Iron Deficiency Anemia in People with Down Syndrome

When a person has low levels of iron in their bodies, they are more likely to develop iron deficiency anemia (IDA). Learn about IDA and symptoms to look for, and how to add more iron into people’s diets.

What is Iron Deficiency Anemia?

Iron deficiency anemia (IDA) occurs when low iron levels cause the body to not make enough red blood cells to carry oxygen to all the body’s tissues. In some cases, IDA can affect a person’s motor skills (how our bodies move) and cognitive development (how our brains develop).

IDA is more likely to affect people who have disabilities, such as those with Down syndrome. A multivitamin may not be enough to treat IDA. If needed, the care team can prescribe an iron supplement called ferrous sulfate. This supplement is stronger than iron supplements you might buy at the store.

What are Common Causes of IDA?

Common causes of IDA include:

• Low levels of iron in our diets (what we eat and drink every day)
• Blood loss from menstruation (monthly period) or an injury to the gastrointestinal tract (the passage food travels through, including the mouth, throat, stomach and intestines)
• When the body has trouble absorbing iron from food

Why are People with Down Syndrome More Likely to Have IDA?

IDA is the most common cause of anemia in children with Down syndrome. Sometimes, people with Down syndrome have feeding difficulties (challenges with eating or with certain tastes, textures or types of food). Feeding difficulties can make it challenging for people with Down syndrome to get enough iron in their diet.

What are the Symptoms of IDA?

• Extreme fatigue (tiredness)
• Headache, dizziness or lightheadedness
• Pale skin
• Cold hands and feet
• Brittle (fragile) nails or spooning of nails (when the center of the fingernail curves inward)
• More serious symptoms include motor skills (skills that help us move or use our bodies in certain ways) and cognitive development (how the brain develops and grows over time)

How Often Should People with Down Syndrome Have Their Iron Levels Screened?

The care team might recommend that that people with Down syndrome should have blood tests once a year to check for IDA.

How to Make Sure People with Down Syndrome Get Enough Iron

The most common cause of iron deficiency is not eating enough foods with iron. To boost levels of iron in the diet, you can:

• Ask a registered dietitian-nutritionist about foods that are rich in iron.
• Eat foods high in vitamin C and high in iron together. Vitamin C helps our bodies absorb iron better.
• Use an iron supplement. Ask the care team for iron supplement recommendations or a prescription.

Snack and Meal Ideas to Boost Iron

Below is a list of foods you can eat together to boost iron levels in the body. For more ideas, ask a registered dietitian-nutritionist or doctor.

• An orange with fortified breakfast cereal. When a food is fortified, it means there are extra nutrients, like iron, added to it.
• Strawberries with a handful of roasted cashews or cashew butter
• Broccoli with beef
• Whole wheat spaghetti with tomato, spinach or cauliflower
• Tuna with diced tomato on Triscuits® or crackers
• Tofu with lentils

Rev. 4/2020. Written by Hannah Rivard, Simmons College. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.