Iron deficiency (medicine)
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Iron deficiency (or "sideropenia") is the most common known form of nutritional deficiency. In the human body, iron is present in all cells and has several vital functions -- as a carrier of oxygen to the tissues from the lungs in the form of hemoglobin, as a facilitator of oxygen use and storage in the muscles as myoglobin, as a transport medium for electrons within the cells in the form of cytochromes, and as an integral part of enzyme reactions in various tissues. Too little iron can interfere with these vital functions and lead to morbidity and mortality.
The direct consequence of iron deficiency is iron deficiency anemia. Groups that are most prone to developing this disease are children, and pre-menopausal women.
Total body iron averages approximately 3.8 g in men and 2.3 g in women. There are several mechanisms that control human iron metabolism and safeguard against iron deficiency. The main regulatory mechanism is situated in the gastrointestinal tract. When loss of iron is not sufficiently compensated by adequate intake after some time that is determined by the state of body iron storage, iron deficiency develops.
Causes
- chronic bleeding (hemoglobin contains iron)
- * excessive menstrual bleeding
- * non-menstrual bleeding
- * bleeding from the gastrointestinal tract (ulcers, hemorrhoids, etc.)
- * rarely laryngological bleeding or from the respiratory tract
- inadequate intake (special diets low in dietary iron)
- substances (in diet or drugs) interfering with iron absorption
- malabsorption syndromes
- genetic defects of iron metabolism
Symptoms
Symptoms of iron deficiency are not characteristic, however the following may be present:- Pale skin color (pallor)
- Fatigue
- Irritability
- Weakness
- Shortness of breath
- Sore tongue
- Brittle nails
- Unusual food cravings, such as pagophagia, the excessive eating of ice
- Decreased appetite
- Headache
Likely lab test results in people with iron deficiency
- A full blood count would likely reveal microcytic anemia
- Low serum ferritin
- Low serum iron
- High TIBC (total iron binding capacity)
- A possibly positive fecal occult blood test, if iron deficiency is the result of gastrointestinal bleeding.
Consequences
Continued iron deficiency may lead to worsening anemia and fatigue. Thrombocytosis, or an elevated platelet count, can also result. A lack of iron in the blood is a reason that some people cannot donate blood.Treatment
Before any treatment is commenced there should be definitive diagnosis of the underlying cause for iron deficiency, particularly in older patients who are most susceptible to colorectal cancer.If the cause is benign, temporary or not easily treatable, people can receive iron supplements, e.g. in the form of ferrous sulfate or amino acid chelate tablets.
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