19 April, 2024

Iron, an essential fuel

2 basics:
*Iron is an essential nutrient of the human body
*Low iron level (iron deficiency) is prevalent among Indians

2 reasons:
*Blood loss (examples include menstrual loss, stomach ulcers, intestinal worms, etc.)
*Reduced intake (restricted diet, poor oral intake)

2 tests:
*Hemoglobin level (a complete profile is called Hemogram, or Complete Blood Picture – CBP)
*Transferrin saturation (TSAT), Serum Ferritin level (often combined in a panel called ‘Iron studies’)

2 medicines:
*Oral iron supplements (usually given as a daily tablet or syrup)
*Intravenous (injectable) iron therapy (usually given as a single dose, repeated every few weeks for a total of 2-6 doses)

Discussion on Iron deficiency:
Iron deficiency is most commonly associated with anaemia (low haemoglobin). However, a spectrum of iron deficiency-related disorders appear before anaemia develops.

Milder forms of iron deficiency can lead to:
1. Generalized fatigue, weakness, reduced exercise capacity
2. Brittle nails, thin hair (or early hair loss), thin skin
3. Restless leg syndrome (RLS). Patients with RLS have disturbed sleep and often wake up with a vague discomfort or pain in their legs.
4. Early memory loss
5. Reduced immunity
6. Poor cardiovascular health

Iron deficiency anaemia (IDA) is low haemoglobin due to reduced iron levels. It is often discovered during routine blood tests. A milder form of IDA has symptoms like weakness and fatigue, but patients with severe IDA (haemoglobin level less than 8) often have shortness of breath, dizziness, chest discomfort, fainting, etc.
*Women with IDA have a higher risk for infertility.
*Patients with heart disease (heart failure) tend to do poorly if they have iron deficiency.

Patients with low iron levels should consume food items rich in iron content, as listed below.
Veg: Spinach, Peas, Broccoli, Green beans, Beetroots, Sweet potatoes, Kale, Lentils, Strawberries, Watermelon, Dates, Raisins, Dried apricots, and many more
Non-veg: Meat products including Chicken, Liver, Eggs

*Patients who remain iron deficient even after dietary adjustments should be started on iron supplementation therapy.
*Oral iron tablets are readily available and should be taken with the dominant meal of the day. Common side effects of oral iron therapy are abdominal bloating, constipation, and excessive gas.
*Iron injections are given if side effects related to oral tablets are too disturbing, or blood iron levels fail to increase even after 3 months of therapy. Sometimes, iron injections are given if a quick response is desired. For patients with heart failure, iron injections are preferred over tablets. Iron injections should always be administered under close nursing supervision.
*Blood transfusion may be necessary if haemoglobin levels are very low.

I am sure I didn’t answer all your questions on this topic. Feel free to message me with your queries; I will happily answer them.

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