Anaemia (Iron Deficiency) — The Most Common Hidden Health Problem in Women

What Is Anaemia?

Anaemia means the blood has fewer red blood cells than normal, or those red blood cells carry less haemoglobin than they should. Haemoglobin is the protein that carries oxygen from the lungs to every organ and tissue.

Anaemia is present when haemoglobin falls below:

• 12 g/dL in non-pregnant women
• 11 g/dL in pregnant women

Types Most Common in Indian Women

• Iron deficiency anaemia — by far the most common; from poor dietary intake, heavy periods, or pregnancy
• Folate (B9) deficiency — from inadequate green vegetables and legumes; critical in pregnancy
• Vitamin B12 deficiency — very common in vegetarians and vegans; animal products are the primary source
• Thalassemia — inherited haemoglobin disorder; Gujarat has one of the highest carrier rates in the world

Symptoms — Recognising Anaemia

• Profound fatigue and weakness — "I've rested but I'm still exhausted"
• Pale face, pale inner eyelids, pale nails
• Shortness of breath on exertion — climbing stairs becomes difficult
• Dizziness and headache
• Cold hands and feet
• Heart palpitations
• Brittle nails and significant hair fall
• Unusual cravings — ice, clay, chalk (called pica) — a sign of severe iron deficiency
• Difficulty concentrating — brain fog

How Anaemia Affects Women Specifically

Heavy Periods (Menorrhagia)

Every month, heavy bleeding causes significant iron loss. Over months and years, iron stores become depleted. There's also a vicious cycle — anaemia affects platelet function and clotting, which can worsen the bleeding that caused the anaemia.

Pregnancy

Iron demand nearly doubles in pregnancy — to supply the developing baby, the placenta, and the dramatically increased maternal blood volume. Untreated anaemia in pregnancy significantly increases the risks of:

• Preterm birth
• Low birth weight baby
• Severe maternal fatigue and impaired immune function
• Postpartum haemorrhage (PPH)

Fertility

Severe anaemia can disrupt ovulation. Restoring iron stores is an important step before fertility treatment in affected women.

Adolescent Girls

The combination of rapid growth plus the onset of menstruation creates very high iron demands during adolescence. With poor dietary iron intake — common in Gujarat — anaemia in teenage girls is almost the norm rather than the exception. This affects academic performance, physical energy, and long-term health.

Iron-Rich Foods for an Indian Diet

Non-Haem Iron (Plant Sources — Less Readily Absorbed, but Important)

• Fenugreek leaves (methi) — one of the richest plant iron sources
• Spinach (palak)
• Rajma, chana, lentils (all legumes)
• Sesame seeds (til)
• Ragi (finger millet / nachni)
• Jaggery (gur) — a traditional source of iron
• Dry fruits — dates (khajur), figs (anjeer), raisins (kismis)

Haem Iron (Animal Sources — Better Absorbed)

• Lean chicken and eggs
• Fish

Boost iron absorption significantly: Adding vitamin C to iron-rich meals increases absorption by up to 3 times. Squeeze lemon juice over dal, add amla or guava to your meal, or drink a small glass of orange juice alongside iron-rich food.

Things that block iron absorption (eat separately from iron-rich foods):

• Tea and coffee — tannins in these bind iron
• Calcium (dairy) — competes with iron for absorption

A Day of Eating for Iron — Practical Indian Meals

Treatment

Mild to Moderate Iron Deficiency

Oral iron tablets (ferrous sulphate, fumarate, or gluconate) prescribed by your doctor. Need 3–6 months to rebuild stores. Side effects — constipation, dark stools — are normal and harmless. Take with food to reduce nausea.

Severe Anaemia

• IV (intravenous) iron — much faster correction; ideal in pregnancy or when oral tablets aren't tolerated
• Blood transfusion — in emergency or very severe cases

Folate and B12 Deficiency

Folic acid and B12 supplements — simple, effective.

Treating the Underlying Cause

• Heavy periods from PCOS or fibroids — treat the cause
• Thalassemia carriers — genetic counselling and specialist care

Frequently Asked Questions

What is a normal haemoglobin level for women?

12 g/dL or above for non-pregnant women. 11 g/dL or above in pregnancy.

Why do iron tablets cause constipation?

This is a well-known side effect. Taking tablets with food, splitting the dose, or choosing a gentler iron form reduces the problem. Dark stools from iron are harmless.

Is anaemia in pregnancy serious?

Yes — it significantly increases risks for both mother and baby. Iron levels should be checked early in pregnancy and monitored throughout.

I'm a thalassemia carrier — will I have anaemia?

Carriers of thalassemia trait (minor) typically have mild anaemia. Thalassemia major causes severe anaemia requiring regular transfusions. In Gujarat, thalassemia carrier testing before pregnancy is one of the most important pre-conception steps a couple can take.