Serum iron in blood test. Iron: normal in the blood, why low or high Pathological conditions of the body with low iron levels
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The human body contains almost all the elements of D. I. Mendeleev’s table, but not all of them carry such biological significance as iron. Iron in the blood is most concentrated in red blood cells-, namely, in their important component - hemoglobin: heme (Fe ++) + protein (globin).
A certain amount of this chemical element is permanently present in plasma and tissues - as a complex compound with protein and in the composition of hemosiderin. The normal adult body should have 4 to 7 grams of iron.. The loss of an element for any reason leads to an iron deficiency condition called anemia. To identify this pathology, laboratory diagnostics include a test such as the determination of serum iron, or iron in the blood, as the patients themselves say.
Normal level of iron in the body
In blood serum, iron is found in complex with a protein that binds and transports it – transferrin (25% Fe). Typically, the reason for calculating the concentration of an element in blood serum (serum iron) is a low level of hemoglobin, which, as is known, is one of the main parameters.
The level of iron in the blood fluctuates throughout the day, its average concentration for men and women is different and is: 14.30 – 25.10 µmol per liter of male blood and 10.70 – 21.50 µmol/l in the female half. Such differences are largely due to the menstrual cycle, which affects only individuals of a certain gender. With age, the differences disappear, the amount of the element decreases in both men and women, and iron deficiency can be observed to the same extent in both sexes. The level of iron in the blood of infants, as well as children and adults, male and female, is different, therefore, to make it more convenient for the reader, it is better to present it in the form of a small table:
However, it should be borne in mind that, like other biochemical indicators, normal blood iron levels may vary slightly from one source to another. In addition, we consider it useful to remind the reader of the rules for passing the analysis:
- Blood is donated on an empty stomach (it is advisable to fast for 12 hours);
- A week before the study, pills for the treatment of IDA are discontinued;
- After a blood transfusion, the analysis is postponed for several days.
To determine the level of iron in the blood, serum is used as a biological material, that is, blood is taken without an anticoagulant and dried new a test tube that never comes into contact with detergents.
Functions of iron in the blood and biological significance of the element
Why is so much attention paid to iron in the blood, why is this element considered a vital component, and why can’t a living organism survive without it? It's all about the functions that the hardware performs:
- Ferrum (heme of hemoglobin) concentrated in the blood is involved in tissue respiration;
- The microelement found in the muscles (in the composition) ensures the normal activity of skeletal muscles.
The main functions of iron in the blood coincide with one of the main tasks of the blood itself and what it contains. Blood (erythrocytes and hemoglobin) takes oxygen that enters the lungs from the external environment and transports it to the most remote corners of the human body, and carries out carbon dioxide formed as a result of tissue respiration for removal from the body.
scheme: myshared, Efremova S.A.
Thus, iron plays a key role in the respiratory activity of hemoglobin, and this applies only to the divalent ion (Fe++). The conversion of ferrous iron to ferric iron and the formation of a very strong compound called methemoglobin (MetHb) occurs under the influence of strong oxidizing agents. Degeneratively altered red blood cells containing MetHb begin to break down (), and therefore cannot perform their respiratory functions - a condition occurs for the body tissues acute hypoxia.
A person himself does not know how to synthesize this chemical element; iron is brought into his body by food products: meat, fish, vegetables and fruits. However, it is difficult for us to absorb iron from plant sources, but vegetables and fruits containing large quantities of ascorbic acid increase the absorption of the microelement from animal products by 2–3 times.
Fe is absorbed in the duodenum and along the small intestine, and a deficiency of iron in the body promotes enhanced absorption, and an excess causes a blockage of this process. The large intestine does not absorb iron. During the day, we absorb an average of 2 - 2.5 mg of Fe, but the female body needs almost 2 times more of this element than the male, because monthly losses are quite noticeable (1 mg of iron is lost from 2 ml of blood).
Increased content
An increased content of iron in, just like a lack of the element in the serum, indicates certain pathological conditions of the body.
