Don't think iron deficiency is a big deal? While it won't kill you, it can result in pesky symptoms and My Strange Addiction-type behaviour. Dr Zeng Shanyong of DTAP Clinic tells us about the common causes of the condition, symptoms and treatment options.
The common causes of iron deficiency are decreased intake and increased losses.
A decreased intake of iron usually happens with a vegan diet. Iron from food comes in two forms: heme iron, which is found in animal flesh like meat, poultry and seafood; and non-heme iron, which is found in plant foods like whole grains, nuts, seeds, legumes, and leafy greens. However, heme iron is better absorbed by the body, so the total intake of iron might be lower with a plant-based diet.
Increased iron loss happens when there is ongoing blood loss, which typically happens in patients with gastrointestinal bleeding like gastritis, gastric ulcers, colon polyps or colon cancer or who take blood thinners like aspirin or warfarin.
Another cause is iron malabsorption. If patients have had gastric bypass surgery or suffer from some type of inflammatory bowel disease, their absorption of iron will be affected. In this instance, they might develop iron deficiency even if on an heme iron-rich diet.
One of the symptoms is pica, the craving for non-food items like dirt.
The most common symptoms are fatigue, brain fog, thinning hair, brittle nails and mild infections such as cold or flu, but iron deficiency can also result in anemia, which can lead to decreased exercise tolerance or shortness of breath.
In some cases, patients may also develop pica, an eating disorder where they crave items that are not typically considered food and that do not contain any nutritional value. These items include clay, paper, ash or dirt.
Iron supplementation is the mainstay in treating iron deficiency.
Iron deficiency can be diagnosed through a simple blood test, and if treatment is required, iron can be supplemented either via oral preparation or an intravenous infusion.
Oral iron supplementation through iron tablets is the most popular type of treatment and they are widely available and useful for all ages. However, oral treatment can result in gastrointestinal side effects such as constipation, nausea, flatulence or even black and sticky stools. If this is the case, an intravenous infusion might be a good alternative.
But an iron-rich diet isn't always the solution.
If the iron deficiency is due to insufficient iron in the diet, it can be reversed through dietary supplementation.
But in malabsorptive cases of iron deficiency, an iron-rich diet would not be useful and intravenous iron supplementation might be required. Similarly, if the iron deficiency is due to blood loss, the iron deficiency will not be alleviated unless the underlying cause of the blood loss is corrected.
There is such a thing as too much iron.
Iron overload due to overconsumption is known as secondary hemochromatosis. It can be caused by repeated blood transfusion or excessive iron supplementation whether through pills or infusion. However, this is more commonly seen in men as women lose iron on a monthly basis through menstruation.
Complications can arise when the excess iron accumulates in various organs, which can lead to heart failure, diabetes, arthritis and even damaged reproductive issues like hypogonadism and erectile dysfunction. Patients may also exhibit a noticeable 'graying' or 'bronzing' of the skin.