[/quote]...iron plays a key role not only in the body's oxygen transport and delivery system, but also in the regulation of metabolism. Iron is needed to synthesize vital substances such as the brain chemical, dopamine, DNA and white blood cells. Thus iron deficiency can do much more harm than merely causing anemia; it can have widespread effects -- from damaging a person's ability to think to weakening their resistance to infection.
You can assess your risk of developing iron deficiency by looking for the major risk factors: an iron-poor diet, unusual blood loss, a history of iron deficiency and actual symptoms. A good way to do this is to give yourself the following test.
-Do you consume two or more portions of meat, fish, chicken, nuts, seeds or legumes per day?
-Do you eat at least six servings of grains per day?
-Do you generally eat at least one serving of fruits or vegetables containing foods at the same meal as grains or beans?
-Do you take a calcium supplement or over-the-counter antacid at every meal?
The first two questions ask about consumption of iron containing foods. The third and fourth questions ask about consumption of foods that may affect iron absorption. If you answered no to one of the first three questions or yes to the last question, you may be at risk for iron deficiency.
Menstrual and Other Blood Loss
-Do you soak through your tampons or pads?
-Does your period last longer than six days?
-If you answered yes to either of these questions, you may be at risk.
Other causes of blood loss to look out for are gastrointestinal, urinary or pulmonary bleeding. Any patient with one or more of these types of blood loss should seek medical treatment or, if they are being treated, raise the issue of iron deficiency with their doctor. Another relatively common cause of increased iron requirements is frequent blood donation. Anyone who donates blood regularly should be screened for iron deficiency during their annual check-up.
History of Iron Deficiency
-Have you been treated for iron deficiency in the past?
Even if a previous iron deficiency problem was treated and easily corrected, whatever caused the deficiency may remain and the deficiency may recur. For this reason, anyone who has been diagnosed with iron deficiency in the past should be periodically reevaluated.
Signs and Symptoms
-Do you have any of the following signs and symptoms: general lethargy; unusual fatigue after exercise; pica (compulsive eating of non-food items); pagophagia (compulsive eating of ice); signs of iron deficiency including paleness of the skin or eyes, intestinal problems, cognitive problems such as impaired learning ability, and spoon nails (thin and concave fingernails)? Anyone having any of these should see a doctor as soon as possible.
Treating Iron Deficiency
When doctors suspect an iron deficiency, the first thing they will do is measure the blood level of a protein called ferritin. Ferritin concentration indicates how much iron is stored in the body. Chronic infection, inflammation or certain diseases causing tissue and organ damage can produce a false reading. In the absence of one of these conditions, however, if ferritin is low, doctors will usually assume iron deficiency and begin treatment. This holds true even if there is no obvious sign of anemia.3,4
The Federal Centers for Disease Control and Prevention (CDC) recommends a three-month course of therapy for the treatment of iron deficiency. Some authorities, however, advise patients to continue iron supplementation for six to twelve months. An important note about iron supplements is that they can often produce black-colored stools. Whichever approach your doctor chooses, it is important that you add more iron in the form of iron-rich foods to your diet and that your doctor treats any correctable cause of blood loss. Patients with ongoing blood loss that cannot be corrected may need, in addition to eating a more iron-rich diet, to continue taking low-dose iron supplements indefinitely.
Micronutrients and susceptibility to infection
G. T. Keusch
Department of Medicine, New England Medical Center/Tufts University School of Medicine, Boston, Massachusetts 02111.
Iron deficiency and vitamin A deficiency are both reported to predispose to infection morbidity and to mortality. In both situations, however, the data are insufficient to draw firm conclusions, primarily owing to flaws in the design of the studies. To be sure, these are difficult studies to carry out, and the investigators whose reports have been reviewed should be praised rather than adversely criticized for their efforts. In the case of iron deficiency, there is a further complication in interpretation, that is the suggestion that iron deficiency states may be protective and that conditions of iron overload may predispose to infection. These concepts appear to pertain most convincingly to malaria and Yersinia infections, and to situations in which iron dextran is given parenterally to young children in the first few months of life. There are still too few data to suggest that oral iron is harmful and there is no reason at present that it should not be employed for the correction of iron deficiency anemia.
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