iron | What we need to know

Iron is one of the most important elements of blood. It ensures the course of vital processes in the body, such as the formation of red blood cells, oxygen supply to various parts of the body, proper functioning of the thyroid gland, DNA synthesis, immune function, etc. Approximately 70% of the body's iron reserves are found in hemoglobin.

Iron deficiency causes anemia. At this time, the tissues are not supplied with the required amount of oxygen. Anemia is characterized by: impairment of working capacity, memory, concentration and other mental functions, as well as weakness, headache, dizziness, acceleration of the heart rate, decrease of the immune system, etc.

Iron is a major component of hemoglobin, a type of protein in red blood cells that carries oxygen from the lungs to all parts of the body. Without iron, red blood cells will not be able to carry oxygen, so iron deficiency will cause health problems. Iron is also part of myoglobin, a protein that carries and stores oxygen specifically in muscle tissues. Iron is important for healthy brain development and growth in children, as well as for the normal production and function of various cells and hormones.

There are two types of iron: heme and non-heme. Dairy and vegetable products contain non-heme iron, and animal products contain partly heme and partly non-heme iron. Heme iron is easily absorbed by the body, while non-heme iron is relatively difficult to absorb. That is why, in the case of a vegetarian diet, fasting or any type of plant-based diet, it is important, in order to facilitate the absorption of non-heme iron, to take food elements that promote iron absorption along with iron. This is, for example, vitamin C.

Iron is stored in the body as ferritin (in the liver, spleen, muscles, and bone marrow) and transported throughout the body via transferrin (a blood protein that binds iron). A doctor can sometimes check blood levels of these two components if anemia is suspected.

Food sources

Meat, poultry and seafood are rich in heme iron. Grains, nuts, seeds, legumes and vegetables contain non-heme iron.

Heme iron is better absorbed by the body than non-heme iron. Several factors can improve or impair the absorption of non-heme iron. Bran, large amounts of calcium, especially from supplements and plant substances such as phytates and tannins, can interfere with the absorption of non-heme iron.

Absorption of non-heme iron is also improved by foods containing vitamin C.

Tea, coffee, milk and dairy products, on the contrary, reduce it.

Sources of Heme Iron:

• oysters, mussels;
• beef liver;
• canned sardines;
• Beef;
• poultry farming;
• Tuna.

Sources of non-heme iron:

• processed breakfast cereals;
• bean;
• dark chocolate (at least 45%);
• Lentils;
• Spinach
• potatoes with skin;
• nuts, seeds;
• rice
• bread
• lettuce leaves;
• garlic;
• beet;
• Walnut;
• dried apricots.

iron supplements

Iron is available as a supplement. Some cereals and multivitamin/mineral supplements contain iron. 100% of the recommended daily dose for women (18 mg). For people with or at high risk for iron deficiency anemia, over-the-counter iron supplements may contain 65 mg or more. Common side effects of high-dose iron supplements include constipation and nausea.

Always consult a specialist and follow his instructions.

Signs of deficiency and toxicity

deficit

Iron deficiency is most common in children and women.

Iron deficiency occurs gradually. [4] The primary stage begins with depletion of iron stores in the body, usually due to poor diet or excessive bleeding. If this is not resolved, the next stage is more iron depletion and a drop in red blood cells. This eventually leads to iron deficiency anemia (IDA), in which iron stores are depleted and the total number of red blood cells is reduced as well.

As a rule, a doctor starts screening for anemia first by checking a complete blood count (including hemoglobin, hematocrit, and other factors that measure the volume and size of red blood cells). If this is below normal, ferritin and transferrin levels can be measured to determine whether the anemia is of the 'IDA' type (there are other forms of anemia that are not specifically caused by iron deficiency).

"IDA" signs:

Anemic syndrome is manifested by non-specific symptoms:

• Dizziness;
• tinnitus;
• increased heart rate;
• Fatigue, weakness;
• confusion, loss of concentration;
• sensitivity to cold;
• ერის Air shortage;
• Rapid heartbeat;
• pale skin;
• Hair loss, brittle nails.

