HELLO IRON 

   Iron is very important in maintaining many body functions, including the production of hemoglobin, the molecule  that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout your body. Iron is also necessary to maintain healthy cells, skin, hair, and nails.

   Iron from food is absorbed into your bloodstream in your small intestine.The iron is then released into the bloodstream, where a protein called transferrin attaches to it and delivers the iron to the liver. Iron is stored in the liver as ferritin and released as needed to make new red blood cells in the bone marrow. If you aren't consuming enough iron, or if you're losing too much iron, your body can't produce enough hemoglobin and iron deficiency anemia will eventually develop. IRON-DEFICIENCY ANEMIA is the most common form of anemia.

   ARE YOU AT RISK OF IDA ?

  • Women who menstruate, particularly if menstrual periods are heavy,  pregnant or breastfeeding or those who have recently given birth.
  • People who have undergone major surgeries or physical trauma or other blood losses.
  • Vegetarians and vegans whose diet is less in iron
  • Children who drink more than 16 to 24 ounces a day of cow's milk (Cow's milk not only contains little iron, but it can also decrease absorption of iron and irritate the intestinal lining causing chronic blood loss.)
  • Frequent blood donars

CAUSES OF IDA :

  • Blood loss:  conditions  such as  peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer or regular use of over the counter pain relievers.
  •  A lack of iron in your diet:  poor diet or poverty especially in babies or children
  •  Malabsorption : Peptic ulcer disease or  inflammatory bowel diseases such as ulcerative colitis, or Crohn disease or GI diseases such as celiac disease (sprue). People who have undergone bariatric procedures, especially gastric bypass operation or  part of your small intestine has been bypassed or removed surgically.
  • Hookworm :  most common cause in tropics due to GI blood loss.

COMPLICATIONS :

Mild iron deficiency anemia usually doesn't cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems.

  •  Heart problems like rapid or irregular heartbeat or an enlarged heart or heart failure.
  • Problems during pregnancy like premature births and low birth weight babies. But the condition is preventable by taking iron  supplements during pregnancy.
  • Growth problems like  delayed growth and development and increased susceptibility to infections in infants and children .

SIGNS AND SYMPTOMS OF IDA:

 The symptoms of iron-deficiency anemia can be mild at first, and you may not even notice them. Most people don’t realize they have mild anemia until they have a routine blood test. Symptoms of iron-deficiency anemia are related to decreased oxygen delivery to the entire body

  • Being pale or having yellow "sallow" skin
  • Unexplained fatigue or lack of energy
  • Shortness of breath or chest pain, especially with activity
  • Unexplained generalized weakness
  • Rapid heartbeat
  • Pounding or "whooshing" in the ears
  • Headache, especially with activity
  • Craving for ice, starch, dirt or clay - "picophagia"
  • Sore or smooth tongue  (atrophic glossitis), angular cheilosis
  • Brittle nails or hair loss or koilonychia

DIAGNOSIS OF IDA:

Blood film shows microcytic, hypochromic anaemia with anisocytosis and poikilocytosis

A complete blood count (CBC), confirmed by ferritin, TIBC, iron serum. anemic from iron deficiency  usually show the following results:

  • Low hemoglobin (Hg) and hematocrit (Hct)
  • Low mean cellular volume (MCV)
  • Low ferritin
  • Low serum iron (FE)
  • High transferrin or total iron-binding capacity (TIBC)
  • Low iron saturation

Consider coeliac serology. Stool microscopy for ova gastroscopy or colonoscopy, etc.

PREVENTION :

  • Choose iron-rich foods:

Red meat, pork and poultry, Seafood, Beans, Dark green leafy vegetables, such as spinach, Dried fruit, such as raisins and apricots, Iron-fortified cereals, breads and pastas, Peas etc.

  • Choose foods containing vitamin C to enhance iron absorption:

You can enhance your body's absorption of iron by drinking citrus juice  eating other foods rich in vitamin C  like orange juice or eating other foods rich in vitamin C like Broccoli, Grapefruit, Kiwi, Melons, Strawberries, Tomatoes at the same time that you eat high-iron foods.

  • Preventing iron deficiency anemia in infants:

Feed your baby breast milk or iron-fortified formula for the first year. After age 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake.

TREATMENT :

  • Treat the cause.
  • Oral iron: Your doctor may recommend over-the-counter iron tablets in salts form like ferrous sulphate, fumarate or gluconate to replenish the iron stores in your body. Your doctor will let you know the correct dose for you as the amount of elemental iron varies with different preparations.. Iron is also available in liquid form for infants and children. To improve the chances of absorption, you might be instructed to take  iron tablets on an empty stomach with vitamin C. Take iron two hours before or four hours after you take antacids as it can interfere with the absorption of iron. Side effects of oral iron are nausea, abdominal discomfort, diarrhoea or constipation. You may need to take iron supplements for several months or longer to replenish your iron reserves. Generally, you'll start to feel better after a week or so of treatment. Ask your doctor when to have your blood rechecked to measure your iron levels.  The usual reason that IDA fails to respond is that the patient has rejected the pills - CHECK COMPLIANCE.
  • IV iron: is only indicated if the oral route is impossible or ineffective like Iron dextran, Iron sucrose or Ferric gluconate
  • Blood Transfusions: Red blood cell transfusions may be given to patients with IDA who are actively bleeding or having  significant severe symptoms.

Iron deficiency anemia isn't something to self-diagnose or treat. So see your doctor for a diagnosis rather than taking iron supplements on your own. Overloading the body with iron can be dangerous because excess iron accumulation can damage your liver and cause other complications .

    

     SO HELLO TO IRON AND LIVE LONG.. LIVE STRONG…..

DR. Neha N. Lohiya

General practitioner