The role of iron

Iron is responsible for oxygen transportation around the body

(within haemoglobin)

Iron is responsible for oxygen utilisation by all cells in our body (giving us energy)

References:1) Camaschella (2015) Iron-Deficiency Anemia. England Journal of Medicine, 372: 1832-1843.   
2) Munoz, et al. (2017) Current misconceptions in diagnosis and management of iron deficiency. Journal of Blood Transfusions, 15: 422-437.

 

References:1) Camaschella (2015) Iron-Deficiency Anemia. England Journal of Medicine, 372: 1832-1843.   
2) Munoz, et al. (2017) Current misconceptions in diagnosis and management of iron deficiency. Journal of Blood Transfusions, 15: 422-437.

 

Where do we have iron in our body?

50%

in red blood cells

15%

in other cells of the body

10%

in muscles

25%

in liver
(iron storage)

 

Reference: Camaschella (2015) Iron-Deficiency Anemia. England Journal of Medicine, 372: 1832-1843

Signs & Symptoms of iron deficiency

References:

1) Rabel et al.  J Am Assoc Nurse Pract. 2016;28(2):116-120.   2) Bryant et al. Transfusion. 2013;53(8):1673-1644.   3) Lacey. Public Health Rep. 1990;105(1):29-35.  4) Trost et al. J Am Acad Dermatol. 2006;54(5):824-44.   5) Malkud. J Clin Diagnostic Res. 2015;9(8):1-4.   6) Beard.  JL. J Nutr. 2001:568-580.   7) Hung et al. PLOS ONE | DOI:10.1371/journal.pone.0119647   8) Fallah et al. Iran J Pediatr Hematol Oncol. 2016;6(1):32-7.   19) Lopez et al. Lancet. 2016;387(10021):907-16.   10) Brigham et al. Crit RevFood SciNutr. 1996;36(1040-8398):747-763.   11) Gerwin. Acupunct Med. 2005 Sep; 23(3):121-34.   12) Dama et al. J Obstet Gynaecol Can. 2018.   13) Lozoff et al. 2006.

14) Beard.  J. Nutr. 2008;138: 2534–2536.   15) Patterson et al. Qual Life Res. 2000;9:491-497.   16) Radlowski et al. Front Hum Neurosci. 2013;7:585.   17) Pinero et al. Neurosci. 2000;6(6):435-453.   18) Patterson et al. J Am Coll Nutr. 2001;20(4):337-342.   19) Jankowska et al. Eur Heart J. 2010;31(15):1872-80.   20) https://www.livestrong.com/article/489269-can-iron-deficiency-cause-psychological-problems/    21) http://www.progressivehealth.com/signs-of-anemia.htm    22) Barton et al. BMC Blood Disord. 2010;10:9.   23) Sloan et al. Clin Dermatol. 2010; 28(4):420-5.   24) Daubian-Nosé et al. Sleep Sci. 2014 Dec;7(4):234-7  

 

The iron deficiency journey

References:1) Bryant et al. Transfusion 2013; 53(8): 1673-1644.  2) Camaschella. N Engl J Med 2015; 372: 1832-43.   3) Kantor et al. JID VOL.121, NO. 5 NOVEMBER 2003.   4) Lacey EP. Public Health Rep. 1990; 105(1): 29-35.   5) Malkud. J Clin Diagnostic Res. 2015; 9 (8): 1-4.   6) Muñoz et al. J Blood Transf 2017; 15:422–37.   7) Patterson et al. Qual Life Res. 2000; 9: 491-497.   8) Patterson et al. 2001; 20(4): 337-342.   9) Park et al. J Korean Med Sci 2013; 28: 934-938.   10) Pinero et al. Neurosci. 2000; 6(6): 435-453.   11) Rabel et al. J Am Assoc nurse Pract 2016; 28(2): 116-120.   12) Radlowski et al. Front Hum Neurosci 2013; 7: 585.   13) Shashikant. JCDR/2015/14089.6170.   14) Trost et al. Am Acad Dermatol 2006; 54 (5): 824-44.
 

 

Diagnosing iron deficiency

 - with a simple blood test -

  • Iron Deficiency occurs when serum ferritin is lower than <30ng/mL.
     

  • Serum ferritin between 30 -100ng/mL indicates low iron stores.
     

  • The ideal level of serum ferritin should be >100ng/mL.
     

30ng/ml

  • In case of inflammation or infection, iron saturation (% Fe saturation), is a more reliable indicator as serum ferritin levels might be artificially increased.
     

  • Our medical experts do not diagnose iron deficiency based on lab results alone but rather take the individual symptoms of patients into consideration.

References:1) Camaschella (2015) Iron-Deficiency Anemia. England Journal of Medicine, 372: 1832-1843.   
2) Munoz, et al. (2017) Current misconceptions in diagnosis and management of iron deficiency. Journal of Blood Transfusions, 15: 422-437.

Available treatments

 

Iron Rich Diet

Click here for iron content in food

 

~5% of plant based iron and

~25% from meat based iron can be absorbed by the body

 

1kg of spinach = 200g of fish

= 1mg of iron

Oral Iron

Iron tablets / liquid formulation should contain at least 100mg iron per serving

only 10% of the iron is absorbed & require 6-12 months of continuous treatment

30-50% may suffer from gastrointestinal side effects (constipation / diarrhea)

Intravenous Iron

up to 1,000mg iron administered  via a single infusion

rapid correction with functional improvements reported within 48hours

~10% will experience headache

and / or feeling warm the next day

 

References:1) Camaschella (2015) Iron-Deficiency Anemia. England Journal of Medicine, 372: 1832-1843.   
2) Munoz, et al. (2017) Current misconceptions in diagnosis and management of iron deficiency. Journal of Blood Transfusions, 15: 422-437.

 

Benefits of an intravenous iron infusion

  • In the last decade new preparations of iron have been developed that permit 'total dose' infusions safely in 15 to 30 minutes. This means we can safely and effectively give you enough iron to replenish your iron stores in a singly treatment. 
     

  • An iron infusion is considerably faster (1hour) and more effective than iron tablets (6-12 months).  

  • Iron is delivered straight to the muscles and bone marrow, where it is needed most and patients treated in our clinic routinely advise symptomatic improvements within ~ 48 hours to 1 week.
     

  • Following the infusion, provided you maintain a healthy diet which includes iron, you will not need any further treatment with iron tablets.

References:1) Camaschella (2015) Iron-Deficiency Anemia. England Journal of Medicine, 372: 1832-1843.   
2) Munoz, et al. (2017) Current misconceptions in diagnosis and management of iron deficiency. Journal of Blood Transfusions, 15: 422-437.

 

For more information on iron deficiency

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A medical clinic focused on managing iron deficiency and experts in the administration of intravenous iron.

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SBF Center, Singapore 068914

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