Updated: Jan 29, 2020
Iron deficiency is the most common nutritional deficiency globally, affecting ~1 in 3 women (consistently shown in global and local data). Unfortunately, it is usually only detected when patients develop anaemia which often occurs a few years later. Symptoms of iron deficiency include fatigue, hair loss, brain fog, poor immune function (i.e. more prone to common cold/flu), cold intolerance and much more.
Difference between iron deficiency and anaemia
Iron deficiency and anaemia are often confused – or considered the same disease. Anaemia is detected by looking at haemoglobin (Hb) with a routine blood test. Iron deficiency is the most common cause of anaemia but not the only cause. More importantly, iron deficiency generally occurs years before anaemia so early detection and treatment can avoid anaemia completely.
How to diagnose iron deficiency
Iron deficiency can be diagnosed with a simple blood test that measures patient’s serum ferritin. Knowing your iron levels early may avoid the need for blood transfusions once anaemia develops.
Serum ferritin is a marker of the iron stores in the body. When the blood concentration falls below 30ng/mL, the body no longer has enough iron and a patient is probably experiencing many of the symptoms of iron deficiency. Only with serum ferritin levels above 100ng/mL can we be sure that we have enough iron in our body.
Women at highest risk
Women are most at risk of iron deficiency due to regular menses. For every 1mL of blood that is lost we lose 0.5mg iron. Over a year, a woman with heavy menses can have annual losses exceeding 500mg iron. Considering that most women only have about 3,000mg or iron in their body it is easy to understand why so many are at risk of iron deficiency.
To make things worse, during pregnancy the growing baby will require about 500mg of iron from the mother. As 40% of women are already iron deficient when trying to conceive, , the additional requirement of iron forthe baby may result in iron not being available to make red blood cells and can lead to iron deficiency anaemia during pregnancy – which, in very severe cases, could require a blood transfusion. . During child birth there is further loss of blood (often >500mL) which equates to another 250mg iron that may be lost,placing the mother in a more iron deficient state. During labour, women need as much energy and alertness as possible which can be severely affected if they are experiencing Iron Deficiency. Beyond fatigue and tiredness, other significant consequences can include post-partum depression, low birth weight, etc.
How to increase iron levels in the body?
Humans cannot make iron so we are 100% reliant on external sources like our diet. Iron is best absorbed from red meat, fish, seafood and chicken which is haem iron. Whilst many vegetables have high iron content our bodies cannot absorb this non-haem form of iron as effectively. The addition of vitamin-C with food sources, both haem and non-haem can aid in the absorption of iron (as it helps increase the acidity in the stomach which is required to absorb iron).
When patients are diagnosed with iron deficiency, the first line of treatment recommend is oral iron. Unfortunately, this option can often cause constipation and nausea and is not usually tolerated well by many patients, hence needs to be closely monitored. Another option is an intravenous Iron Infusion, which is a rapid repletion of iron stores resulting in faster correction of the symptoms of iron deficiency such as fatigue, depression, hair loss, etc.
If you are experiencing any of these symptoms, Check your ferritin and know your iron!