Given that we have a mechanism that prevents the absorption of excess iron, an increase in iron may be due to the formation of ferrum as a result of pathological reactions somewhere in the body (increased breakdown of red blood cells and the release of iron ions) or a breakdown of the mechanism that regulates intake. An increase in iron levels makes you suspect:
- of various origins (, aplastic,);
- Excessive absorption in the gastrointestinal tract due to a violation of the limiting mechanism (hemochromatosis).
- caused by multiple blood transfusions or overdose of ferrum-containing drugs used for the treatment and prevention of iron deficiency conditions (intramuscular or intravenous administration).
- Failure of hematopoiesis in the bone marrow at the stage of incorporation of iron into erythrocyte precursor cells (sideroachrestic anemia, lead poisoning, use of oral contraceptives).
- Liver lesions (viral and acute hepatitis of any origin, acute liver necrosis, chronic cholecystitis, various hepatopathies).
When determining iron in the blood, one should keep in mind cases where the patient has been receiving iron-containing tablets for a long time (2–3 months).
Lack of iron in the body
Due to the fact that we ourselves do not produce this microelement, we often do not pay attention to the nutrition and composition of the products we consume (as long as it is tasty), over time our body begins to experience iron deficiency.
Fe deficiency is accompanied by various symptoms of anemia: dizziness, spots before the eyes, pale and dry skin, hair loss, brittle nails and many other troubles. A low level of iron in the blood can be due to many reasons:
- Nutritional deficiency that develops as a result of low intake of the element from food (preference for vegetarianism or, conversely, a passion for fatty foods that do not contain iron, or a transition to a dairy diet containing calcium and preventing the absorption of Fe).
- The body's high needs for any microelements (children under 2 years of age, adolescents, pregnant women and nursing mothers) lead to a reduced level of them in the blood (this applies primarily to iron).
- Iron deficiency anemia as a result of diseases of the gastrointestinal tract that prevent the normal absorption of iron in the intestine: gastritis with reduced secretory ability, enteritis, enterocolitis, neoplasms in the stomach and intestines, surgical interventions with resection of the stomach or part of the small intestine (resorption deficiency).
- Redistribution deficiency against the background of inflammatory, purulent-septic and other infections, rapidly growing tumors, osteomyelitis (absorption of iron from plasma by cellular elements of the mononuclear phagocytic system) - in a blood test, the amount of Fe will, of course, be reduced.
- Excessive accumulation of hemosiderin in the tissues of internal organs (hemosiderosis) leads to a low level of iron in the plasma, which is very noticeable when examining the patient's serum.
- Lack of erythropoietin production in the kidneys as a manifestation of chronic renal failure (CRF) or other kidney pathology.
- Increased excretion of iron in urine in nephrotic syndrome.
- The cause of low iron content in the blood and the development of IDA can be prolonged bleeding (nose, gum, during menstruation, from hemorrhoids, etc.).
- Active hematopoiesis with significant use of the element.
- Cirrhosis, liver cancer. Other malignant and some benign (uterine fibroids) tumors.
- Stagnation of bile in the biliary tract (cholestasis) with the development of obstructive jaundice.
- Lack of ascorbic acid in the diet, which promotes the absorption of iron from other foods.
How to increase?
In order to increase the level of iron in the blood, you need to accurately identify the reason for its decrease. After all, you can consume as many microelements as you like with food, but all efforts will be in vain if their absorption is impaired.
Thus, we will only ensure transit through the gastrointestinal tract, but will not find out the true reason for the low Fe content in the body, therefore first you need to undergo a comprehensive examination and listen to the recommendations of your doctor.
And we can only advise increasing it with an iron-rich diet:
- Consumption of meat products (veal, beef, hot lamb, rabbit). Poultry meat is not particularly rich in the element, but if you have to choose, turkey and goose are better choices. Pork lard contains absolutely no iron, so it is not worth considering.
- There is a lot of Fe in the liver of various animals, which is not surprising, it is a hematopoietic organ, but at the same time, the liver is a detoxification organ, so excessive consumption may not be beneficial.
- There is little or no iron in eggs, but they contain a high content of vitamins B12, B1 and phospholipids.
- Buckwheat is recognized as the best cereal for the treatment of IDA.
