 Iron deficiency anemia
Clinical
biochemistry: Iron is an essential for
carrying oxygen in the body (respiration). A deficiency of iron leads to: limited
oxygen delivery to cells; fatigue, poor work performance; decreased immunity. Excess amounts of iron can result in toxicity
and can be very dangerous. Hemoglobin, the protein in red blood cells that carries oxygen to
tissues, contains almost two-thirds of iron in the body. Two forms
of dietary iron: heme and nonheme iron. Heme iron is derived from
hemoglobin. Heme iron is found in animal foods that originally contained
hemoglobin, such as red meats, fish, and poultry. Iron in plant foods such as
lentils and dry beans is called nonheme iron. This is the form of iron added to
iron-enriched and iron-fortified foods.
Nonheme iron occurs in two states in the body.
The state or form that is able to enter the cells of the intestine is
important. Taking vitamin C and
foods containing this vitamin (oranges, lemon, lime, red and green pepper [capsicum]
in the same meal along with dietary sources of iron will improve the absorption
of nonheme. This is owing to the
capacity of vitamin C to keep ion in the particular state that is able to enter
the cells of the intestine; tea, calcium, dry beans, peas (legumes), kale (dark
green vegetable), etc., consumed in the same meal, can decrease the absorption
of nonheme iron (due to the presence of phytates in these foods). It is most
important to include foods that enhance nonheme iron absorption when daily iron
intake is less than recommended, when iron losses are high. Some sources of nonheme
iron: fortified cereal, oat meal, dry
beans, soybeans, lentils, black eyed beans, etc.
Vitamin A deficiency may worsen exacerbate
iron deficiency anemia. Vitamin A supplementation has been shown to
have beneficial effects on iron deficiency anemia and improve iron status among
children and pregnant women. The combination of vitamin A and iron seems to improve
anemia more effectively than either iron or vitamin A alone. Adequate copper
nutritional status appears to be necessary for normal iron metabolism and
red blood cell formation. Anemia is a clinical
sign of copper deficiency. In anemia of iron
deficiency, red blood cells are measurably smaller than normal and their
hemoglobin content is decreased.
Ulcer
bacterium:
Helicobacter pylori (H. pylori) infection is associated
with iron deficiency anemia, especially in children. Plants, dairy products, meat, and iron
salts added to foods and supplements are all sources of nonheme iron. Iron supplements vary depending upon the iron
salt. Only a portion of the iron supplement is iron itself. Example: ferrous gluconate is
12% iron; ferrous fumarate is 33% iron.
When
chronic iron deficiency occurs in an individual, certain labs are recommended
to check for anemia. Recommended labs: Blood tests for hemoglobin, hematocrit,
iron, red blood cells (RBC), ferritin, transferrin, total iron binding capacity
(TIBC) and mean corpuscular hemoglobin (MHC) may be recommended by physician if
one’s symptoms do not improve.
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