Anaemia is widespread among women and adolescent girls in Bangladesh. It is so common that its symptoms get accepted as an ordinary state of being: always tired, breathless on the stairs, unable to concentrate. It is treatable, and the treatment works.
What it feels like
- Tiredness that rest does not fix
- Breathlessness or a pounding heart on mild exertion
- Dizziness, headache, poor concentration
- Pale skin, inner eyelids and nail beds
- Brittle nails and hair fall
- A craving for ice, soil, chalk or raw rice — unusual, and a strong pointer to iron deficiency
Why it happens
Usually several reasons at once: menstrual blood loss, especially with heavy periods; pregnancies close together; a diet low in absorbable iron; and intestinal worms. Less commonly there is a bleeding source in the gut, or a condition such as thalassaemia trait, which is present in this population and behaves differently.
Anaemia is a sign, not a diagnosis
This matters. Iron tablets will usually raise the haemoglobin, but if the cause is heavy bleeding from a fibroid, or a slow bleed in the stomach, treating only the number leaves the real problem in place. A haemoglobin and ferritin test tells us how deficient you are; the history and examination tell us why.
Food that genuinely helps
Iron from animal sources is absorbed far better than iron from plants. Liver, red meat, and small whole fish such as mola and dhela are excellent — the small fish bring vitamin A and calcium as well. From plants: dal, dark leafy greens like palong and kalmi shak, and gur.
Two habits that change absorption
- Vitamin C helps. Lemon, guava, amra, amloki or tomato alongside a meal significantly increases how much iron you absorb from it.
- Tea does not. Tea taken with or just after a meal binds iron and blocks it. Leave an hour either side — for many households this alone makes a real difference.
Iron tablets are often stopped early because of constipation or nausea. Tell us instead of stopping — the preparation, dose or timing can usually be changed.
Adolescent girls and pregnancy
Girls entering their teens are at high risk once periods begin, at exactly the age when diets are often poorest. In pregnancy, anaemia raises the risk of a premature or small baby, and of dangerous blood loss at delivery. Both groups are worth testing rather than assuming.
Deworming
Where worms are a likely contributor, periodic deworming is simple and cheap. Ask whether it applies to you and your children.
This article is general health information, not a diagnosis. For anything specific to you, please come to the chamber or call 01357-296604 for a serial.
