Ancient medical system Siddha has recognized the medicinal and therapeutic values of iron. Iron deficiency is a widespread condition that affects various biological functions. Iron is an abundant element on earth and is biologically essential for every living organism. Inorganic iron is needed for haemoglobin synthesis and iron deficiency can lead to severe health issues, especially in the context of anaemia.
Physiology of iron
In the human body, iron exists mainly in complex forms bound to proteins as heme compounds like haemoglobin, myoglobin, heme enzymes, and non-heme compounds. The body requires iron for the synthesis of its oxygen transport proteins, particularly haemoglobin and myoglobin, and formation of heme enzymes and other iron-containing enzymes involved in electron transfer and oxidation-reductions.
Iron also plays a vital role in the production of energy. It helps in the functioning of mitochondrial enzymes that are crucial for cellular respiration. Without adequate iron, these processes become less efficient, leading to reduced energy levels and overall fatigue, a common symptom of iron deficiency.
Almost two-thirds of body iron is found in the haemoglobin present in circulating erythrocytes (red blood cells). 25% is contained in a readily mobilizable iron store, and the remaining 15% is bound to myoglobin in muscle tissue. When iron deficiency occurs, these stores are depleted, leading to an increased risk of anaemia.
In the event of blood loss or iron deficiency, the body tries to make up for the loss by using these reserves. However, if the deficiency persists, the body's ability to produce enough healthy red blood cells declines, which contributes to iron deficiency anaemia.
Types of iron
Dietary iron occurs in two forms – heme iron and non-heme iron. The primary sources of heme iron are haemoglobin and myoglobin from consumption of meat, poultry, and fish. Non-heme iron is obtained from cereals, pulses, legumes, fruits, and vegetables. Iron deficiency may occur if the body is not absorbing enough non-heme iron or if dietary intake is insufficient, increasing the risk of anaemia.
It is important to note that the absorption of iron from plant-based foods (non-heme iron) is less efficient than that from animal-based sources (heme iron). Factors like vitamin C can enhance the absorption of non-heme iron, while foods high in calcium or tannins can inhibit it.
Iron requirements
During early infancy, iron requirements are met by maternal milk. However, the iron requirement increases to 11 mg/day from 4-6 months to 1 year. Iron deficiency is more likely in periods of rapid growth, such as adolescence, and during pregnancy. Adults generally require about 8 mg of iron per day, adult women need 18 mg/day, and pregnant women need 27 mg/day to prevent iron deficiency anaemia.
In older adults, iron deficiency can be common due to reduced absorption and dietary intake. Postmenopausal women typically need 8 mg/day, similar to men, due to the absence of menstrual blood loss.
Causes of iron deficiency
Iron deficiency results from the depletion of iron stores due to poor absorption, poor intake, or blood loss. The primary causes of iron deficiency include:
- Low intake of bioavailable iron
- Increased iron requirements during rapid growth, pregnancy, and menstruation
- Excess blood loss due to various pathologies, such as gastrointestinal bleeding, ulcers, or heavy menstrual periods
- Worm infestations that consume iron from the body
- Impaired absorption of iron, which may be due to conditions like celiac disease or inflammatory bowel disease (IBD)
Consequences of iron deficiency
Iron deficiency is a condition in which there are no mobilizable iron stores and signs of a compromised supply of iron to tissues. Iron deficiency can exist with or without anemia. Some functional changes may occur in the absence of anemia, but mostly these occur with the development of anemia. Even mild and moderate forms of iron deficiency anemia can be associated with cognitive impairments, compromised immunity, and reduced work capacity.
For children, iron deficiency can impair cognitive and behavioral development, affecting learning ability and motor skills. Pregnant women with iron deficiency are at a higher risk of complications like preterm delivery, low birth weight, and post-partum hemorrhage.
Iron deficiency anemia also contributes to symptoms like fatigue, weakness, paleness, and dizziness, making daily tasks more difficult to manage.
Prevention of iron deficiency
The following four strategies can be used to correct iron deficiency, either alone or in combination:
- Adapt food diversification: Include both heme and non-heme sources of iron in the diet.
- Take oral iron supplementation: For individuals with diagnosed iron deficiency, supplements are often necessary.
- Intake of iron-fortified foods: Many foods like cereals and breads are fortified with iron, which can help improve intake.
- Prefer bio-fortified foods: Choose foods that are naturally enriched with higher levels of nutrients, including iron, through bio-fortification methods.
Conclusion
Iron deficiency is easily preventable with proper diet and supplementation Ensuring adequate iron intake is crucial for maintaining energy, immune function and overall well-being. Proper management of iron deficiency ensures better health outcomes, particularly during pregnancy, childhood and periods of growth.