iron deficiency (medicine)"? No, I don't believe so. Merge--metta, The Sunborn 04:34, 8 April 2006 (UTC)

Don't merge

I don't believe they should be merged. While directly related, iron deficiency anemia is a condition while iron deficiency is the cause. That does not mean they are the same. Iron deficiency can also be linked to other conditions (mouth ulcers being one of them, and the reason I found the page in the first place). --Oticon6 7:09, 16 June 2006 (UTC)

• I oppose the merge. I agree with the comments by Oticon6. Nephron  T|C 23:58, 13 July 2006 (UTC)

• I oppose the merge for the reasons above. Also, the nutritional info on the iron deficiency page is a reasonable and helpful for that page but would be a bit out of place on the iron deficiency anemia page--it would be misleading to suggest that frank anaemia can be easily corrected by eating a lot of tofu. since this discussion has been inactive for a few months now, I'm removing the merge tags--others can feel free to re-open this conversation. Joewright 15:14, 16 November 2006 (UTC)

Merge

I think that it has caused confusion with two pages (a page on Fe def and another on Fe def anaemia) because edits have been tidied up from editors who are confused about the difference between the two. I can see the benefits of both "merge" or "no-merge", but I guess it would be generally less confusing if the pages were merged, for people who are not trained in haematology or iron metabolism. Snowman 00:20, 17 November 2006 (UTC)

I've put cross-referencing sentences at the top of each page to direct interested readers to the other. I do think that these two pages have a different tone and that merging them properly would create a quite long and somewhat muddled article--ie the danger is reducing confusion of topic at the cost of increasing confusion of content. Perhaps these cross-ref sentences can address some of the issue of confusion of topic? Unfortunately I don't have time in the next weeks to give the merge a try, so unless someone else is gung-ho to try it, my personal inclination is towards this lazier and I hope actually better solution.Joewright 06:23, 17 November 2006 (UTC)

Colonoscopy

doi:10.1111/j.1572-0241.2006.00908.x - men with IDA don't need colonoscopy if their Hb >10g/dL and low-normal ferritin. JFW | T@lk 16:54, 11 March 2007 (UTC)

I think this wording of this statement should be changed to "men with IDA anemia don't need colonoscopy if their Hb >10g/dL and low-normal ferritin". Also note in the studies methods that "We excluded patients with overt or occult gastrointestinal bleeding, marked change in bowel habits, lower abdominal pain, history of colon cancer, first-degree relative with colon cancer, familial adenomatous polyposis syndrome, hereditary nonpolyposis colon cancer syndrome, and inflammatory bowel disease." The men in this study with ferritin over 50 probably did not have iron deficiency. Badgettrg 23:43, 27 March 2007 (UTC)

"Hypochromic" versus "Iron deficiency"

Can someone with relevant knowledge make the distinction (within the articles) between Hypochromic anemia and Iron deficiency anemia? -- Shunpiker 15:32, 31 May 2007 (UTC)

I don't have relevant knowledge but it looks like iron-deficiency anaemia refers to the anaemia caused by lack of iron, and that one could be caused by a few other things (as the page mentions). Fdskjs (talk) 15:47, 16 January 2008 (UTC)

Information

I have restored at least most of the information-deleting edits by a recent anonymous editor. I hope that the rests of you will take a careful look at the changes and fix whatever's still broken.

I am so irritated by this editor's wholesale deletion of nearly all symptomatic, diagnostic, and treatment information under the guise that it's a "doctor's" (presumably "physician" is intended) legal privilege to diagnose medical conditions, that I just wanted to climb up on my soapbox and say that this is an encyclopedia. We are supposed to provide information.

In my field, ignorance kills people. Please do not delete accurate, sourced information. Physicians do not have -- or want -- a monopoly on medical information. WhatamIdoing (talk) 01:24, 14 December 2007 (UTC)

Haem iron reference

Informally, I think the following statement is probably true though not very encyclopedic. However, the cited reference has absolutely nothing on the subject, as far as I can see. Should the statement be removed, or the citation, or what?!

Some people[who?] believe that "heme iron”, found only in animal foods such as meat, fish and poultry, is more easily absorbed than "non-heme" iron, found in plant foods and supplements [14].

--Gangle (talk) 13:04, 13 October 2008 (UTC)

Symptom or cause?

