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15/01/2020

Iron Deficiency Clinical Consequences

Iron deficiency (???? ?? ???) or sideropenia is the state in which a body lacks enough iron to supply its needs. Iron is present in all cells in the human body and has several vital functions. Too little iron can interfere with these vital functions and lead to morbidity and death. Untreated iron deficiency can lead to iron-deficiency anemia, a common type of anemia. Looking at the risks of iron deficiency, Siddha Spirituality of Swami Hardas Life System appeals to our readers to read this article and know the symptoms, causes, diagnosis, treatment, and clinical consequences in detail.

Image result for iron deficiency images
Iron Deficiency

Iron deficiency Symptoms (???? ?? ??? ?? ?????)

Symptoms of iron deficiency can occur even before the condition has progressed to iron deficiency anemia.

Iron is needed for many enzymes to function normally, so a wide range of symptoms may eventually emerge, either as the secondary result of the anemia or as other primary results of iron deficiency. Symptoms of iron deficiency include:

  • Fatigue
  • Dizziness/lightheadedness
  • Pallor
  • Hair loss
  • Twitches
  • Irritability
  • Weakness
  • Pica
  • Brittle or grooved nails
  • Hair thinning
  • Plummer–Vinson syndrome: painful atrophy of the mucous membrane covering the tongue, the pharynx, and the esophagus
  • Impaired immune function
  • Pagophagia
  • Restless legs syndrome

Continued iron deficiency may progress to anemia and worsening fatigue. Thrombocytosis, or an elevated platelet count, can also result. A lack of sufficient iron levels in the blood is a reason that some people cannot donate blood.

Iron deficiency symptoms in children include (?????? ??? ???? ?? ??? ?? ????? ?????):

  • Pale skin
  • Fatigue
  • Slowed growth and development
  • Poor appetite
  • Behavioral problems
  • Abnormal rapid breathing
  • Frequent infection

Iron requirements for young children to teenagers (???? ?????? ?? ??????? ?? ??? ???? ?? ??????????): 

Age group The recommended amount of iron a day
7 – 12 months 11 mg
1 – 3 years 7 mg
4 – 8 years 10 mg
9 – 13 years 8 mg
14 – 18 years, girls 15 mg
14 – 18 years, boys 11 mg

Iron deficiency Causes (???? ?? ??? ?? ????)

  • Blood loss (hemoglobin contains iron)
  • Donation of blood
  • Excessive menstrual bleeding
  • Bleeding from the gastrointestinal tract (ulcers, hemorrhoids, ulcerative colitis, stomach or colon cancer, etc.)
  • Rarely, laryngological bleeding or from the respiratory tract
  • Inadequate intake of proper food
  • Malabsorption syndromes
  • Inflammation where it is adaptive to limit bacterial growth in infection but is also present in many other chronic diseases such as Inflammatory bowel disease and rheumatoid arthritis
  • Parasitic infection

Though genetic defects causing iron deficiency have been studied in rodents, there are no known genetic disorders of human iron metabolism that directly cause iron deficiency.

Iron deficiency in Athletics (????????? ??? ???? ?? ???)

Possible reasons that athletics may contribute to lower iron levels include:

  • Mechanical hemolysis, loss of iron through sweat and urine
  • Gastrointestinal blood loss
  • Haematuria

Although small amounts of iron are excreted in sweat and urine, these losses can generally be seen as insignificant even with increased sweat and urine production, especially considering that athletes’ bodies appear to become conditioned to retain iron better.

Mechanical hemolysis is most likely to occur in high-impact sports, especially among long-distance runners who experience “foot-strike hemolysis” from the repeated impact of their feet with the ground.

Inadequate intake of Iron (???? ?? ????????? ????)

A U.S. federal survey of food consumption determined that for women and men over the age of 19, average iron consumption from foods and beverages was 13.1 and 18.0 mg/day, respectively.

For women, 16% in the age range 14–50 years consumed less than the Estimated Average Requirement (EAR), for men ages 19 and up, fewer than 3%.

People in the U.S. usually obtain adequate amounts of iron from their diets. However, subgroups like infants, young children, teenaged girls, pregnant women, and premenopausal women are at risk of obtaining less than the EAR. Socio-economic and racial differences further affect the rates of iron deficiency.

Image result for iron deficiency causes images
Causes

Bioavailability of Iron (???? ?? ??? ????????)

Iron is needed for bacterial growth making its bioavailability an important factor in controlling the infection. Blood plasma, as a result, carries iron tightly bound to transferrin, which is taken up by cells by endocytosing transferrin, thus preventing its access to bacteria.

Human milk (???? ?? ???)

Between 15 and 20 percent of the protein content in human milk consists of lactoferrin that binds iron. As a comparison, in cow’s milk, this is only 2 percent. As a result, breastfed babies have fewer infections. Lactoferrin is also concentrated in tears, saliva, and wounds to bind iron to limit bacterial growth.

