Clinical consequences of iron deficiency in the body

Read Time:7 Minute, 27 Second

Iron deficiency in the human body is the most frequent case of a chemical element deficiency in the whole world. It is economically important because it reduces the ability of individuals to cope with physical work and reduces both growth and learning in children.

Of more than 100 chemical elements that exist in nature, only 26 of them are important for the structural construction and functioning of the human organism.

Of them, 15 are essential microelements; they are in very small quantities in the body, they are not synthesized by it, so they must be taken from outside through food. One of them is exactly iron.

If a definition were needed to understand what iron deficiency is, then we would describe it as a decrease in the total content of this microelement in the body. Deficit which is related to the reduction of its absorption by the gastro-intestinal apparatus, but primarily to its losses through hemorrhages of various forms, which in most cases are very small, often underestimated, but which are extended in time.

In healthy people, the concentration of iron in the body is perfectly regulated by the enterocytes of the proximal part of the small intestine. Thus, enterocytes regulate the absorption of iron obtained through different foods, depending on the daily amount of iron loss in order to maintain a constant iron balance. Persistent errors in iron balance cause; iron deficiency anemia – its negative balance, i.e. losses greater than absorption, or hemosiderosis – its positive balance, i.e. losses smaller than the amount introduced into the body. Both are diseases with significant consequences.

Iron deficiency is the most preventable nutritional problem. It is almost eliminated in developed countries, but 750 million children in developing countries have Ferriprive Anemia.

Iron deficiency anemia

Red blood cells, erythrocytes, are among the most perfect cells of the organism because they have no nucleus, no organelles, provide the largest surface for a given volume, provide the necessary energy from not very effective pathways such as anaerobic glycolysis , spend many times a day in microcirculation (mechanical and hypoxic stress), every 20 seconds they circulate throughout the body and all this for 120 days. So this cell makes “these sacrifices”; it almost completely empties the cytoplasm and takes the form of a biconcave disc to fill with a major pigment, hemoglobin, centered on an iron atom. It is the hemoglobin of red blood cells and precisely the iron atom that transports oxygen to all tissues. Iron deficiency in the body is followed, among others, by the decrease of hemoglobin in red blood cells. Precisely the quantitative reduction of hemoglobin is known as anemia and pointing out the cause, the anemia is described as iron deficiency; therefore, due to iron deficiency.

Iron deficiency anemia is the most common anemia in the world and very common in women in the reproductive period due to the constant bleeding of the menses during the menstrual cycle. Iron deficiency anemia is often called hemorrhagic anemia. So, in general, it is based on the loss of iron for various reasons, with the consequence of the reduction of its reserves in the body, and then it appears from the clinical and laboratory side. This means that if the cause is removed and the reservoirs are filled, with treatment that continues for at least 3 months, the anemia is cured and does not recur. If the cause persists, despite replenishment of stores, anemia will recur.

It should be emphasized that iron does not only participate in the transport of oxygen, but it serves as a cofactor of many enzymes of the organism with vital functions for it. So, the consequences of iron deficiency are not only hematological, but also non-hematological; rapidly proliferating tissues such as mucosal and skin epithelium are affected.

Clinical consequences of iron deficiency in the body

The clinical consequences of iron deficiency are; hematologic and non-hematologic.

Iron deficiency hematological clinic. Iron deficiency is expressed primarily with the development of iron deficiency anemia with the clinical syndrome of anemia:

Symptoms; weakness, fatigue, twitching, palpitations, difficulty breathing, headache, flies before the eyes, ringing in the ears. At advanced ages and when it is installed quickly, the symptoms of angina pectoris, etc. may appear.

General signs; pallor of the skin and mucous membranes which appear when Hb is less than 9-10 gr/dl). Anemia is best seen in mucous membranes; lips, mouth, pharynx, conjunctivae, ear lobes, palms of hands and soles of feet.

Clinic of non-hematological changes from iron deficiency

Epithelial changes; hair loss, cracked corners of the lips, nails, first brittle and then taking the form of scabs, glossy, pale, smooth tongue with varying degrees of redness and burning, difficulty in overcoming foods most pronounced in the place where the oropharynx passes into the esophagus.