'Heavy menstrual period' is listed as a symptom of anaemia. Is that correct? Surely heavy periods can cause anaemia, but they're not a symptom of it? 80.41.11.177 (talk) 22:40, 23 November 2008 (UTC)

Given http://professorkateclancy.blogspot.com/2011/01/iron-deficiency-is-not-something-you.html is there sourced evidence for either statement? What is "common sense" or "stands to reason" ain't always so, and while documenting a cultural assumption as such is worthwhile, stating it as fact may be actively dangerous. 212.44.43.80 (talk) 14:36, 7 February 2011 (UTC)

I think heavy periods are a symptom of iron deficiency (with or without anemia). I came across a clinical paper about this the other day, which investigated how iron supplmentation helped with menorrhagia in iron deficient women. I will post it if I can find it again. The paper was from 1986 if I remember right. Opticalgirl (talk) 20:23, 23 March 2011 (UTC)

Iron deficiency anemia

under the subtitle ( Symptoms and Signs) it was writtin that "Pagophagia or pica for ice is a very specific symptom and may disappear with correction of iron deficiency anemia". But under the title ( Diagnosis) it is mentioned " Pica, an abnormal craving for dirt, ice, or other "odd" foods occurs variably in iron and zinc deficiency, but is neither sensitive nor specific to the problem, so is of little diagnostic help" ?! . Which is right? Please advice. --92.253.1.225 (talk) 11:21, 23 April 2011 (UTC)

The last is correct. I'll fix it. SBHarris 19:58, 15 May 2012 (UTC)

Move Iron deficiency anemia to Iron-Deficiency Anemia

Iron deficiency anemia → Iron-Deficiency Anemia – There seem to be varying opinions on the internet about the correct punctuation of this condition. The Mayo Clinic's website uses "iron deficiency anemia," while the American Society of Hematology uses "iron-deficiency anemia," with a hyphen. The hyphenated version is grammatically correct, but I'm not sure whether the non-hyphenated version is also correct and fit to remain this page's title. Mentions of the name within this article were divided with neither version predominant one edit ago, but I changed them to a consistent "iron-deficiency" before realizing that I might be wrong. That may have been unnecessary and can be undone. Kajabla (talk) 17:52, 31 December 2013 (UTC)

• Support if case fixed – should be Iron-deficiency anemia without the spurious caps. Dicklyon (talk) 06:24, 2 January 2014 (UTC)
• Support Dickylon should be hyphenated without caps. --LT910001 (talk) 06:33, 2 January 2014 (UTC)
• Support if done without caps in the beginning of every word. Anonimski (talk) 12:48, 2 January 2014 (UTC)

Thanks. What's the correct way to change the request to remove that capitalization? Will changing this talk page be sufficient? Kajabla (talk) 17:29, 2 January 2014 (UTC) I have moved it per discussion above. --WS (talk) 14:58, 7 January 2014 (UTC)

Difficult cases

Some people with iron-defiency anaemia do not respond to normal treatment. doi:10.1182/blood-2013-10-512624 is a good secondary source on how this is approached by specialists. JFW | T@lk 18:20, 16 January 2014 (UTC)

http://www.bloodjournal.org/content/123/3/326?sso-checked=true Copy-Paste "January 16, 2014; Blood: 123 (3)

Ferrous iron salts have superior bioavailability compared with ferric iron salts. Because of relatively low cost and reasonable bioavailability, FERROUS SULFATE is the iron compound used most often for oral iron therapy. A number of preparations with SLOW iron-release properties have been designed, but for the most part bioavailability does NOT equal that of standard ferrous sulfate tablets.

The concomitant administration of ascorbic acid enhances iron absorption. In some of our patients, SERINE FERROUS sulfate and FERROUS GLYCINE sulfate elicited GOOD responses when other iron preparations FAILED, BUT the relative advantage of these preparations still awaits objective evaluation by prospective randomized trials".

==> So amino acid chelates are better for some patients. For example Ferrochel(R) is ferrous bisglycinate chelate. http://www.albionferrochel.com/index.php/iron-importance/ferrochel?id=47 What I don't like is Ferrochel advertises it is safe: "A body suffering iron-deficiency anemia may uptake 90 percent of the iron, while a body that is not iron deficient may only take up 10 percent. Ferrochel has been found to be 2.6 times safer than iron sulfate". What I want is maximum absorption in all cases and checking blood ferritin levels regularly is enough safety. Safety is for people who do not want to take all relevant blood tests regularly.

ee1518 (talk) 17:57, 7 June 2016 (UTC)

Pregnancy

Screening and treatment in pregnancy, from the USPSTF doi:doi:10.7326/M14-2932 JFW | T@lk 11:59, 23 April 2015 (UTC)

Lancet seminar

doi:10.1016/S0140-6736(15)60865-0 JFW | T@lk 14:57, 26 February 2016 (UTC)

Thanks! Copy paste from here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960865-0/fulltext#cesec80 Volume 387, No. 10021, p907–916, 27 February 2016

Oral supplements: 4 common iron preparations are available: ferrous sulphate, ferrous sulphate exsiccated, ferrous gluconate, and ferrous fumarate. No one compound seems better than the others.

