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Iron, Iron Deficiency Symptoms and Iron Rich Foods

Iron deficiency means less than adequate iron levels in the body.

Iron is an essential component of haemoglobin - the oxygen carrying pigment in the blood. Iron-deficient people tire easily because their bodies remain starved for oxygen. Without enough iron, the body's fuel cannot be properly synthesized.

Iron deficiency is the most common cause of low red blood cell count or anaemia, worldwide. Women are more prone to iron deficiency. In general, it affects about 10 percent of pre-menopausal women, 6 percent of post-menopausal women, and less than 2 percent of men.

Symptoms of iron deficiency:

• If a person is otherwise healthy, symptoms only appear after haemoglobin level drops below 10g/dl.

• The initial symptoms are tiredness, giddiness and fast palpitations (tachycardia).

• Shortness of breath even on slight exertion.

• Pale appearance

• Fainting

• If iron deficiency is severe, angina (chest pain), headache and leg pain (difficulty walking).

In pronounced cases of iron deficiency, noticeable symptoms appear in the tongue and throat and include:

• burning sensation in the tongue.

• dryness in the mouth and throat.

• sores at the corners of the mouth.

• the nails become brittle

• pica (an insatiable craving for a specific food, often not rich in iron)

• brittle hair.

• difficulty swallowing.

What are the causes of iron deficiency?

Human bone marrow needs iron, along with vitamins, to produce haemoglobin and red blood cells. Our body gets vitamins and iron from the food we eat, as well as also recycles iron from old red blood cells.

Iron deficiency can lead to anaemia - when the body lacks adequate iron to make haemoglobin.

Causes of iron deficiency include:

# Pregnancy - Iron deficiency may occur in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of haemoglobin for the growing foetus.

# Blood loss - Women with heavy periods are at risk of iron deficiency because they lose a lot of blood during menstruation. Other causes may be peptic ulcer, hernia, a kidney or bladder tumour, polyp or uterine fibroids. Gastrointestinal bleeding due to regular use of aspirin or non-steroidal anti-inflammatory drugs can be a source of iron loss.

# A lack of iron in diet - iron-rich foods include meat, eggs, green leafy vegetables such as spinach, whole-grain or iron-fortified foods.

# Inability to absorb iron – maybe due to some intestinal disorder such as Crohn's disease or celiac disease, which affects the intestine's ability to absorb nutrients from food.

# Diseases such as leukaemia, piles, stomach cancer.

Who are at risk of iron deficiency?

# Older people – maybe due to chronic internal bleeding usually caused by ulcers, polyps, or tumours.

# People, who have lost their teeth, as they have difficulty eating a proper balanced diet. Such people should take a multi-vitamin and mineral supplement containing iron.

# Women, especially those who menstruate heavily.

# Pregnant women - must take a daily supplement containing iron to provide the extra iron required to nourish the developing foetus.

How can iron deficiency be treated?

The treatment definitely depends on the cause of iron deficiency. If iron deficiency is left untreated, symptoms will gradually get worse. The person may become very tired and weak, and subsequently develop angina or leg pain.

The cause of the deficiency should be early identified, particularly in older patients who are most vulnerable to intestinal cancer.

Several oral iron supplements are available over the counter. The best absorption of iron is on an empty stomach, but many people are unable to tolerate this and may need to take it with food. It is important to note that milk (especially calcium rich foods) and antacids interfere with absorption of iron and should not be taken at the same time. Vitamin C helps increase iron absorption and is essential in the production of haemoglobin.

Supplemental iron is also necessarily needed during pregnancy and lactation, because normal dietary intake is unable to fulfil the required amount.

Intravenous or intra-muscular iron is also available for patients who can't tolerate oral forms.

Dietary sources of iron:

Although iron is found in a variety of different foods, its availability to the body varies significantly. In general, the body does not readily absorb iron – depends on whether the iron is found in the form of heme or non-heme iron.

Heme iron is found only in meat, fish and poultry and is absorbed much more easily than non-heme iron, which is found primarily in fruits, vegetables, dried beans, nuts and grain (plant sources).

One can increase the body’s iron absorption from non-heme foods by:

• A good source of vitamin C, such as citrus fruits, oranges, olives and strawberries, if eaten with a non-heme food.

• A non-heme iron source if cooked in an iron pot.

Iron-rich foods include raisins, leafy green vegetables such as spinach, broccoli, red meat (liver is the highest source), fish, poultry, eggs (yolk), legumes (green peas and beans), chick peas, almonds, apricots, beet root, pomegranate, dates, figs, and whole grain bread.

If iron-deficient, some precautions:

• Coffee, tea and other caffeine drinks should be avoided because they decrease iron absorption.

• Excess consumption of high fibre foods (the phytates in such foods) restrict iron absorption.

• Limit high intake of calcium - take your calcium supplement at a different time from your iron supplement.

• Do not eat foods that are high in oxalic acid - a substance that decreases the ability of our body to absorb iron. Iron blockers include tomato, soda, dairy products, coffee and black tea. Avoid cow's milk, which can cause hidden bleeding in the intestinal tract.

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