- Cottage cheese, cheeses, milk, white bread, being calcium-containing products, inhibit the absorption of iron, so these products should be consumed separately from a diet aimed at combating low ferrum levels.
- To increase the absorption of the element in the intestines, you will have to dilute the protein diet with vegetables and fruits containing ascorbic acid (vitamin C). It is concentrated in large quantities in citrus fruits (lemon, orange) and sauerkraut. In addition, some plant foods themselves are rich in iron (apples, prunes, peas, beans, spinach), but iron is absorbed very limitedly from foods of non-animal origin.
When increasing iron through diet, you don't have to worry about getting too much of it. This will not happen, because we have a mechanism that will not allow excessive increases, if, of course, it works correctly.
Video: story about iron and iron deficiency anemia
Characterized by a decrease in red blood cells and (or) hemoglobin per unit volume of blood.
According to WHO, anemia occurs in 20% of the world's population, more often in women and children. The classification of anemia distinguishes between deficient, posthemorrhagic, hypo- and aplastic, hemolytic anemia and anemia in other diseases.
In children, deficiency anemia (mainly iron deficiency) is most common. In pregnant women and young children, up to 70-75% of all anemic conditions are associated with iron deficiency in the body.
Iron-deficiency anemia is a condition characterized by a decrease in red blood cells and (or) hemoglobin per unit volume of blood, a low level of color index and serum iron, a reduced transferrin saturation coefficient and an increased iron-binding capacity of blood serum.
Etiology and pathogenesis. There are three main groups of factors influencing the development of iron deficiency in children:
1) antenatal factors:
- conditions of a pregnant woman leading to disruption of the uteroplacental circulation and placental insufficiency (preeclampsia, exacerbation of somatic diseases, infections, placental, etc.);
- multiple pregnancy, prematurity;
2) intrapartum factors - bleeding during childbirth, premature or late ligation of the umbilical cord, fetoplacental transfusion;
3) postnatal factors:
- nutritional (incorrect feeding regimen and introduction of complementary foods (lack of meat dishes), early artificial feeding(including unadapted mixtures));
- increased need for iron (premature babies, children with a birth weight of more than 4 kg, pre- and pubertal periods);
- blood loss of various etiologies (nasal, uterine, gastrointestinal, helminthiasis, etc.) in children;
- impaired absorption and redistribution of jelly (dysbacteriosis and inflammatory bowel diseases, cystic fibrosis, celiac disease, infectious diseases, etc.).
Depending on the degree of iron deficiency, tritogenetic stages are distinguished.
- 1. Iron (Fe) deficiency is accompanied by its release from the depot, i.e., mobilization of deposited iron occurs. Serum iron levels remain normal (prelatent iron deficiency).
- 2. With the progressive removal of iron from the depot, the level of serum iron decreases. This stage of latent iron deficiency is detected using a laboratory blood test: the transferrin saturation coefficient is reduced, the hemoglobin level is close to the lower limit of normal.
- 3. This is actually iron deficiency anemia (lack of iron depots, increased iron-binding capacity of blood serum, decreased levels of serum iron and hemoglobin).
Clinical picture. There are five leading clinical syndromes:
- epithelial;
- dyspeptic;
- asthenoneurotic;
- cardiovascular disorders;
- immunodeficient.
Epithelial syndrome appears first in all patients. It is characterized by pale and dry skin, dull, split ends, nail plates with a spoon-shaped concavity (koilonychia). in the corners of the mouth, cracks, inflamed red border of the lips (cheilitis). The phenomenon of blue sclera is noted. Glossitis and gingivitis are also characteristic.
Dyspeptic syndrome is expressed in the following symptoms: unstable appetite, refusal to eat, sideropenic dysphagia, geophagia (children eat sand, chalk, earth). Against this background, diarrhea develops, which further aggravates anemia.
Asthenoneurotic syndrome includes headache, fatigue, dizziness, spots before the eyes, drowsiness, and decreased performance at school. Labile pulse, detrusor weakness appear (children leak urine into their panties; episodes of nocturnal enuresis occur), and delayed physical development (in 20% of children).
Cardiovascular disorders are manifested by myocardial dystrophy (muffled tones, change in waveform voltage), gentle systolic murmur (usually at the apex), and tachycardia.