Iron chelates have also been assessed. Inulin, a natural fructose polymer, can be chelated with iron to enhance iron absorption within the colon. Similar results were reported for bisglycinate iron and liposomal iron. ee1518 (talk) 17:45, 7 June 2016 (UTC)

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Student editor

Over the next few weeks, I will contribute to this article with the following in mind. I plan to add more information to the Epidemiology section. I will also look into current guidelines regarding iron deficiency anemia screening and the gold standard to see if those have changed in any way. In addition, I will consider other aspects of the mechanism of iron deficiency anemia and include that in the article.

I will also expand upon diseases associated with iron deficiency anemia and incorporate this information into the subheadings under Cause. Additionally, I will spend some time reviewing the Treatment section. Specifically, I will look over the references in the Treatment section and add references as needed.Amole90 (talk) 20:31, 20 November 2017 (UTC)

I look forward to seeing you progress on this page. AngeladMD (talk) 14:27, 29 November 2017 (UTC)

As of now, I have added some information to the Epidemiology section. I also edited the Iron malabsorption section under Cause. My next goals are to edit the Treatment section and address areas throughout the article where "citation needed" is noted. I will also consider adding additional information to the article that may be valuable to the topic of Iron deficiency anemia.Amole90 (talk) 11:14, 6 December 2017 (UTC)

I also wanted to note that I still plan to address the Screening, Gold standard, and Mechanism sections, as mentioned in my initial work plan. However, as I have continued to look over the article, I noticed the edits mentioned in my last post were edits I wanted to complete first.Amole90 (talk) 11:32, 6 December 2017 (UTC)

Student Peer Review. The first objective in this peer review was to take a global scale look at the article as a whole and answer;

Is the article clear and understandable? Is everything in the article relevant to the article topic? Is there anything that distracted you? Would it be understandable to a non-medical person? Overall, Yes the article is clear and understandable with the exceptions to some medical jargon. Everything in the article is relevant in my opinion. However some of the signs & symptoms listed in bullets can be misleading to the average reader. Not to say they are not true based upon many factors such as age, change in HgB/ change in time, but can be distracting and overwhelming in my opinion. Yes, I believe it would be understandable, I really like to simplified definitions in parenthesis bedsides some of the terms in the article.

Is the article neutral and balanced? Are there any claims that appear heavily biased toward a particular position? Is the supporting evidence from unbiased sources? Are there viewpoints that are overrepresented, or underrepresented? I cannot find that the article is biased one way or another towards a particular position. It touches on the worldwide population of people and really explains the topics well in a neutral fashion with unbiased sourcing. I am not sure if this is a particular viewpoint or not, but the most common cause worldwide has very little representation in the article as a whole.

Is the article supported by reliable evidence? Is each fact referenced with an appropriate, reliable reference? Are the citations from publicly available sources? Does the article paraphrase or plagiarize? Is the cited evidence current? Yes, the supporting evidence is reliable based upon the cited sources. There is a mix of information from primary sources, systematic reviews and textbooks that are well known in the United States and therefore probably most of the developed world. In the developed portions of the world the articles cited should be available, I can not comment on developing country access. There seems to be no plagiarism. There could be some paraphrasing, but it could also be argued that some of the information is commonly known, worded in different ways by individuals who know about signs & symptoms, causes, mechanism, diagnosis, etc.Anderclamusc (talk) 17:42, 9 December 2017 (UTC)

Thank you so much for your peer review!Amole90 (talk) 02:07, 12 December 2017 (UTC)

To Amole90, Good job with the article. I am surprised that this article would have been rated "C". I imagine that it has bumped up after your contributions.Anderclamusc (talk) 05:04, 14 December 2017 (UTC)