Eggs (????)

Egg white contains 12% conalbumin to withhold it from bacteria that get through the eggshell (for this reason, prior to antibiotics, egg white was used to treat infections).

Protection against infection (??????? ?? ???????)

A moderate iron deficiency, in contrast, can provide protection against acute infection, especially against organisms that reside within hepatocytes and macrophages, such as malaria and tuberculosis. This is mainly beneficial in regions with a high prevalence of these diseases and where standard treatment is unavailable.

Iron deficiency Diagnosis (???? ?? ??? ?? ?????)

  • A complete blood count can reveal microcytic anemia, although this is not always present – even when iron deficiency progresses to iron-deficiency anemia
  • Low serum ferritin
  • Low serum iron
  • High TIBC (Total Iron-Binding Capacity)

It is possible that the fecal occult blood test might be positive if iron deficiency is the result of gastrointestinal bleeding. As always, laboratory values have to be interpreted with the lab’s reference values in mind and considering all aspects of the individual clinical situation.

Iron deficiency Treatment (???? ?? ??? ?? ?????)

Before commencing treatment, there should be a definitive diagnosis of the underlying cause of iron deficiency. This is particularly the case in older patients, who are most susceptible to colorectal cancer and the gastrointestinal bleeding it often causes. In adults, 60% of patients with iron-deficiency anemia may have underlying gastrointestinal disorders leading to chronic blood loss. It is likely that the cause of the iron deficiency will need treatment as well.

Upon diagnosis, the condition can be treated with iron supplements. The choice of the supplement will depend upon both the severity of the condition, the required speed of improvement and the likelihood of treatment being effective e.g. if it has underlying IBD, is undergoing dialysis, or is having ESA therapy.

Examples of oral iron that are often used are:

  • Ferrous sulfate
  • Ferrous gluconate
  • Amino acid chelate tablets

Recent research suggests the replacement dose of iron, at least in the elderly with iron deficiency, maybe as little as 15 mg per day of elemental iron.

Iron deficiency Food sources (???? ?? ??? ?? ????? ?????)

Mild iron deficiency can be prevented or corrected by eating iron-rich foods and by cooking in an iron skillet. Because iron is a requirement for most plants and animals, a wide range of foods provide iron.

Dietary foods (???? ?????? ??????)

Good sources of dietary iron have heme-iron, as this is most easily absorbed and is not inhibited by medication or other dietary components, which includes:

  • Red meat
  • Poultry, and
  • Insects.

Non-heme sources do contain iron, though it has reduced bioavailability, which includes:

  • Lentils
  • Beans
  • Leafy vegetables
  • Pistachios
  • Tofu
  • Fortified bread
  • Fortified breakfast cereals

Iron from different foods is absorbed and processed differently by the body. For example, iron in meat (heme-iron source) is more easily absorbed than iron in grains and vegetables (non-heme iron sources).

Iron deficiency foods (???? ?? ??? ???? ????? ??????)

In both the following tables, food serving sizes may differ from the usual 100g quantity for relevancy reasons. Arbitrarily, the guideline is set at 18 mg, which is the USDA Recommended Dietary Allowance for women aged between 19 and 50:

Heme Iron Foods (??? ???? ?????)

Richest foods in heme iron
Food Serving size Iron % guideline
Clam 100g 28 mg 155%
Pork liver 100g 18 mg 100%
Lamb’s kidney 100g 12 mg 69%
Cooked oyster 100g 12 mg 67%
Cuttlefish 100g 11 mg 60%
Lamb’s liver 100g 10 mg 57%
Octopus 100g 9.5 mg 53%
Mussel 100g 6.7 mg 37%
Beef liver 100g 6.5 mg 36%
Beef heart 100g 6.4 mg 35%

Non-heme Iron Foods (???-??? ???? ?????)

Richest foods in non-heme iron
Food Serving size Iron % guideline
Raw yellow beans 100g 7 mg 35%
Spirulina 15g 4.3 mg 24%
Falafel 140g 4.8 mg 24%
Soybean kernels 125ml=1/2cup 4.6 mg 23%
Spinach 125g 4.4 mg 22%
Lentil 125ml=1/2cup 3.5 mg 17.5%
Treacle (CSR Australia) 20ml=1Tbsp 3.4 mg 17%
Molasses (Blue label Australia) 20ml=1Tbsp 1.8 mg 9%
Candied ginger root 15g~3p 1.7 mg 8.5%
Toasted sesame Seeds 10g 1.4 mg 7%
Cocoa (dry powder) 5g~1Tbsp .8 mg 4%

Iron deficiency Foods for Children (?????? ?? ??? ???? ?? ??? ???? ????? ??????)

