Iron Deficiency Anemia Iron is necessary for the formation of heme, a component of the hemoglobin molecule. Hemoglobin is the primary oxygen-carrying molecule in the blood. Iron is also needed for the formation of other body enzymes (myoglobin, a muscle enzyme, for example). Iron in the body is stored in the form of ferritin or hemosiderin. Iron deficiency most commonly occurs because lack of absorption in the stomach and intestines, blood loss in gastrointestinal tract, or blood loss from the uterus. May have none Fatigue Heart racing Palpitations Shortness of breath on exertion Ice craving Brittle nails Smoothing of the tongue Lip cracking Iron malabsorption Ulcer Disease Stomach Cancer Colorectal Cancer Heavy menstrual blood loss Repeated pregnancy Hemoglobinuria Chronic aspirin use Laboratory: Low hemoglobin/hematocrit Low MCV (red blood size) Low ferritin level Low Iron level and high TIBC (Total Iron Binding Capacity) level Low transferrin saturation Urinalysis to look for hemoglobin or myoglobin or red blood cells Colonoscopy and/or upper endoscopy/upper GI series to rule out cancer or Ulcer Disease Endometrial biopsy and/or pelvic Ultrasound may be consider in women Bone marrow biopsy if diagnosis or cause not clear Oral iron supplementation -- usually Iron sulfate 325mg, three times a day. A stool softener is often needed because iron is constipating. There are "slow" iron preparations available that may be easier on the stomach. Find and treat underlying the cause(s). You need to see your doctor very soon. Since this condition is commonly caused by Colon Cancer, Stomach Cancer, or Ulcer Disease, it is important to catch these diseases as soon as possible. Anemia of chronic disease Thalassemia Sideroblastic anemia Lead Poisoning