Saturday, 26 July 2014

IRON DEFICIENCY ANEMIA

IRON DEFICIENCY ANEMIA 

Normally red cell of our blood carry oxygen from lungs to the required site hence in tissue low oxygen level lead to hypoxia of that tissue.There are 400 different types of anemia i-e Iron deficiency anemia,Aplastic anemia,Pernicious anemia,Macrocytic megaloblastic anemia,thalaseemia,sickle cell anemia....

Ideally speaking:
                      "anemia is condition in which total body RBCs mass is reduced "
Practically :
                      "anemia is any condition which reduce the PCV(pack cell volume)/hematocrit "
Generally :
                      "Anemia a condition in which the blood cell count less than normal value due to any reason"

IRON DEFICIENCY ANEMIA "anemia is due to iron deficiency "



TOTAL BODY IRON
Normal body store approx 2-5 gm ,condition like pregnancy ,lactation ... requires more iron that is the reason in USA every 6th women of reproductive age lack iron stores ,affect overall 3 million people .
Total iron in body has 2 forms
1. Functional iron
2. Storage iron






FUNCTIONAL IRON
This type of iron perform normal body functions and present in
1. Heamoglobin (in red blood cell of body )
2. Myoglobin (in muscle )                          
3. Enzymes(catalase,cytochrome)              






STORAGE FORM
This form of iron utilize when need ,present in
1. Ferritin(2/3 of store iron )       
2.Hemosiderin(1/3 of store iron )





DIETARY IRON

Off 2 type
1. Animal source
2. Vegetable source







ANIMAL SOURCE
Getting the iron from animals product i-e meat, liver,egg yolk ....,the iron we get is superior type of iron the Heme iron which has better bioavailability then inorganic iron (from vegetable source ), from which 10-20% absorb .






VEGETABLE SOURCE
Getting the iron from vegetable  product i-e fruits ....., inferior type of iron(inorganic iron ) only 1%is absorb.







 IRON LOSSES FROM BODY
IN MALE
1mg/day iron loss in feaces,exfoliated cells of sweat and GI tract .






FEMALE OF REPRODUCTIVE AGE
2-1.5mg/day loss ;during menstruation 30-50ml blood loss every month so loss of 1ml of blood mean 1mg of iron is lost hence female loss 30-50ml over a 4-5day equal to 30-50 mg of iron loss but over a month because other remaning days are not menstruating one more point is that female loss iron as male do additionally loss in menstruation that is the reason females are more anemic.







SYMPTOMS
A lot of symptoms including fatigue(not related to any other cause), dizziness .........






 CAUSES

FEMALE OF REPRODUCTIVE AGE
Female of reproductive age is prone to iron deficiency anemia due to highly loss of iron which can't replaced by dietary intake .






VEGETARIAN OR LOW IRON INTAKE
Strict vegetarians or low animal product consumption lead to low heme iron so body iron is utilizing and not getting enough iron to replace iron stores .






HEAVY MENSTRUAL BLEEDING
High loss of iron in bleeding lead to anemia because 1ml blood loss equal to 1gm iron loss.
COMPOUNDS NEGATIVE INFLUENCE ON INORGANIC IRON
Which interfere iron absorption i-e
  1. Phytates(in cereals ,wheat..)
  2. Tannates(in tea)
  3. Phosphates(in fruit ,vegetable )
  4. Carbonates(in food)
  5. Oxalate (in spanish ,tomatoes )






COMPOUNDS POSITIVE  INFLUENCE ON INORGANIC IRON

  1. Ascorbate(vitamin C)
  2. Citrate 
  3. Aminoacid
  4. Sugars (glucose)


ULCERS
Peptic ulcer intrup the iron absorption




COLON CANCER
Middle age man with unknown loss of iron develop anemia must suspect colon cancer until prove otherwise .






SEE THE DOCTOR
If you suspect your skin is pale, you suffer breathlessness ,tachycardia ,chest pain ,cold extremities and numbness in hand feet you must rush to the doctor for further evaluation .






TREATMENT
Get animal source iron initially then iron supplementation plus vitamin B-12 injections/supplementation.
B-12 is necessary because they highly concentrate in animal products and also require for nervous system ,lack of B-12 symptoms of nervous system ensure.
Pregnant women ;must take iron ,follic acid and B-12 supplements.
Note: if you started iron supplement must continue until 6 months because they fulfill body iron stores .