Iron deficiency is the most common form of anaemia and usually results from blood loss. It can also be a result of malabsorption syndrome. symptoms are usually non-specific. RBCs tend to be microcytic and hypochromic and iron stores are low as shown in low ferritin levels and low serum iron levels with high serum total iron-binding capacity. If a diagnosis is made occult blood loss should be suspected until proven. Treatment involves iron replacement and treatment of the cause of blood loss.

Iron is distributed inactive metabolic acid and storage pools. Total body iron is about 3.5g in healthy men and 2.5 g in women, the difference relates to women’s smaller body size because of iron loss due to menses.

Iron absorption :

Iron is absorbed in the duodenum and upper jejunum. absorption of iron is determined by the type of iron molecule and by what other substances are ingested, Iron absorption is best when the food contains heme iron. Dietary no heme iron is usually in ferric state and must be reduced to the ferrous state and released from the food binders by gastric secretions. Non – heme iron absorption is reduced by other food items (for example vegetable fibre phytates and polyphenols, tea tannates )and certain antibiotics. Ascorbic acid is only  food element known to increase iron absorption

Iron transport and usage :

Iron from intestinal mucosal cells is transferred to transferrin an iron transport protein synthesized in the liver; transferring transports iron to the erythroblasts mitochondria which insert the iron into protoporphyrin for it to become heme. synthesis of transferring increases with iron deficiency but decreases with the type of chronic disease

Iron storage and recycling

Iron not used for erythropoiesis is transferred by transferring, an iron transporting protein to the storage pool. The iron is stored in two forms ferritin and hemosiderin. The most important group ferritin which is soluble and active storage fraction located in the liver, bone marrow and spleen . in RBCs and serum. Iron stored in ferritin is readily available for anybody requirement. Because iron absorption is limited, the body recycles and conserves iron. Transferrin grasps and recycles available iron from ageing RBCs undergoing phagocytosis by mononuclear phagocytes.

Iron deficiency

Iron deficiency develops in stages. In the 11 st stage iron requirement exceeds intake causing progressive depletion in bone marrow iron stores. As stores decrease, absorption of dietary iron increases in compensation. during later stages, deficiency impairs RBC synthesis ultimately causing anaemia. Severe and prolonged iron deficiency also may cause dysfunctioning of iron-containing cellular enzymes

Iron absorption and aetiology :

Because iron is poorly absorbed, dietary iron barely meets the daily requirement for most people. Even so, people who eat typically western diet are unlikely to become iron deficient solely as a result of dietary deficiency.

Blood loss

It is the commonest cause of the iron deficiency. In men and postmenopausal women, the most frequent cause is chronic occult bleeding usually from the GT tract (eg from the peptic ulcer disease . malignancy, haemorrhoids ) in premenopausal women, cumulative menstrual blood loss meaning 0.5 mg iron /day is a common cause.
Intestinal bleeding due to hookworm infection is a common cause in the developing countries Recurrent pulmonary haemorrhage.

Increase iron requirement

It may contribute to iron deficiency. From birth to age 2 and during adolescence when rapid growth requires a large iron intake dietary iron is often inadequate. During pregnancy, the fetal iron requirement is present despite the absence of menses. Lactation also increases the iron requirement.

Decreased iron absorption

Decreased iron absorption can result from gastrectomy or malabsorption syndromes such as celiac disease atrophic gastritis. rarely absorption is decreased by dietary depreciation due to undernutrition.

Signs and symptoms of iron deficiency

Most common signs and symptoms of iron deficiency is due to anaemia. such symptoms include fatigue loss of stamina, shortness of breath, weakness, dizziness and pallor, Another common symptom is restless leg syndrome which is an unpleasant urge to move the legs during the period of inactivity.

Koilonychia In addition to the unusual manifestation of anaemia some uncommon symptoms occur in severe iron deficiency. Patients may have pica, an uncommon craving to eat substances. Other symptoms of severe deficiency include glossitis, cheilosis and concave nails.

5 foods high in iron to add to your food

When it comes to getting enough vitamins and minerals you may focus on meeting your daily recommended values of calcium, potassium and vitamin c. But what about eating enough iron-rich foods. Iron is an essential mineral that provides oxygen from lungs to all parts of the body tissues and muscles. It is necessary to human development and growth as well as functions of our cells and even some hormones.

The best sources of iron are lean meats, chicken and fish. there are however plenty of plant-based iron supplement foods. Here are the most delicious iron-based foods you can add to your daily meals.

1) Spinach

this dark green leafy vegetable is packed with iron. Your body absorbs the best source of plant iron with vitamin C so try adding fresh spinach to your food

2) Pulses

Chickpeas, lentils, peas, beans and more sometimes fall short of iron so these plant-based food are great sources of iron. Vegans and vegetarians sometimes fall short of iron so these plant-based food are a great source of iron. There are tons of ways to reap the benefits of pulses have them in soup add them to salads or scoops them up as hummus for crackers

3) Quinoa

Unlike most grains, quinoa is high in protein and gluten-free which is why it is so popular. It is a great source of iron.

4) Pumpkin seeds

Whether you add them to your morning toast or sprinkle them on top of salads you should consider adding pumpkin seeds to your diet. They are a great source of omega 3 fatty acid and magnesium which is another mineral that they are deficient.

5) Fortified breakfast cereals can be packed with iron :

Opt for a fortified version to start for the day with a dose of iron. Check the nutrition label for the amount of iron per serving. Many varieties offer 90 – 100% of daily recommended value along with other vitamins and minerals such as fibre zinc and calcium

These are the top 5 foods to combat iron deficiency anaemia and fight blood loss. Also, remember to take your iron supplement if your Hb count is very low and if you have been prescribed by the doctor.