Immunodeficiency syndrome is characterized by frequent infectious diseases.
Diagnostics
Laboratory tests confirm the diagnosis and severity of anemia. Mild (I) degree is characterized by a decrease in hemoglobin from PO-90 g/l, red blood cells (3.5-3.0)10 12 /l, serum iron to 10-9 µmol/l. The total iron-binding capacity of blood serum is 70 µmol/l.
Average (II) degree - hemoglobin level from 90 to 70 g/l, erythrocytes - (3.0-2.5)10 12 /l, serum iron 8-7 µmol/l; The iron-binding capacity of blood serum increases to 80 µmol/l.
Severe (III) degree - hemoglobin level less than 70 g/l, red blood cells - less than 2.5 * 10.2 / l, serum iron - less than 7.0 µmol/l; iron-binding capacity of blood serum is more than 80 µmol/l.
Iron deficiency anemia is always hypochromic: the color index is less than 0.8; anulocytes appear in the smear - red blood cells with a wide zone of clearing in the center, resembling a donut. Anisocytosis and poikilocytosis are characteristic. The average hemoglobin content per red blood cell (MCH) is reduced (less than 24 pg).
Laboratory criteria for iron deficiency in children are given in Table. 11.1.
Differential diagnosis. Iron deficiency anemia is differentiated from other types of anemia (folate deficiency anemia, B 12 deficiency anemia, hemolytic anemia).
Treatment. For mild anemia, treatment can be carried out at home, as well as in nurseries, kindergartens, and orphanages. Children with severe anemia are usually treated in a hospital setting, if possible hospitalized in separate small wards to avoid the addition of certain diseases.
The main place in the treatment of anemia is occupied by the regimen and correctly selected one. During the period of manifestation of the disease, it is necessary to organize additional rest, walks in the fresh air, and conduct physical therapy.
The child should be breastfed for the first 6 months of life. If this is not possible, adapted milk formulas are prescribed. The lack of iron intake by the end of the first six months of life is compensated for by the introduction of meat complementary foods.
When preparing a diet, it is necessary to take into account that the degree of iron absorption is highest (20-22%) when consuming meat products: beef, beef tongue, rabbit meat, turkey, chicken. Among products of plant origin, the degree of absorption is lower: these are dried mushrooms, seaweed, fresh rose hips, oatmeal, buckwheat, oats, and fruits. The most optimal is a combination of meat and vegetable dishes. Organic acids improve the absorption of iron: lemon and apple juice. Dairy products and flour dishes impair the absorption of iron and are therefore incompatible with taking iron-containing medications. Due to the presence of tannin, which also interferes with the absorption of iron, tea and coffee are limited.
Modern iron preparations are divided into three groups:
1) monocomponent (hemofer, conferon, ferrogradomet);
- combined with folic acid, serine, ascorbic acid, vitamins B, C, amino acids (feromed, fefol, actiferrin, tardiferon);
- for parenteral administration (ferrum-lek, ectofer, ferco-ven).
The most effective drugs in pediatric practice are those containing non-ionic forms of iron (ferrum-lek, maltofer, venofer), which have a minimum of side effects.
The main route of administration of iron supplements is enteral. If this route is not possible (resection of the stomach and intestines, nonspecific ulcerative colitis, chronic enterocolitis, malabsorption syndrome), drugs are prescribed parenterally.
The total course dose of iron preparations for parenteral administration is calculated using the formula
D= 120-НН-М-0.4,
where D is the dose of the drug, mg; Hb - hemoglobin, g/l; M - body weight, kg.
To increase the effect of ferrotherapy, the following recommendations must be followed:
- Iron supplements are taken on an empty stomach or 1.5-2.0 hours after a meal, washed down with water or fruit and vegetable juices (it is forbidden to take iron supplements with tea, milk, coffee);
- It should be taken into account that some medications interfere with the absorption of iron (tetracyclines, drugs, chloramphenicol, antacids);
- The daily therapeutic dose for elemental iron is 3-5 mg/kg body weight. At the beginning of therapy, tolerance to iron is determined, the drug is not prescribed in the full therapeutic dose (V 2 -V3 doses). The duration of the course must be at least 3 months and is determined by laboratory blood parameters. Normalization of hemoglobin levels is carried out within 1.0-1.5 months of treatment. To restore tissue iron reserves, medications are continued at half the therapeutic dose (for 4 weeks);
- Ferric iron preparations have advantages over the divalent form: they do not irritate the mucous membrane of the digestive tract (do not cause necrosis of the mucous membrane, diarrhea; overdose of the drug is excluded).
