WHEN a young woman comes into my clinic, appearing pale and complaining of fatigue, weakness and lightheadedness, my first suspicion is usually iron-deficiency anaemia.

Anaemia is a condition where the body does not have enough red blood cells. In many women, especially Asian women, it is caused by iron deficiency in the diet.

There are also other types of anaemia, caused by haemolysis (destruction of red blood cells), such as in patients with sickle cell disease or thalassaemia, or anaemia caused by other deficiencies (for example, vitamin B12 or folate).

As many as 25 per cent of pregnant women and 19 cent of adolescent girls in Malaysia have some form of iron-deficiency anaemia.

How red blood cells are made

Iron is very important for making red blood cells. Without adequate iron, your body does not produce enough red blood cells.

This is cause for concern because red blood cells contain a protein called "haemoglobin", which is responsible for carrying oxygen to the rest of the body. When the body has a low red blood cell count, that means there is not enough oxygen getting to the tissues, muscles and organs of the body.

You need an adequate supply of these red blood cells to perform daily physical activities and maintain overall well-being, as oxygen is essential for muscles to burn calories from food and convert them into energy. That is why someone with low iron often feels tired and weak, and experiences a host of other health problems.

Many factors contribute to a woman's risk of becoming anaemic. They include a diet low in iron, restricted calorie intake, eating disorders, heavy menstrual flow, pregnancy and lactation, and blood donations. A woman who suffers from bleeding in the gastrointestinal tract - sometimes caused by excessive use of anti-inflammatory medications such as aspirin and ibuprofen - may also suffer from anaemia.

Women and anaemia

Women are more prone to suffering from anaemia, but it is certainly not because they are the "weaker sex"!

Women lose more iron than men due to menstrual blood loss. Thus, women need nearly twice as much iron in their diet (18mg per day) compared to men (10mg per day). Women who are athletes may also have increased iron needs, by up to another one to two milligrams per day.

I mentioned earlier that Asian women are particularly prone to iron-deficiency anaemia. The reason is because Asian diets do not contain as much red meat, such as beef and lamb, which are the richest food sources of iron.

Along with fatigue, dizziness, lightheadedness and paleness of skin, the other symptoms of low iron and anaemia are irritability, difficulty concentrating and loss of appetite.

Anaemia can also be present in children. However, it is often overlooked because symptoms like difficulty concentrating are sometimes blamed on the child's age or naughtiness.

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