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1. Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory condition that causes pain and swelling in your joints.

Anaemia is common in RA, with 30-70 % of RA patients being anaemic. 2

There are several types of anaemia that can occur in patients with RA:

  • Anaemia of chronic disease (ACD): where your body stores a good amount of iron but the release of iron from your stores is reduced, reducing iron available for red blood cell production 3
  • Iron deficiency anaemia (IDA): where the amount of iron stored in your body is too low for your body’s needs, meaning that you cannot make the normal number of healthy red blood cells, due to reduced iron availability for uptake into red blood cells 3,4

ACD and IDA oftentimes occur together in patients with RA.2 ID can also occur without anaemia, and you may still experience symptoms of ID.2

2. Restless Legs Syndrome

Restless legs syndrome (RLS) is a condition which can lead to you feeling unpleasant creeping, tingling or burning in your legs and an urge to move your legs when you are resting. 5

RLS is associated with ID and IDA.5,6 In people who have increased risk of ID, such as pregnant women,5 patients with chronic kidney disease (CKD),5 patients undergoing haemodialysis,7 and people with coeliac disease 8 are also more likely to have RLS.

3. Special diets (vegetarian and vegan)

A well-balanced vegetarian or vegan diet should be sufficient to keep your iron levels up. 9

However, if you eat a restricted vegetarian diet (e.g. macrobiotic diet), you may have a greater risk of being iron deficient. 9

Iron from plant sources is not as easily absorbed as iron from animal sources and its uptake can also be reduced by other food and drinks, such as tea, coffee and dairy products. 10 If you are a vegetarian or vegan, you rely on iron from plant-based sources. It is important that you: 10

  • Eat a variety of iron-rich foods
  • Eat foods that increase the absorption of iron
  • Avoid foods that inhibit iron absorption around the time you are eating iron-rich meals

References:

  1. Alamanos Y, Drosos AA. Epidemiology of adult rheumatoid arthritis. Autoimmun Rev 2005;4(3):130-136.
  2. Peeters HR, Jongen-Lavrencic M, Raja AN, Ramdin HS, Vreugdenhil G, Breedveld FC, Swaak AJG. Course and characteristics of anaemia in patients with rheumatoid arthritis of recent onset. Ann Rheum Dis 1996;55(3):162-168.
  3. Weber J, Werre JM, Julius HW, Marx JJM.Decreased iron absorption in patients with active rheumatoid arthritis, with and without iron deficiency. Ann Rheum Dis 1988;47(5):404-409.
  4. Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci 2014;19(2):164-174.
  5. Sun ER, Chen CA, Ho G, Earley CJ, Allen RP.Iron and the restless legs syndrome. Sleep 1998;21(4):371-377.
  6. Leschziner G, Gringras P.Clinical review: Restless legs syndrome. BMJ 2012;3056:1-5.
  7. Gigli GL, Adorati M, Dolso P, Piani, A, Valente M, Brotini S, Budai R. Restless legs syndrome in end-stage renal disease. Sleep Med 2004;5(3):309-315.
  8. Moccia M, Pellecchia MT, Erro R, Zingone F, Marelli S, Barone DG, et al.Restless legs syndrome is a common feature of adult celiac disease. Mov Disord 2010;25(7):877-881.
  9. Craig WJ.Iron status of vegetarians. Am J Clin Nutr 1994;59(5 Suppl):1233S-1237S.
  10. Hurrell R, Egli I.Iron bioavailability and dietary reference values. Am J Clin Nutr 2010;91(Suppl):1461S-1467S.
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