Forecast.
Usually the prognosis is favorable. Children with iron deficiency have an increased susceptibility to intestinal infections and acute respiratory viral infections.
Prevention
Prevention of anemia should be carried out in the antenatal period. It comes down to strengthening the health of a pregnant woman, combating toxicosis, measures to prevent prematurity and postmaturity, taking preventive or therapeutic doses of iron and folic acid.
An important preventive element is the preservation of breastfeeding and the timely introduction of nutritious complementary foods to the child in the 1st year of life. It is also necessary to protect children as much as possible from acute infectious diseases (pneumonia, acute respiratory and gastrointestinal diseases), which contribute to anemia in the body. During menstruation, girls are recommended to take iron supplements (Fenulls, etc.) to prevent anemia.
Children born from multiple pregnancies, premature, post-term, with intrauterine malnutrition, as well as children from mothers who suffered from anemia during pregnancy, from mothers with placental abnormalities are prescribed iron supplements (together with ascorbic acid) prophylactically.
Clinical observation is carried out by a pediatrician and hematologist.
Children who have had anemia or are at risk of developing anemia need periodic red blood testing.
The human body consists of various chemical elements that perform specific functions in the body. Chemical elements are in balance, which allows maintaining normal functions of organs and systems. Violation of this balance leads to pathological processes and various diseases.
The human body consists of 60% water, 34% organic matter and 6% inorganic matter. Organic substances include carbon, oxygen, hydrogen and others. Inorganic substances contain 22 chemical elements - Fe, Ca, Mg, F, Cu, Zn, Cl, I, Se, B, K and others.
All inorganic substances are divided into microelements and macroelements. It depends on the mass fraction of the element. Microelements include iron, copper, zinc and others. Macroelements include calcium, sodium, potassium and others.
Iron ( Fe) refers to microelements. Despite the small iron content in the body, it plays a special role in maintaining its vital functions. A lack of iron in the human body, as well as its excess, negatively affects many functions of the body and human health in general.
If the patient complains of increased fatigue, malaise, or rapid heartbeat, the doctor prescribes a serum iron test. This analysis helps evaluate iron metabolism in the body and identify many pathological processes associated with iron metabolism. In order to understand what serum iron is, why it is needed and how it appears, it is necessary to consider the functions of iron and its metabolism in the human body.
Why is iron needed in the body?
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Iron, which is contained in the body, is divided into:
- Functional iron. Functional iron is part of hemoglobin ( iron-containing protein of red blood cells, which captures and carries oxygen to the organs and tissues of the body), myoglobin ( oxygen-containing protein of skeletal muscles and cardiac muscles, creating oxygen reserves), enzymes ( specific proteins that change the rate of chemical reactions in the body). Functional iron is involved in many processes in the body and is constantly used.
- Transport iron. Transport iron is the amount of an element that is transported from the source of iron entering the body to each of its cells. Transport iron is not involved in body functions. It is part of carrier proteins – transferrin ( the main carrier protein of iron ions in blood plasma), lactoferrin ( a carrier protein found in breast milk, tears, saliva and other secretory fluids) and mobilferrin ( iron ion transport protein in the cell).
- Deposited iron. Part of the iron that enters the body is stored “in reserve.” Iron is deposited in various organs and tissues, mainly in the liver and spleen. Iron is deposited in the form of ferritin ( water-soluble complex protein complex, which is the main intracellular iron depot) or hemosiderin ( iron-containing pigment formed during the breakdown of hemoglobin).
