How IBD Can Cause Low Iron Levels

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Inflammatory bowel disease (IBD) is a term used to describe medical conditions that involve chronic inflammation of the digestive tract. In addition to the gastrointestinal symptoms that you might expect with IBD, there are a variety of complications that can occur. For example, many people with IBD develop low iron levels in their blood, which can result in anemia. Let’s take a closer look at what this means and how it occurs.    

What happens to your body with IBD?

There are two main types of inflammatory bowel disease: Crohn’s disease and ulcerative colitis. They share many symptoms in common, including:

Ulcerative colitis affects only the large intestine, also called the colon. Crohn’s disease, on the other hand, can affect anywhere along the digestive tract from the mouth to the anus.

5 Things You Didn't Know About Anemia

We don’t know the exact cause of IBD, but it is believed to be related to the immune system. Your immune system is necessary to prevent things like viruses and bacteria from getting you sick, but in some cases, it mistakenly triggers inflammation along your digestive tract. This causes problems with the normal process of breaking down food, absorbing the nutrients your body needs, and eliminating any waste.  

What’s the link between IBD and anemia?

Red blood cells play an important role in daily health: they carry oxygen to all of your body’s tissues. But if you have anemia, you don’t have enough red blood cells in your body, and this makes it hard to transport oxygen as needed. Sometimes anemia is caused by low levels of iron, known as iron-deficiency anemia. Iron is a necessary component for helping red blood cells spread oxygen through your body.  

Many people with IBD have low iron levels. There are a few ways this can happen:

  • Ongoing blood loss: Ulcers develop along the inflamed digestive tract that can bleed internally. Patients may experience bloody stool, especially in ulcerative colitis. This leads to a depletion of iron in the body.

  • Inflammation of the intestines: When your intestines are inflamed, vitamins and minerals like iron, folate and vitamin B12 can’t be absorbed from your food like they should. The inflammation may also prevent your body from “tapping into” the iron already stored within the body.

  • Dietary changes: IBD can decrease your appetite, so you may not take in as much iron and important vitamins as your body needs. Also, some people with IBD are hesitant to eat iron-rich foods like leafy greens and red meat because they are worried they will exacerbate their symptoms.

What are the symptoms of low iron levels?

When iron levels in your blood are mildly low, you may not have any symptoms. However, if it progresses into anemia, you may notice things such as:

In extreme cases, anemia can affect organs like the heart, which has to work harder as the result of low circulating oxygen in the blood.

Anemia can be diagnosed with a blood test, and in most cases, it’s easily treatable. Treatments include oral iron supplements, intravenous iron transfusions, medications that increase your body’s production of red blood cells, and rarely, blood transfusions. Getting your IBD under control is also important to prevent and treat anemia.

If you think you might be anemic, schedule a visit with your doctor. There are also complications that can result from having too much iron in your blood, so don’t diagnose it and treat it yourself.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Oct 9

  1. Anemia in Inflammatory Bowel Disease: An Underestimated Problem? Frontiers in Medicine.

  2. Inflammatory Bowel Disease. Mayo Clinic.

  3. Iron Deficiency Anemia in Inflammatory Bowel Disease. World Journal of Gastrointestinal Pathophysiology.

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