INTRODUCTION:
Iron is an essential mineral that contributes to many important physiologic functions in the body. Much of the iron in the body is attached to hemoglobin molecules in red blood cells, thereby delivering oxygen to all of the tissues. Extra iron is stored in the liver, bone marrow, spleen, and muscles.
Significant deficiency in iron leads to anemia. The most common symptoms of anemia are weakness and fatigue. Pregnant women, young women during their reproductive years, and children tend to be at the highest risk of becoming deficient in iron. Anemia may be mild, moderate, or severe and may be caused by significant or prolonged blood loss such as that from a bleeding ulcer, menstruation, severe trauma, surgery, or a malignant tumor.
It can also be caused by an iron-poor diet, inefficient absorption of dietary iron, pregnancy, and the rapid growth that takes place during infancy, early childhood, and adolescence.
On the other hand, excessive iron in the body can lead to a condition known as hemochromatosis, which can cause diabetes, liver damage, and discoloration of the skin.
On the other hand, excessive iron in the body can lead to a condition known as hemochromatosis, which can cause diabetes, liver damage, and discoloration of the skin.
The World Health Organization (WHO) considers iron deficiency the number one nutritional disorder in the world. As many as 80% of the world's population may be iron deficient, while 30% may have iron deficiency anemia.
Uses:
Anemia:
The most important use of iron supplements is to treat anemia caused by iron deficiency. Anemia is low levels of iron in the blood. Iron is important, as it is a key component of hemoglobin, which carries oxygen to our tissues. Anemia can be caused by many conditions, including PMS and menopausal loss, pregnancy, blood donation, bleeding ulcers, surgery (before and after), and chronic diseases such as cancer and kidney failure. Anemia treatment is directed and supervised by a health care provider, who may first search for the underlying reason for the low levels of iron.
Exercise capacity
Low levels of iron can lead to diminished exercise capacity, whether anemia is present or not. Therefore, if your iron stores are low (as measured by your doctor), iron supplements (for example, in a multivitamin or iron supplement) may improve endurance during aerobic activities.
Attention-deficit hyperactivity disorder (ADHD):
Symptoms of iron deficiency (including decreased attention, arousal, and social responsiveness) are similar to symptoms of attention-deficit hyperactivity disorder (ADHD). There is little clinical evidence, however, that iron supplementation improves behavior in children with ADHD who are deficient in iron. Since iron can be toxic in children who are not deficient, there is little justification for its supplementation as a treatment for ADHD in children with normal levels of this mineral. If iron levels are low, a health care provider can determine whether replacement is needed.
Cough associated with ACE inhibitor use:
One preliminary clinical study suggested that iron supplementation may soothe and even prevent cough associated with a class of medications known as angiotensin-converting enzyme (ACE) inhibitors, including enalapril (Vasotec), captopril (Capoten), and lisinopril (Zestril or Prinivil). ACE inhibitors are medications commonly used to treat high blood pressure and heart failure, but dry cough is a side effect that leads many people to discontinue their use. Despite this encouraging information, it is premature to conclude that taking iron with ACE inhibitors to reduce dry cough is safe or effective.
Plus, it is important to note that taking ACE inhibitors at the same time as iron may diminish the absorption of this nutrient. Therefore, if used together, the two should be taken at least two hours apart. Also, iron is associated with some risk for heart disease. For this reason, it should not be used by individuals with high blood pressure or heart failure without the consent and supervision of a doctor.
Infants and children:
Iron deficiency is a significant public health problem in young children due to their high iron requirements, and iron supplements are therefore often recommended by health care providers. Iron deficiency may increase the risk of lead poisoning in children. However, the use of iron supplementation in lead poisoning is reserved for those individuals who are truly iron deficient or for those individuals with continuing lead exposure, such as continued residence in lead-exposed housing. Do not give iron supplements to infants or children under 18 unless under the supervision of a doctor.
PROPERIES OF IRON:
Iron is a silver-white or gray metal that is malleable and ductile. In a pure form, it is relatively soft and slightly magnetic. When hardened, it becomes much more magnetic. Iron is the most widely used of all metals. Prior to its use, however, it must be treated in some way to improve its properties or it must be combined with one or more other elements to form an alloy. By far the most common alloy of iron is steel.
One of the most common forms of iron is pig iron, produced by smelting iron ore with coke and limestone in a blast furnace. Pig iron is approximately 90% pure iron and is used primarily in the production of cast iron and steel.
Cast iron is a term used to describe various forms of iron that also contain carbon and silicon ranging in concentrations from 0.5-4.2% of the former and 0.2-3.5% of the latter. Cast iron has a vast array of uses ranging from thin rings to massive turbine bodies. Wrought iron contains small amounts of a number of other elements including carbon, silicon, phosphorus, sulfur, chromium, nickel, cobalt, copper, and molybdenum. Wrought iron can be fabricated into a number of forms and is widely used because of its resistance to corrosion.
What Are the Signs and Symptoms of Iron-Deficiency Anemia?
The signs and symptoms of iron-deficiency anemia depend on how serious the condition is. Mild to moderate iron-deficiency anemia may have no signs or symptoms.
When signs and symptoms do occur, they can range from mild to severe. Many of the signs and symptoms of iron-deficiency anemia apply to all types of anemia.