Children at 6 months should start having solid food that contains enough iron, which could be found in both heme and non-heme iron.

Heme iron (???? ????)

  • Red meat 
  • Fatty fish
  • Poultry or turkey
  • Eggs

Non-heme iron (???-???? ????)

  • Iron-fortified infant cereals
  • Tofu
  • Beans and lentils
  • Dark green leafy vegetables

Iron deficiency can have serious health consequences that diet may not be able to quickly correct; hence, an iron supplement is often necessary if the iron deficiency has become symptomatic.

Iron deficiency Foods during Pregnancy (?????????? ?? ????? ???? ?? ??? ???? ????? ??????)

Many women suffer from anemia during pregnancy for several reasons, however, it is easy to combat the condition with a small change in diet. Listed below are few foods that help you overcome an iron deficiency naturally:

  • Apple
  • Peach
  • Honey
  • Seafood
  • Nuts
  • Soybeans
  • Pomegranates
  • Eggs
  • Beatroot
  • Tomato
  • Spinach

Treatment through Blood transfusion (???? ???? ?? ?????? ?? ?????)

Blood transfusion is sometimes used to treat it with hemodynamic instability. Sometimes transfusions are considered for people who have chronic iron deficiency or who will soon go to surgery, but even if such people have low hemoglobin, they should be given oral treatment or intravenous iron.

Image result for iron deficiency foods images
Iron-Rich Foods

Clinical consequences (??????? ??????)

Clinical consequences include:

  • Anemia
  • Decreased memory, impaired learning, and concentration
  • Impaired immune function
  • Decreased aerobic sports performance
  • Decreased work productivity
  • Fatigue
  • Adverse pregnancy outcomes:
    • Risk of low birth weight
    • Increased risk of prematurity
    • Risk of maternal morbidity
  • Infant motor and mental function delay
  • Increased risk of transfusion and associated outcomes

Reference:

  • https://en.wikipedia.org/wiki/Iron_deficiency
  • https://transfusion.com.au/transfusion_practice/anaemia_management/iron_deficiency_anaemia/clinical_consequences
  • https://parentinghealthybabies.com/foods-overcome-iron-deficiency-pregnancy/

 

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Comments (35)

  1. Sanjeev Gupta says:
    15/01/2020 at 10:20 am

    ???????????? ??????????

    Reply
    1. N G Khirolkar says:
      15/01/2020 at 12:11 pm

      ????? ????, ???????! ???? ?? ????? ?? ??? ??? ??? ?? ??! ????? ????? ???? ???? ????? ???? ?? ?? ????? ?? ??? ??! ??? ?? ?????????? ??????? ???? ?? ????? ?????? ???? ??????! ????? ??? ????!!!

      Reply
  2. clifford Imbrah says:
    15/01/2020 at 12:47 pm

    Very insightful presentation. Bravo!

    Reply
    1. N G Khirolkar says:
      15/01/2020 at 3:16 pm

      So nice of you, dear Clifford! Your nice words give me immense pleasure and energy for presenting my work to the expectations of people like you. I shall always try to maintain the same decorum in the future too. Please be in touch. Thanks!

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  3. Suman Khirolkar says:
    16/01/2020 at 8:04 pm

    Yes. Iron deficiency is a great concern for women. Preganent women are at risk. Thanks for such an amazing information. Every woman must read this article.

    Reply
    1. N G Khirolkar says:
      17/01/2020 at 8:22 am

      Rightly said, Madam! We had been hearing this problem is faced by women. However, people affected with diabetes mellitus also found to be at greater risk. Thanks for your good words. Please keep in touch.

      Reply
  4. hemangi4 says:
    17/01/2020 at 9:05 am

    iron deficiency shoul be taken care of at right time????????????????

    Reply
    1. N G Khirolkar says:
      17/01/2020 at 12:26 pm

      Rightly said Dr. Hemangi! Care at the right time is a must. Excess of iron is also harmful. Thanks for your guidance. Please keep me guiding in the future too.

      Reply
    2. Gajanan Sawarkar says:
      04/02/2020 at 8:11 pm

      Great content sir.

      Reply
      1. N G Khirolkar says:
        05/02/2020 at 5:36 am

        Yes, iron deficiency can lead to various other problems hence it is wise to undergo regular medical tests to know our condition. Thanks for your nice words!

        Reply
  5. shubhamsavankar says:
    27/01/2020 at 6:40 pm

    Useful knowledge sir…

    Reply
    1. N G Khirolkar says:
      28/01/2020 at 5:42 am

      Yes, Shubham. Every person should know about Iron Deficiency and it’s adverse effects on health. Many problems can be avoided if one has knowledge about it. I feel privileged when people like you find my article “useful”. Thanks for your nice words. Please be in touch.

      Reply
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