Iron Deficiency Clinical Consequences

Iron deficiency (आइरन की कमी) 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.

Iron deficiency Symptoms (आयरन की कमी के लक्षण)

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 (बच्चों में आयरन की कमी के शामिल लक्षण):

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

Iron requirements for young children to teenagers (युवा बच्चों से किशोरों के लिए आयरन की आवश्यकताएं): 

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 (आयरन की कमी के कारण)

• 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 (एथलेटिक्स में आयरन की कमी)

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 (आयरन का अपर्याप्त सेवन)

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.

Bioavailability of Iron (आयरन की जैव उपलब्धता)

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 (मानव का दूध)

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 (अंडे)

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 (संक्रमण से सुरक्षा)

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 (आयरन की कमी का निदान)

• 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 (आयरन की कमी का उपचार)

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 (आयरन की कमी के खाद्य स्रोत)

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 (आहार संबंधी पदार्थ)

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 (आयरन की कमी वाले खाद्य पदार्थ)

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 (हेम आयरन फूड्स)

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 (नॉन-हीम आयरन फूड्स)

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 (बच्चों के लिए आयरन की कमी वाले खाद्य पदार्थ)

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 (हेमे आयरन)

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

Non-heme iron (गैर-हेमे आयरन)

• 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 (गर्भावस्था के दौरान आयरन की कमी वाले खाद्य पदार्थ)

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 (रक्त आधान के माध्यम से उपचार)

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.

Clinical consequences (नैदानिक परिणाम)

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/