- Free iron. Free iron or free pool is iron unbound to proteins inside cells, formed as a result of the release of iron from the ternary complex - iron, apotransferrin ( transferrin precursor protein) and receptor ( molecules on the surface of the cell that attach molecules of various chemical substances and transmit regulatory signals). In its free form, iron is very toxic. Therefore, free iron is transported inside the cell by mobilferrin or deposited with ferritin.
- Heme iron ( cellular). Heme iron makes up the bulk of the total iron content in the human body - up to 70 - 75%. Participates in the internal exchange of iron ions and is part of hemoglobin, myoglobin and many enzymes ( substances that accelerate chemical reactions in the body).
- Non-heme iron. Non-heme iron is divided into extracellular and stored iron. Extracellular iron includes free plasma iron and iron-binding transport proteins - transferrin, lactoferrin, mobilferrin. Deposited iron is found in the body in the form of two protein compounds - ferritin and hemosiderin.
- transport of oxygen to tissues – the erythrocyte contains hemoglobin, the molecules of which contain 4 iron atoms; iron in hemoglobin binds and transports oxygen coming from the lungs to all cells of the body;
- participation in hematopoietic processes – bone marrow uses iron to synthesize hemoglobin, which is part of red blood cells;
- detoxification of the body - iron is necessary for the synthesis of liver enzymes involved in the destruction of toxins;
- regulation of immunity and increasing body tone – iron affects the composition of the blood, the level of leukocytes necessary to maintain immunity;
- participation in the process of cell division – iron is part of proteins and enzymes involved in DNA synthesis;
- synthesis of hormones - iron is necessary for the synthesis of thyroid hormones, which regulates metabolism in the body;
- providing cells with energy – iron delivers oxygen to protein energy molecules.
Daily iron requirement
Floor | Age | Daily iron requirement |
Children
(regardless of gender) | 1 – 3 years | 6.8 mg per day |
3 – 11 years | 10 mg per day | |
11 – 14 years old | 12 mg per day | |
Female | 14 – 18 years old | 15 mg per day |
19 – 50 years | 18 mg per day | |
over 50 years old | 8 mg per day | |
Pregnant women | - | 38 mg per day |
Breastfeeding women | - | 33 mg per day |
Male | 14 – 18 years old | 11 mg per day |
over 19 years old | 8 mg per day |
Iron is found in the body in different concentrations depending on the type of iron, as well as gender.
Distribution of iron in the human body
Iron type | Iron concentration ( mg Fe/kg) | |
women | men | |
Total iron | ||
The total iron content in the human body is 4.5 – 5 grams. | 40 mg Fe/kg | 50 mg Fe/kg |
Functional iron | ||
Hemoglobin ( Hb). Of the total amount of iron in the body, 75–80% ( 2.4 g) accounts for hemoglobin iron ( hemoglobin is an iron-containing protein that transports oxygen to tissues). | 28 mg Fe/kg | 31 mg Fe/kg |
Myoglobin. The composition of myoglobin ( oxygen - binding protein of skeletal muscles and heart muscles) includes 5–10% of the total amount of iron. | 4 mg Fe/kg | 5 mg Fe/kg |
Heme and non-heme enzymes ( chemicals that accelerate chemical reactions occurring in the human body). Respiratory enzymes account for about 1% of the total amount of iron in the body. | 1 mg Fe/kg | 1 mg Fe/kg |
Transport iron | ||
Transferrin ( specific protein – carrier of iron in blood plasma). | 0.2) mg Fe/kg | 0.2) mg Fe/kg |
Iron depot ( iron reserves in the body). Reserve iron makes up 20–25% of the total amount of iron in the body. | ||
Ferritin. | 4 mg Fe/kg | 8 mg Fe/kg |
Hemosiderin. | 2 mg Fe/kg | 4 mg Fe/kg |
Iron metabolism in the human body
Metabolism ( exchange) gland is a very well organized process. The body clearly regulates the processes of intake and recycling of iron, since it is a very valuable microelement.Iron absorption occurs in three stages. The first stage is the initial stage ( absorption in the small intestine), the second is intracellular transport with the formation of iron reserves, the third is the release of iron into the blood plasma.
