Iron Deficiency Anemia

Hemoglobin contains 70% of the body iron. One gram of hemoglobin contains 3.4 mg of iron and 1 ml of packed red blood cells(RBC`s) contains 1 mg of iron. Iron intake averages about 10mg/day of which 10% is absorbed. Iron loss averages about 1mg/day in men and non-menstruating women and about 2 mg/day in menstruating women. There is an additional iron requirement for pregnant and lactating women.

Iron deficiency can occur in 3 ways:
1)iron intake not sufficient to replace iron losses,
2) iron not available for formation of red blood cell despite adequate body iron, and
3) increase loss of body iron (blood loss) not adequately replaced by normal intake.

In children, the most common cause is due to inadequate diet or parasitism. Hookworms, one of the most common parasite competes with the body`s iron.

In men, this is usually bleeding from gastrointestinal tract. In women, iron deficiency anemia can be caused by either vaginal or GI bleeding.

It has been estimated that 20-50% of women in the menstrual age group have some degree of iron deficiency; menstrual loss is aggravated by poor diet. Gastrointestinal bleeding is most frequent due to ulcer in men and women below 40. After age 40, Gastrointestinal Cancer is more common and should always be ruled out.

Manifestations includes numbness or tingling sensation, ulcers on the corners of the mouth, concave or spoon shaped nails (koilonychia).Others maybe due to the general manifestation of anemia such as easy fatigability, faintness, palpitation, headache and pallor.

The first principle in therapy is that the underlying cause be identified and corrected. Ferrous iron is given orally, about 200mg/day in 3 doses between meals. This will provide 40-60 mg of absorbed iron per day.

_{Bibliography:
Clinical Laboratory Medicine by Richard Ravel 6th edition
Clinical Diagnosis and Management by John Bernard Henry 20th edition}