Signs and Symptoms of Anemia:
The most common symptom of all types of anemia is fatigue (tiredness). Not having enough hemoglobin in the blood causes fatigue. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen to the body.
Anemia also can cause shortness of breath; dizziness, especially when standing up; headache; coldness in your hands or feet; pale skin, gums, and nail beds; and chest pain.
If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to circulate the reduced amount of oxygen in your blood. This can lead to arrhythmia, heart murmur, an enlarged heart, or even heart failure.
In infants and young children, signs of anemia include poor appetite, slowed growth and development, and behavioral problems.
Signs and Symptoms of Iron-Deficiency Anemia:
Signs and symptoms of iron-deficiency anemia may include brittle nails, swelling or soreness of the tongue, cracks in the sides of the mouth, an enlarged spleen, and frequent infections.
People who have iron-deficiency anemia may have unusual cravings for nonfood items such as ice, dirt, paint, or starch. This craving is called pica (PI-ka or PE-ka).
Some people who have iron-deficiency anemia develop restless legs syndrome (RLS). RLS is a disorder that causes a strong urge to move your legs. This urge to move often occurs with strange and unpleasant feelings in your legs. People who have RLS often have a hard time sleeping.
Iron-deficiency anemia can put children at greater risk for lead poisoning and infections.
Some signs and symptoms of iron-deficiency anemia are related to the condition's causes. For example, a sign of intestinal bleeding can be bright red blood in the stools or black, tarry-looking stools.
Very heavy menstrual bleeding, long periods, or other vaginal bleeding may suggest that a woman is at risk for iron-deficiency anemia.
Interactions with Herbs and Dietary Supplements :
Acacia: Acacia forms an insoluble gel with ferric iron. Clinical significance is unknown.
Calcium: Calcium supplements have been shown to inhibit absorption of iron supplements when taken with food. Calcium inhibits the absorption of dietary heme- and non- However, in people with adequate iron stores, this does not appear to be clinically significant. If at risk for iron deficiency, it is recommended to take calcium supplements at bedtime, instead of with meals, to avoid inhibiting dietary iron absorption.
Copper: Copper metabolism may be altered by iron supplements, but the clinical importance of this observation is unknown.
Organic acids:Citric, malic, tartaric, and lactic acids have some enhancing effects on nonheme iron absorption.
Phytic acid (phytate):Phytic acid is present in legumes, grains, and rice and is an inhibitor of nonheme iron absorption. Small amounts of phytic acid (5 to 10mg) can reduce nonheme iron absorption by 50%. The absorption of iron from legumes, such as soybeans, black beans, lentils, mung beans, and split peas, has been shown to be as low as 2%.
Polyphenols: Polyphenols, found in some fruits, vegetables, coffee, tea, wines, and spices, can markedly inhibit the absorption of nonheme iron. This effect is reduced by the presence of vitamin C.
Riboflavin (vitamin B2): Riboflavin supplements may improve the hematological response to iron supplements in some people with anemia.
Selenium: Based on preliminary data, iron may decrease selenium levels. Further research is needed to confirm these results.
Soy: Soy protein reduces absorption of dietary non-heme (plant-derived) iron, probably due to binding of iron by phytate and calcium present in soy. Fermented soy products seem to inhibit of iron absorption less.
Vitamin A,Beta-carotene: Vitamin A appears to be involved in mobilizing iron from tissue stores for delivery to developing red blood cells in the bone marrow. Vitamin A may also be involved in the differentiation and proliferation of blood stem cells in the bone marrow, and in the synthesis of erythropoietin. Preliminary evidence also suggests that vitamin A and beta-carotene may enhance non-heme iron absorption from iron-fortified wheat and corn flour, and rice. It is unlikely that vitamin A supplements would have significant effects on iron status in people without vitamin A deficiency.
Vitamin C (ascorbic acid): The amount of vitamin C in the diet is a factor in dietary iron absorption and iron status. Vitamin C can counteract the effects of substances, which inhibit iron absorption. Supplemental or dietary vitamin C improves absorption of supplemental or dietary non-heme (plant-derived) iron ingested at the same time. Taking a vitamin C supplement to improve absorption of dietary or supplemental iron probably is not necessary for most people, especially if their diet contains adequate amounts of vitamin C. One study concludes that the addition of ascorbic acid increased fractional iron absorption from ferric pyrophosphate significantly, but to a lesser extent than from FeSO4.
Vitamin E: Use of oral iron preparations in premature infants with low serum vitamin E levels may cause hemolysis and hemolytic anemia. Vitamin E deficiency should be corrected before administering supplemental iron.
Zinc: Iron may decrease zinc absorption but there does not seem to be a clinically significant interaction between dietary iron and zinc, or between supplemental iron and zinc dietary sources.
Interactions with Food :
Dairy products: Calcium in dairy products such as milk and cheese can reduce the absorption of dietary and supplemental iron. It is recommended that iron supplements be taken with a meal that is relatively low in dairy products when possible.
Juice: Preliminary study shows that a small supplement of iron is better absorbed when given with to infants with juice than with cow's milk.
Meat, fish, poultry: Animal protein provides highly absorbable heme iron and enhances absorption of non-heme iron.