The disease usually develops slowly. Most of the patients are used to their condition and consult a doctor only in case of severe anemia.

Other symptoms (with sideropenic syndrome):

• Skin and mucous membranes - dryness, damage to hair and nails;
• Gastrointestinal tract – dysphagia, constipation, diarrhea, loss of appetite or perversion (pathophagia) – desire to eat chalk, earth, raw meat mince, pathosomia – unusual tendency towards smells (acetone, petrol and others);
• Nervous system - easily tired, tinnitus, dizziness, decreased intellectual abilities;
• Vascular system – tachycardia.

Groups at risk of IDA:

• Pregnant women – During pregnancy, a woman produces a lot more red blood cells for the fetus, which increases the need for extra food or extra iron. During pregnancy, IDA can cause premature birth or low birth weight, so iron is usually included in prenatal vitamins. The Centers for Disease Control and Prevention recommends that all pregnant women begin taking 30 mg of supplemental iron daily.
• Children – Babies and children have a high iron requirement due to rapid growth.
• Elderly – Older age is associated with a higher risk of poor nutrition and chronic inflammatory diseases that can lead to anemia. [1]
• Vegetarians – those who eat a diet without heme iron from meat, fish and poultry may develop IDA. Since non-heme iron is poorly absorbed, large amounts of these foods may be needed, or special attention should be paid to their foods to improve absorption (eating with foods rich in vitamin C and avoiding calcium-rich foods, calcium supplements. or tea).
• Athletes - Running can cause gastrointestinal bleeding and a condition called "kicking" hemolysis, in which red blood cells are destroyed more quickly. Female athletes are at greatest risk of IDA. [4]
• People with chronic kidney disease on dialysis – The kidneys produce the hormone erythropoietin (EPO), which signals the body to make red blood cells. Kidney failure reduces the production of EPO and therefore blood cells. In addition, there is some blood loss during hemodialysis.

toxicity

Toxicity is rare because the body regulates iron absorption and less is absorbed if iron stores are adequate.[2] Excess iron is most often caused by taking high doses of supplements when they are not needed, or by genetic diseases in which too much iron accumulates.

General signs:

• Constipation;
• diarrhea;
• Nausea, vomiting;
• Pain in the abdomen.

Some people have an inherited disease called hemochromatosis, which causes excess iron in the body. Treatment is given periodically to remove excess iron from the blood or blood. People with hemochromatosis are prescribed an iron diet. If not treated in time, iron can accumulate in certain organs, which increases the risk of developing diseases such as liver cirrhosis, liver cancer or heart disease.

Treatment

• Treatment of iron deficiency, of course, involves its elimination. First of all, the cause of the deficiency should be found out. If he is a foodie, we should focus on the diet. When there is an increased need for iron, sometimes it is not enough to adjust the diet - it is also necessary to take supplements.
• If iron deficiency is the cause of the blood loss, we must determine its cause - allowing it to happen may lead to serious complications. We may need it for that Stool analysis To detect occult bleeding from the gastrointestinal tract and other instrumental studies.
• Anemia may not be caused by iron deficiency, but by other factors, against the background of which iron preparations cannot be taken, so we must first find the cause. for that with general blood analysis We will also need to determine the iron content in the blood. After finding the cause, appropriate treatment will be prescribed. But remember - supplements alone will not help you, you will have to adjust your diet in any case.

source

1.  Le CH. The prevalence of anemia and moderate-severe anemia in the US population (NHANES 2003-2012). PLoS One. 2016 Nov 15;11(11):e0166635.
2.  Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc : a Report of the Panel on Micronutrients. Washington, DC: National Academy Press; 2001.
3.  National Institutes of Health Office of Dietary Supplements: Iron Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/. Accessed 9/2/2019.
4.  Powers JM, Buchanan GR. Disorders of Iron Metabolism: New Diagnostic and Treatment Approaches to Iron Deficiency. Hematology/Oncology Clinics. 2019 Jun 1;33(3):393-408.
5.  https://www.hsph.harvard.edu/nutritionsource/iron/

Alexander Tsintsabadze