Thanks! I wanted to specifically respond to your helpful feedback. I spent some time in the Signs and Symptoms section trying to decrease the amount of bullets in the list. After reviewing several sources, the list is now representative of findings that are supported by cited sources that are given right before the list. Thanks again for the suggestion! Also, in regards to your comment about parasitic disease representation in the article, I added more information to that section. Even though that section represents a small part of the article in terms of the space it occupies, I think the info covered there, such as the amount of people affected worldwide, along with the fact that it is listed as the first cause and noted as the most common cause, covers the pertinent info related to this aspect of iron-deficiency anemia. But thank you so much for this feedback as well, since it encouraged me to delve into more detail in this section by listing the actual organisms involved and by giving a summary of the mechanism behind how these organisms cause iron-deficiency anemia. Again, thank you so much!Amole90 (talk) 02:32, 15 December 2017 (UTC)

Question About Lead Section

In the last paragraph of the Lead section for this article, a statement is made about a lack of dietary iron as a cause for almost half of anemia cases worldwide, with a citation. However, other resources found present hookworm infections as the most common cause, which is also noted in at least one other section of the article, with appropriate citations. I am unable to access the source cited for the statement in the Lead section, but I wanted to point this out, as it seems this statement may be contradictory to what's stated and appropriately cited elsewhere in the article. But I did not want to delete it without someone first looking at the source to confirm what was noted there. Thanks!Amole90 (talk) 05:09, 15 December 2017 (UTC)

New heading

If you're going to remove someone's edits, please at least *read* the edits that you're removing, and provide a scientific basis for removing them (frivolous additions, not correct, etc.). Simply removing the additions that other people worked hard for is disrespectful and rude. Edits made in a very short amount of time, as has been done by Doc James, show that the articles weren't even read before they were deemed inappropriate. — Preceding unsigned comment added by Hailholyghost (talk • contribs) 01:29, 18 March 2018 (UTC)

This users goal appear to be to primarily add papers the wrote themselves to Wikipedia.

Fair bit of clean up may be required. Doc James (talk · contribs · email) 01:36, 18 March 2018 (UTC)

IDA Work Plan: Medical Student editor

Over the next month, I will be editing the iron-deficiency anemia Wikipedia page. I first plan to study the content of the article and continue to look for areas of improvement. Over the next week to week and a half, I will gather information by searching databases like Access medicine and Clinical key. To prevent plagiarism, I will spend time reading and taking notes in my own words on textbook chapters, articles, and other resources. Afterwards, I plan to start editing the article using the sandbox.

There are specific sections of the IDA article I can help to improve. In particular,the introduction section of the article could be improved to reflect a more basic understanding of anemia since the remainder of the article discusses anemia in more detail. Additionally, the introduction can be written in a more clear and concise manner. Secondly, there is very little information in the article about the effects of anemia on development in children. I will work to research the topic and add information as appropriate. In regards to causes of anemia, I would like to add more subsections. For example, I would like to add cancer and heavy menstrual bleeding as distinct subsections under "causes of IDA". In addition, I will add information to the section titled "Screening." This section currently does not answer the questions, " what kind of screening," "how do we screen," "why do we screen." Again, I will research these topics and more information about screening in asymptomatic patients. Finally, I will add to the "treatment" section by providing more detail about treatment options, when certain treatments are used, and risks/benefits of certain treatment options. I will also add information about certain foods that are high in iron. As the article changes, I may also revise this work plan.

In revising this article, I will decide what to include/exclude by ensuring that I have thoroughly researched the topic before adding/deleting information. In doing so, I hope to be able to choose the most relevant and important information on an otherwise broad topic. I will not include new research on the topic. I will consider that my audience is not necessarily a medical audience, and write to a more basic understanding. If medical terms are used, I will either describe them in my article or embed other Wikipedia articles into my article. This will allow me to give accurate medical information without using terms my readers do not understand.(Sciande (talk) 12:19, 20 November 2018 (UTC))— Preceding unsigned comment added by Sciande (talk • contribs) 20:05, 19 November 2018 (UTC)

Peer Review for Iron-Deficiency Anemia Article

The article is overall clear and understandable. I believe it does a good job of explaining what iron deficiency anemia is and providing the information a non-medical person would want to know; including signs and symptoms and acute vs. chronic onset. The mechanism of action of IDA is clear and provides additional useful information to the public (e.g. taking vitamin C with iron can increase absorption). There are a few instances that I believe could be made clearer including in the signs and symptoms section: “Pallor of mucous membranes in children suggests anemia with the best correlation to the disease” is a confusing statement. This is probably one of the most important sections for a non-medical person and likely the most viewed, so should be as clear as possible.
There is a lot of passive voice used in the article, which can be distracting. I believe going back and making the syntax active voice would clear up some of the odd wording. I’ve also noticed some redundancy (e.g. in the first sentence and in the Child Development section-- Iron-deficiency has an impact on neurodevelopment because the brain requires iron for proper neuron development).

