The Hemoglobin, Iron Deficiency Anemia (IDA)

Questions & Answers How much iron do we need every day? The required iron intake is based on daily iron losses via faeces, urine and sweat and amounts to approximately 1 mg per day. Women also lose blood during menstruation. During growth and pregnancy the required iron intake is higher. However, dietary iron intake of the required amount of around 1 mg per day is not enough as only approximately 10-15% of dietary iron is actually available to the body. The German Nutrition Society (DGE) took this into account in its iron intake recommendations by recommending a daily intake of between 10 and 15 mg per day for adolescents and adults and of between 8 and 10 mg iron per day for children to cover the daily iron requirement of around 1 mg. A far higher intake is recommended for pregnant and breastfeeding women of 30 and 20 mg per day, respectively. Why do women need so much iron during pregnancy? During pregnancy the required iron intake increases because the placenta and uterus must a...

Treatment Treatments for anemia depend on severity and cause . Treatment by oral administration of iron in the form of ferrous sulphate tablets. This must be continued for 4-6 months to replenish iron stores . Any underlying cause should be treated. Parenteral iron is used if the patient has malabsorption or cannot tolerate oral preparation. Iron deficiency from nutritional causes is rare in non-menstruating adults (men and post-menopausal women). The diagnosis of iron deficiency mandates a search for potential sources of loss such as gastrointestinal bleeding from ulcers or colon cancer. Mild to moderate iron deficiency anemia is treated by oral iron supplementation with ferrous sulfate, ferrous fumarate, or ferrous gluconate. When taking iron supplements, it is very common to experience stomach upset and/or darkening of the feces. The stomach upset can be alleviated by taking the iron with food; however, this decreases the amount of iron absorbed. Vitamin C aids in the body...

Diagnosis Gold standard Traditionally, a definitive diagnosis requires a demonstration of depleted body iron stores by performing a bone marrow aspiration, with the marrow stained for iron. Because this is invasive and painful, while a clinical trial of iron supplementation is inexpensive and non-traumatic, patients are often treated based on clinical history and serum ferritin levels without a bone marrow biopsy. Anemia may be diagnosed from symptoms and signs, but when anemia is mild it may not be diagnosed from mild non-specific symptoms. Pica, an abnormal craving for dirt, ice, or other "odd" foods occurs variably in iron and zinc deficiency, but is neither sensitive or specific to the problem so is of little diagnostic help. Anemia is often first shown by routine blood tests, which generally include a complete blood count (CBC) which is performed by an instrument which gives an output as a series of index numbers. A sufficiently low hemoglobin (HGB) by defini...

Symptoms and signs The signs and symptoms of iron-deficiency anemia are often only apparent when the haemoglobin level drops below 8g/dL. The hematological findings are: A microcytic, hypochromic anemia Reduced serum iron and ferritin (to distinguish from thalassemia syndrome)   Increased serum transferrin and total iron binding capacity (TIBC), to distinguish from anaemia of chronic disease) Reduced plasma transferrin saturation Absence of iron stores demonstrated on bone-marrow smear Iron deficiency anemia is characterized by pallor (reduced amount of oxyhemoglobin in skin or mucous membrane), fatigue and weakness. Because it tends to develop slowly, adaptation occurs and the disease often goes unrecognized for some time. In severe cases, dyspnea (trouble breathing) can occur. Unusual obsessive food cravings, known as pica, may develop. Pagophagia or pica for ice is a very specific symptom and may disappear with correction of iron deficiency anemia. Hair loss and ...

Causes of iron deficiency anemia include: Blood loss Blood contains iron within red blood cells. If you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin. Acute blood loss Causes of acute blood loss include trauma, surgery, peripartum haemorrhage, haematemesis and haemoptysis. plasma volume is replaced within 1 to 3 days of the acute blood loss but it can take several weeks for the red cell mass, and therefore hemoglobin to be replenished. Chronic blood loss The most common causes of chronic blood loss are gastrointestinal lesions and menorrhagia. The consequences are those of iron deficiency   A lack of iron i...

Hemosiderin is type of Iron storage  Hemosiderin is defined as non-heme, cytoplasmic iron that is insoluble Hemosiderin iron can be used physiologically. A variety of studies converge on the conclusion that hemosiderin is derived from ferritin. Hemosiderin is an iron-storage complex that is composed of partially digested ferritin and lysosomes. The breakdown of heme gives rise to biliverdin and iron. The body then traps the released iron and stores it as hemosiderin in tissues. Hemosiderin is also generated from the abnormal metabolic pathway of ferritin. It is only found within cells (as opposed to circulating in blood) and appears to be a complex of ferritin, denatured ferritin and other material. The iron within deposits of hemosiderin is very poorly available to supply iron when needed. Hemosiderin is most commonly found in macrophages and is especially abundant in situations following hemorrhage, suggesting that its formation may be related to phagocytosis of red blood...

 I ron Distribution in Human Body The most (about 2500 mg) of the total iron pool is contained in the erythrocytes as hemoglobin bound active iron. A further 400 mg is required as active iron in myoglobin and various enzymes. Only a small fraction (approx. 4 mg) of the body's total iron pool is in the form of transferrin-bound transport iron in the blood plasma.   It is thus once again clear that the measurement of iron in plasma does not provide a true picture of the available storage iron. The total iron store of the body is around 4g, mainly as hemoglobin. The daily requirement is normally around 1mg.   Iron Storage in Human Body Iron is stored in the form of ferritin or its semicrystalline condensation product hemosiderin in the liver, spleen, and bone marrow. Every cell has the ability to store an excess of iron through ferritin synthesis. The transferrin-Fe3+ complex is bound to the transferrin receptor of the cell membrane. Iron uptake can therefor...