Iron Deficiency: The Cause of Constant Fatigue and Solutions

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Persistent fatigue and weakness, often experienced in daily life without a clear cause, is a common concern for many people. Sometimes, these symptoms stem from a deficiency in iron and hemoglobin, which are vital for the body. In particular, low iron levels in the blood can lead to serious health problems.

The Role of Iron and Hemoglobin in Health

Iron in the body is essential for the formation of hemoglobin, the primary protein in red blood cells. Hemoglobin acts as the main 'carrier' molecule, transporting oxygen from the lungs to every tissue and organ in the body.
When iron deficiency occurs, the body is unable to produce enough hemoglobin, resulting in a decrease in the amount of oxygen delivered to the tissues. This condition is known as low hemoglobin or iron deficiency anemia.

What are the Symptoms of Iron Deficiency?

Iron deficiency or iron-deficiency anemia in the blood manifests through various symptoms. The most common are persistent fatigue and weakness, caused by the lack of oxygen in the tissues.

Main symptoms:

  • Constant fatigue and weakness: A feeling of exhaustion that does not go away even after rest.
  • Pale Skin: Paleness of the skin and mucous membranes (inside the eyelids).
  • Headache and dizziness.
  • Hair loss and brittle nails.
  • Shortness of breath and increased heart rate (the heart tries to compensate for the lack of oxygen).
  • Difficulty concentrating and impaired cognitive function.

What are Iron-Boosting Foods?

Balanced nutrition is essential for normalizing iron levels. Consuming iron-rich foods is highly effective in mild cases of anemia and for its prevention.

Iron-Rich Foods:

  • Animal-based sources: Red meat (beef), liver, chicken, fish, and seafood. Iron from these sources is more easily absorbed by the body.
  • Plant-Based sources: Spinach, lentils, beans, dried fruits (raisins, apricots), seeds, and nuts. To improve the absorption of plant-based iron, it is recommended to consume these foods together with vitamin C–rich foods, such as orange juice.

What is Hemoglobin A2 and Why is it Important?

Hemoglobin A2 (HbA2) is a specific type of hemoglobin normally found in small amounts in the blood. But what exactly is hemoglobin A2, and what is its medical significance? The level of HbA2 is primarily used in the diagnosis of beta-thalassemia carriers. In individuals who carry thalassemia, HbA2 levels are usually elevated.

Low HbA2 and Iron Deficiency:

Low HbA2 is not a disease in itself, but is often associated with iron deficiency anemia. Iron deficiency can reduce the synthesis of HbA2, causing its levels to drop below normal.

The main point to pay attention to:
If there is both iron deficiency and a suspicion of thalassemia, low HbA2 levels before iron treatment may lead to a misdiagnosis. Therefore, doctors sometimes recommend rechecking HbA2 levels after iron therapy.

Remember! If you experience persistent fatigue and weakness, you can have your  iron and hemoglobin levels checked to assess your body’s condition, and be sure to consult a doctor for an accurate diagnosis.

Ways to Prevent Hemoglobin A2 Deficiency

Low hemoglobin A2 (HbA2) levels are often associated with two main causes: iron deficiency or alpha-thalassemia carrier (alpha-thalassemia minor). Both conditions require different approaches to prevent or manage.

1. Combating Iron Deficiency (The Most Common Cause)

If the cause of low HbA2 is iron deficiency, this is the easiest problem to solve. Here are some things you can do to increase your iron:

  • Iron-Rich Foods - Include iron-rich foods such as red meat, liver, spinach, legumes (lentils, beans), and dried fruits in your diet.
  • Using Vitamin C supplements - Take iron with vitamin C to help your body absorb it better (for example, drink orange juice after eating iron-rich foods).
  • Doctor's supervision - If diagnosed with iron deficiency, it is important to take iron supplements exactly as prescribed by your doctor. Avoid self-medicating.

2. Genetic Factors in Alpha-Thalassemia Carriers

Alpha-thalassemia carrier is a genetic condition that can cause low HbA2 levels. This condition cannot be prevented because it is an inherited trait. However, it can be managed, and potential complications can be prevented:

  • Genetic Counseling - If you or your family members are carriers of thalassemia, obtaining genetic counseling is especially important when planning a pregnancy. This helps assess the risk of severe forms of the disease in future generations.
  • Avoiding Iron Supplements -  If there is no iron deficiency in thalassemia carriers, taking iron supplements is not recommended, as it can lead to excessive iron accumulation in the body (hemosiderosis). Iron supplements should only be taken under a doctor’s guidance.
  • Regular Medical Monitoring - It is important for carriers to have regular blood tests and medical check-ups so that their condition can be closely monitored and any potential complications can be detected early.

The first step in preventing or managing low HbA2 is to accurately determine its true cause (iron deficiency or genetic carrier status). This can only be established through appropriate tests conducted by a physician, such as ferritin measurement and hemoglobin electrophoresis.

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