Iron is essential for the existence of most life forms and is a mineral that is found abundantly on earth. It is also found in many enzymes and proteins and is critical for good health. In human beings, iron serves many roles – it is needed for cell growth, as part of proteins, iron helps in oxygen transport in the blood. Iron deficiency can result in decreased immunity, fatigue and poor work performance while an excess in the blood can result in toxicity.
Causes for iron deficiency
Those who have low levels of iron become anemic. Iron deficiency anemia prevents the body from producing the required quantities of hemoglobin. This could be due to various reasons and an astonishing 80% (WHO sources) suffer from this. Out of this 30% will have such low levels of iron that it can cause anemia.
Menstruating women : During the time of menstruation, heavy loss of blood can cause iron deficiency. Even after menopause, women can become anemic. Teenagers who are menstruating and have poor diets can have low levels of iron that can weaken memory and learning functions.
Pregnant women are a very vulnerable group. During pregnancy, women need extra iron stores to feed their own increased need and that of the growing fetus. Iron deficiency in pregnant women can lead to preterm or small babies who are more likely to die early or have more health problems than full term babies have.
Excessive bleeding : People suffering from ulcers or hemorrhoids have excessive bleeding. Bleeding can also occur due to regular use of aspirin. Hiatal hernia, colorectal cancer and colon polyp can also cause excessive bleeding leading to anemia.
Poor absorption of iron : Iron deficiency occurs when iron absorption is affected. This can be due to various reasons and usually begins gradually when the daily iron intake does not match the requirement of the individual. Initially the stored iron is depleted to meet the deficiency and blood hemoglobin levels remain the same. Anemia owing to iron deficiency occurs when stored levels of iron are not enough to meet the daily needs and blood hemoglobin levels drop.
Low absorption levels of iron can occur due to celiac disease. It can occur when part of the stomach or small intestine has been surgically removed for various reasons such as bariatric surgery for weight-loss. Stomach conditions like hookworms and food sensitivity increase the need for iron. Those who have acid reflux and peptic ulcers may take antacids for long periods. This prevents optimal absorption of iron by reducing acid in the stomach.
Toddlers and older infants who are growing fast need plenty of iron that they may not get from food. The highest levels of deficiency in small children are between 6 months to 3 years. An extremely vulnerable section is low birth weight or preterm infants. If the mother suffers from anemia, then a breastfed infant can also do so. Babies fed cow’s milk before they are a year old, breastfed babies older than 6 months who are not given iron-fortified foods, babies given formulas not enriched with iron can all suffer from iron deficiency. Children between 1-5 years who are given more milk – soymilk, cow or goat’s milk – than iron-rich solid foods and children with special health needs like restricted diets are all at risk of becoming anemic.
Recommended Dosage of Iron
Type of Food consumed : The type of food we consume can lead to lower levels of iron. Hence, vegetarians can suffer deficiency since their food is low in heme iron. Excessive consumption of coffee, tea, whole grains, milk and legumes can reduce the amount of non-heme iron absorbed by the body.
Other causes for iron deficiency include those undergoing dialysis for kidney failure, those who suffer from arthritis or who work out intensely.
Symptoms of iron deficiency
Initial signs of anemia due to iron deficiency may not be noticed. As anemia worsens, the following signs can appear.
- Tiredness and overall weakness
- Decreased performance at work or school due to trouble concentrating
- Fluctuating body temperature
- Increased propensity to contract illness due to lowered resistance and poor immunity
- Glossitis (inflamed tongue)
- Shortness of breath
- An increased heart beat
- Cold feet and hands
- Sores at the corners of the mouth
- Hair loss
- Brittle nails
- Difficulty in swallowing in acute cases of anemia
- An irrational craving to eat non-nutritive substances like starch, dirt or ice
- Restless legs syndrome – uncomfortable crawling or tingling feeling in the legs
In infants and small children, anemia will manifest itself in the following ways:
- Low attention span
- Excessive fussiness and crying
- Slow growth and development
- Skills such as talking or walking will develop later than normal
It is important to note such signs and get an evaluation quickly. If anemia in this age group is not treated quickly, it can lead to behavioral and mental problems.
Diagnosis of anemia
If you or your children display the above signs, perhaps you are deficient in iron and need to see a doctor. The doctor will order a physical exam and run some blood tests. A complete blood count to check RBC levels in the blood determines the amount of iron.
Treatment of iron deficiency using iron supplements
Once the cause is determined, the appropriate treatment will be prescribed – usually by recommending iron supplements and iron-rich foods. The Recommended Dietary Allowances of iron is – 10mg for men and 15mg for women. Iron supplements for children must be prescribed by the doctor. When anemia resulting from iron deficiency is very severe, a combination of iron and blood will be given intravenously in hospital.
There are several forms of iron supplements available – the most common being ferrous sulfate. Other forms are – ferrous succinate, ferrous fumarate, ferrous gluconate, ferrous glutamate, ferrous lactate, ferrous glycine and ferrous ammonium citrate. The aim of iron supplements is to build-up iron levels and blood hemoglobin in the body. The amount of iron supplements we need depends on the age, gender and health of the individual. Growing children need more iron than adults do. When a woman reaches puberty her iron requirement increases. After menopause, both women and men require the same quantity of iron.
Precautions while using iron supplements
Dietary supplements must be taken under medical supervision since there can be potential side effects when supplements interact with other medications. Some of the side effects of taking iron supplements include diarrhea, nausea and heartburn. Stools of those who take iron supplements will be dark. Hemochromatosis is a disease that occurs due to excess of iron in the blood. This could be an inherited condition or occur gradually in those taking excess iron through food and supplements over a long period.
Symptoms of hemochromatosis include diabetes, skin discoloration and liver damage. The safe daily dosage is 45mg according to the USFDA. Severe overdose of iron (50-100 times recommended dosage) can result in destruction of the cells of the gastrointestinal tract, blood diarrhea, vomiting and in extreme cases of toxicity, even death. When iron is given intravenously to treat severe cases of anemia, some side effects include hives, swollen lymph nodes, fever and painful joints. In some rare cases, people can even develop allergy to IV iron and go into an anaphylactic shock.
As we have seen, iron is very important for overall good health and iron deficiency leads to many health problems that can worsen. Apart from dietary sources, good iron supplements can help to bridge this deficiency. So, find out if you are getting enough of iron and take steps to improve the deficiency if you are suffering from it.