Suggested Edits:

• In the initial statement, I would change “anemia” to decreased blood cells as to not use the word to define itself (“Iron-deficiency anemia is anemia caused by…”). It is defined in the second sentence and I would combine the first two sentences.
• “When onset is slow” could be confusing for a reader. Consider changing to something like, “Typically, iron deficiency anemia develops over time and can present as—list symptoms” (something along those lines).
• Slow symptoms are not in same context: “feeling tired, weak, short of breath, or decreased ability to exercise”
• Wording/Passive voice: “There needs to be significant anemia before a person becomes noticeably pale” (Anemia is significant before an individual shows symptoms of pale skin)
• - Wording/Passive voice: “prevention is by eating” (Iron deficiency anemia can be prevented by…)
• Consider adding specific foods that are high in iron (add additional details beyond “diet high in iron”)
• History: odd wording (The diagnosis of iron-deficiency anemia will be suggested by history that…)
• Child development: the second Iron-deficiency is misspelled

The article seems to come from a neutral and informative position. I did not see discussion of any particular view point while reading this article. I thought it was informative and balanced. I did not see any opinion-like information included in the article. Additionally, references cited seemed to be reliable and appropriate sources. Brittanylauren120 (talk) 13:27, 10 December 2018 (UTC)

Thanks Brittany! Sciande (talk) —Preceding undated comment added 20:21, 11 December 2018 (UTC)

Ulcerative colitis

About this edit: adjusted to what ref supports, why would UC affect absorption?

@Doc James: The ref you're referring to (NIH) says:

Problems absorbing iron

Even if you consume the recommended daily amount of iron, your body may not be able to absorb the iron. Certain conditions or medicines can decrease your body’s ability to absorb iron and lead to iron-deficiency anemia. These conditions include:

• Intestinal and digestive conditions, such as celiac disease; inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease; and Helicobacter pylori infection.
• A history of gastrointestinal surgery, such as weight-loss surgery—especially gastric bypass—or gastrectomy.
• Certain rare genetic conditions, such as a TMRPSS6 gene mutation that causes a person’s body to make too much of a hormone called hepcidin. Hepcidin blocks the intestine from taking up iron.

You can see explanations, for example, here: An impaired absorption also may occur in patients with severe ulcerative colitis. If... --BallenaBlanca 🐳 ♂ (Talk) 16:05, 11 March 2019 (UTC)

Thanks I was looking at an older version [1] that said:

"Even if you have enough iron in your diet, your body may not be able to absorb it. This can happen if you have intestinal surgery (such as gastric bypass) or a disease of the intestine (such as Crohn's disease or celiac disease)."

There is of course a lot of intestinal disorders that can affect absorption. The exhaustive list can go in the body. Doc James (talk · contribs · email) 00:43, 12 March 2019 (UTC)

Yes, that is the problem with outdated information.

A simple and brief solution is to replace Crohn's disease with inflammatory bowel disease. --BallenaBlanca 🐳 ♂ (Talk) 16:48, 12 March 2019 (UTC)

Sure using IBD works. Doc James (talk · contribs · email) 11:28, 13 March 2019 (UTC)

Student project 2019

Hello, I am a graduate student at the University of Edinburgh doing a project. I am going to possibly add some information on pregnancy, infants, and hepcidin on this iron deficiency anemia page. HannahMPH (talk) 14:58, 21 November 2019 (UTC)

Student Edits

Hello! I am a student editor and will be modifying the Child Development section to include more specifics on how iron-deficiency anemia impacts growth and development Student3665 (talk) 02:45, 22 April 2021 (UTC)

hypoferumia?

People in my circles seems to often use the term "hypoferumia" when referring to the iron-defficiency anemia assuming to mean "Hypo" (latin for "below") + "ferum" (latin for "iron") + anemia (latin for "without blood" derived from greek 'anaimia'), thus "Low presence of iron in blood" when translated from latin to english same to the term 'hypomagnesemia' used in the w:Magnesium deficiency article -> I wasn't able to find any good reference to support this naming, but i think it should be included in the article. Kreyren (talk) 10:50, 1 January 2023 (UTC)

Wiki Education assignment: LLIB 1115 - Intro to Information Research

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 August 2023 and 8 December 2023. Further details are available on the course page. Student editor(s): Sbplr5 (article contribs).

— Assignment last updated by Tealover12 (talk) 17:21, 3 November 2023 (UTC)