Neuromuscular system changes; rapid muscle fatigue, nervous and behavioral disorders especially in children, decreased concentration of interest, impaired ability to maintain body temperature when exposed to cold, neuralgic pain, vasomotor disorders, decreased sensation and appetite or sensation of the bite.

Changes in immunity: Decreased immune function and more frequent infections as a result of iron deficiency.

General signs; pallor of the skin and mucous membranes which appear when Hb is less than 9-10 gr/dl). Anemia is best seen in mucous membranes; lips, mouth, pharynx, conjunctivae, ear lobes, palms of hands and soles of feet.

Clinic of non-hematological changes from iron deficiency

Epithelial changes; hair loss, cracked corners of the lips, nails, first brittle and then taking the form of scabs, glossy, pale, smooth tongue with varying degrees of redness and burning, difficulty in overcoming foods most pronounced in the place where the oropharynx passes into the esophagus.

Neuromuscular system changes; rapid muscle fatigue, nervous and behavioral disorders especially in children, decreased concentration of interest, impaired ability to maintain body temperature when exposed to cold, neuralgic pain, vasomotor disorders, decreased sensation and appetite or sensation of the bite.

Changes in immunity: Decreased immune function and more frequent infections as a result of iron deficiency.

Treatment of iron deficiency

1. Eliminating the cause if possible

2. Treatment with iron preparations

The most economical and effective medicine in the treatment of iron deficiency is the oral administration of iron sulfate salts. Ferrous sulfate is the most effective, best tolerated and least expensive preparation. Currently, in Albania, Ferric sulfate is available in the form of Retafer, which contains 100 mg of elemental iron. The daily therapeutic dose of iron is 180-200 mg elemental Fe. This means that you need two tablets a day. Iron is better absorbed when taken on an empty stomach, while when taken after food or together with it, absorption of iron decreases by 40-50 percent. But irritation of the gastro-intestinal mucosa is common when iron is taken on an empty stomach. The goal of treatment is not only the rate of Hb increase, but also the patient’s well-being. Therefore, the patient is advised to take the iron preparation in the middle of the meal or after it, because the support of the medication is more important than the reduction of iron absorption. Iron absorption increases when the preparation is taken in the presence of orange or lemon juice, meat, fish, Vitamin C and is inhibited when taken in the presence of milk, tea, tetracycline, quinolones, methyldopa, calcium and cereals. And the amount of food matters. The greater the amount of food eaten, the better the iron preparation will be tolerated. It has also been seen that iron is well tolerated when taken by increasing the dose gradually until the full dose of the preparation is reached in a few days. If irritation of the gastrointestinal mucosa occurs and when the degree of anemia is mild and/or the cause is removed, iron deficiency anemia can be treated with a therapeutic dose of iron up to 100 mg/day. In this way, we reduce the speed of the response to the medication, but increase the tolerance to it.

If the patient does not tolerate Ferric sulfate, other iron salts can be used: gluconate, fumarate, lactate, succinate. Some of them are more expensive than Ferric sulfate. In some cases, iron deficiency can be corrected by taking iron intramuscularly or intravenously. It should be noted that it is not only more expensive than oral medication, but also has the risk of a number of side effects, and it is preferable to do it in specialized centers. .

As a rule, the treatment continues for a minimum of 3 months; 6 weeks to eliminate the iron deficiency syndrome and 6 weeks to fill the stores. But it can continue longer if the cause is not eliminated. So the goal of the treatment is not simply to normalize the symptoms and signs of iron deficiency, but also to normalize the number of red blood cells and hemoglobinemia and to fill the stores. Replenishment of stores is assessed by normalization of ferritinemia.

Happy
Happy
0 %
Sad
Sad
0 %
Excited
Excited
0 %
Sleepy
Sleepy
0 %
Angry
Angry
0 %
Surprise
Surprise
0 %
Previous post Is the age of tanks coming to an end?
Next post Urinary infections, how to treat them