Posted in Anemia, life

Iron Deficiency Anemia: More than Hemaglobin

For years I suffered from rounds of debilitating fatigue that would ground my life to a halt, days of miserable headaches so strong that I could barely tolerate the intense agony of opening my eyes, at times the slightest effort would leave me winded, and with an ever increasing need for ice water. Like an endless merry-go round I would enjoy a burst of energy that with each passing round slipped away faster and remained away longer.

Month after month the need for rest grew.  Controlling more and more of time as I scheduled my whole life around the expectation that it was not a matter of if, but when the life-halting exhaustion would bring my world to a halt. Instead of attending my college courses in person I switched to only online classes that allowed me to work ahead so I could accomplish as much as I could and would allow me to get ahead if possible in my two to three working days before my body crashed for the rest of the week.

The need for rest soon began to dominate my life.  Controlling both work and play, as I began to schedule my life around the inevitable crash and burn.


At some point I began to notice that my skin looked like someone was taking an eraser to it.  Removing a little color here, and then a little bit of color there.  Until the day came when almost all the color was gone and strangers would comment that I looked so pale and ask me if I ever got any sunlight.

Having no job or health care, my concerned parents struggled to spend  hundreds of dollars to find out the cause of my failing health.  One suspicion that was repeatedly suggested, and explained some of my symptoms was anemia.  But one look at my hemoglobin, which except for a rare wobble, was always normal.

Finally my Father, who was a lab tech at the time, grew impatient of the whole process and animatedly insisted that the doctor needed to check my Ferritin. Saying that hemoglobin was not always accurate, because if the loss is due to some chronic issue and not sudden blood loss, the body will steal from and deplete the stores before it shows up in the hemoglobin. With some reluctance the doctor ordered a blood test to check my ferritin and iron saturation and was surprised to discover that my ferritin and iron saturation was low. Giving a reason for my bouts of chronic fatigue, my frequent headaches, shortness of breath, and increasing need to alleviate the strange discomfort of my tongue by sucking ice.

Glass after glass of ice water was soon required to relieve the strange discomfort of my tongue.


Sadly it took years of needless suffering to reveal that I had anemia because at the time, and probably even today, too many doctors tended to rely solely upon hemoglobin to diagnosis iron deficiency anemia. Figuring that anemia was not something to worry about as long as the hemoglobin was normal.  Ignoring or forgetting that if the iron in one’s blood is getting to low, it will take from the stores to keep the amount of blood in the iron leveled.

Essentially what is happening is that when the levels of iron drop too low, the body borrows money from the stores or the saving account of iron.  This is not a problem if the body only needs to borrow occasionally and has plenty of opportunity to rebuild the account keeping the savings account healthy.

In some instances the draft is sudden and severe as evidenced by a massive drop in the hemoglobin levels.  This is usually caused by something like an accident that has caused massive internal or external bleeding.  A one time dip into the savings account or quick cash loan in the form of an iron infusion or blood transplant is usually all that is required to deal with the emergency need and in a few weeks the account is back to normal.

But there are conditions that cause the emergency loan to become a routine habit. Malnutrition,   malabsorption, and autoimmune disease like lupus are some examples of conditions that can put a consistent strain on the savings account.  Tipping the scale out of balance and causing a steady depletion of the body’s savings account.

The body will do all that it can to keep the iron account balanced, but some conditions such as malnutrition swings the scale so low that the body cannot maintain the balance.


This of course is dangerous.  Because if the savings account were to run dry and an emergency were to occur, were would the checking account turn? The potential for a deadly bankruptcy could become a reality and the body seeks to avoid this at all cost.

So to prevent this the body starts to send warning notes. Mild at first, such as occasional bouts of fatigue, suddenly feeling slightly winded when exercising too hard, or the occasional uptick in mild headaches. But if the situation continues and the savings account drops too low the warnings will become more severe.  Chills, muscle aches, pale skin, headaches, debilitating fatigue, dizziness, and even pica will become an all to routine reality as the body does all it can to prevent  what could turn into a deadly situation.

This is why checking for chronic iron deficiency involves more than just looking at the hemoglobin. And if as in my case, hemoglobin is the only factor taken into consideration, despite the fact that the body will deplete the stores in an attempt to keep the checking account balanced, the anemia will be missed. Potentially allowing the stores to deplete until they have become dangerously low and the symptoms have moved from an occasional annoyance to life halting.


 (Please understand that the above article is not to be construed as medical advice. This is my simplified way  of explaining the role, as I understand it, that iron stores play in chronic anemia.  But it does not deal with other aspects of diagnosing anemia such as looking at the hematocrit or reticulocyte count. I am not a medical professional and  I am only writing this article to share my experience with years of suffering with undiagnosed  iron deficiency anemia , and years of dealing with chronic iron deficiency anemia.)

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