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Information on Iron Deficiency
Iron deficiency is the most common nutritional deficiency in the world. Iron deficiency causes anemia, but it only occurs towards the end of a process of falling iron stores, which in some cases may have been in progress for many years.
The fall in iron stores normally passes through several stages:
Stage 1 - Lowered iron stores: stores are reduced, but not exhausted, and there are no clinical effects.
Stage 2 - Iron depletion: Biochemical deficiency without anaemia. Laboratory indices show that iron stores are exhausted. While the hemoglobin concentration is usually within the reference range, it may well be below 'normal' for that individual. The patient's response to increased iron in the diet might therefore be a rise in hemoglobin. Microcytosis can be present. About 8% of the pre-menopausal adult female population has biochemical iron deficiency.
The complete picture of the clinical consequences and presentation of biochemical iron deficiency is still not entirely clear. Apart from early hematological effects, research also shows adverse consequences on aerobic work performance, immune function and psychomotor development. In clinical studies, iron deficiency has been associated with psychomotor impairment in children, but it is still not certain to what extent adverse effects manifest clinically in adults.
Stage 3 - Iron deficiency anemia: with no iron left in the marrow, hemoglobin production falls to the point where hemoglobin concentration is below the reference range.
Spoon shaped nails is a sign of chronic iron deficiency.
Signs of anemia include: pallor, and tachycardia.
Blood loss is the most common cause:
- obvious blood loss (e.g. major trauma, menorrhagia, surgery)
- occult bleeding (e.g. bowel cancer, gum disease)
- worm infestation (hookworm, roundworm)
- blood donation.
Dietary inadequacy: between 20-40% of reproductive age women consume less than 70% of the recommended dietary intake of iron. In men the proportion is much lower.
Iron in the diet is present as haem iron (animal flesh) and inorganic iron (vegetable iron). The absorption of haem iron is substantially better than inorganic iron. Red meat is the best dietary source of both haem and inorganic iron, but vegetables contain only inorganic iron. As such, vegetarians may be at increased risk.
Regular blood donation is unquestionably a significant cause of iron deficiency in both sexes. Blood banks routinely check hemoglobin in donors, but do not routinely check iron status.
Patients taking aspirin and other NSAIDs are prone to occult blood loss.
Full blood count: to determine whether the iron deficiency is severe enough to have hematological effects (anemia, microcytosis, hypochromia and pencil cells).
Serum ferritin is the most sensitive test for iron deficiency. Some experts advocate widespread use of serum ferritin testing wherever there is any possibility of iron deficiency. However, indiscriminate testing is not recommend. A normal serum ferritin, however, does not entirely rule out iron deficiency.
Transferrin saturation is an index of iron transport rather than storage. This measure (calculated from serum iron and TIBC) is an alternative to serum ferritin. However, as it is affected by the same confounding factors it will not add much additional information in iron deficiency if a serum ferritin has already been ordered. A serum transferrin saturation of >55% can be a very useful indication of possible iron overload. On the other hand, if serum ferritin is elevated but transferrin saturation is low, the patient is unlikely to have iron overload.
Serum iron on its own provides no useful information. Serum iron has a diurnal variation that can be as much as 30% within a single individual, it is sensitive to the day's dietary iron intake and is affected by all the confounding diseases listed above. A low serum iron picked up as an incidental finding has a very low specificity for iron deficiency.
Serum C-reactive protein (CRP) level and ESR can also be useful in distinguishing the patient where inflammation or infection is causing falsely normal or elevated serum ferritin.
Bone marrow biopsy is occasionally required in difficult cases.
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The next step, after you have been diagnosed with a disease, is to find out what is the specific cause, and then choose supplements that address it. Phone consults are my specialty. Please call my at (239) 659-2684 to schedule a consultation.
I recommend that you make an informed choice, and the goal of this web site is to provide you with the information to make a wise choice when it comes to your health and wellness.
As you can see, I don't sell any vitamins on this web site. There are thousands of vitamin stores that will sell you whatever vitamin you want, and many of them offer discounts.
If you are interested in some high-quality basic nutritional supplements, I recommend visiting the Store You will find my recommendations for a multiple, tasty chewable fiber wafers, high-potency probiotics, and fish oils.
Good luck in your journey towards health and wellness!!
Unfortunately, that would be a clear violation of FDA regulations. Also, one of the most important aspect of naturopathy is: "Treat the person, not the disease". This is a profound statement, and many people have spent thousands of dollars on vitamins listed in books or web sites for a specific disease. This is what I call "vending machine medicine". It rarely works! The solution is to find a naturopathic physician, such as myself, to assist you.