Iron enters the body with food. When you receive 10–20 milligrams of iron from food per day, only 10% of the iron is absorbed, which is 1–2 milligrams. The body obtains heme iron from food ( meat, liver) and non-heme iron ( milk, vegetables, fruits). Heme iron enters the body as part of hemoglobin and myoglobin from meat products and is absorbed by the body 20–30% more efficiently ( regardless of the secretion of gastric juice and other factors). Non-heme iron comes mainly from food ( 80 – 90% ). Absorption of such iron occurs passively and in small quantities ( 1 – 7% ). This process is also influenced by many external factors.
Substances that inhibit the absorption of non-heme iron are:
- phytins - found in cereals, legumes, semolina and oatmeal;
- tannins – found in tea, cocoa, coffee, quince, dark grapes, currants;
- phosphoproteins - complex proteins found in milk and egg whites;
- oxalates – found in corn, rice, grains, spinach, milk;
- some medications - calcium supplements, oral contraceptives.
- vitamin C ( ascorbic acid) – found in white cabbage, spinach, red and green peppers, black currants, dried rose hips;
- copper – found in liver, peanuts, hazelnuts, shrimp, peas, buckwheat, lentils;
- meat products - beef, veal, rabbit and others;
- seafood – fish, oysters, shrimp;
- amino acids – found in legumes, nuts, fish, meat, milk, peanuts, eggs.
After the intake of ferrous iron ( Fe 2+) into parts of the small intestine, it enters enterocytes ( epithelial cells of the small intestine). Iron absorption into enterocytes occurs with the help of special proteins - mobilferrin, integrin and others. The cells of the small intestine contain transferrin and ferritin. These two proteins regulate the absorption and distribution of iron throughout the body.
When iron enters the body through enterocytes, part of it is deposited ( put aside in reserve), part is transported using the transferrin protein and is used by the body to synthesize heme ( part of hemoglobin containing iron), erythropoiesis ( formation of red blood cells in the bone marrow) and other processes.
Deposit ( reservation) iron occurs in two forms - as part of ferritin and hemosiderin. Ferritin is a water-soluble protein complex that is synthesized ( produced) cells of the liver, bone marrow, small intestine and spleen. The main function of this protein is to bind and temporarily store iron in a form that is non-toxic to the body. Ferritin in liver cells is the main depot of iron in the body. Ferritin in small intestinal cells is responsible for the transfer of iron entering enterocytes to transferrin in the blood plasma. Hemosiderin is an iron-containing, water-insoluble pigment that deposits excess iron in tissues.
Transport of iron in blood plasma is carried out by a special carrier protein – transferrin. Transferrin is synthesized by liver cells. Its main function is the transport of iron absorbed in intestinal cells and iron from destroyed red blood cells ( red blood cells responsible for transporting oxygen to tissues and organs) for reuse. Normally, transferrin is saturated with iron by only 33%.
The body loses iron daily - up to 1 - 2 milligrams per day. Physiological losses of iron normally occur during the excretion of iron in bile through the intestines, during desquamation of the epithelium of the gastrointestinal tract ( Gastrointestinal tract), with desquamation ( exfoliation) skin, in women with menstrual blood ( from 14 mg to 140 mg per month), hair loss and nail cutting.
What is serum iron and what is the normal level of iron in the blood? Why is serum iron tested?
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Iron in the blood cannot be in a free state, as it is very toxic. Therefore, the level of iron in the carrier proteins – transferrin – is determined. To do this, using special chemical reactions, iron is isolated from the complex with transferrin. The material for the study is venous blood. More often, the colorimetric method is used to analyze serum iron concentration. The essence of the method is to determine the concentration of iron in serum by the color intensity of the solution. The color intensity of the solution is directly proportional to the concentration of the colored chemical microelement. This method allows you to determine the concentration of a trace element with high accuracy.
Indications for analysis of serum iron concentration are:
- diagnostics, differential diagnostics ( the difference between one pathology and another with similar symptoms) and control of anemia treatment ( pathological condition characterized by low hemoglobin content in red blood cells);
- diagnosis of hemochromatosis ( hereditary disease characterized by impaired iron metabolism);
- diagnosis of intoxication ( poisoning) iron;
- malnutrition, hypovitaminosis ( lack of vitamins);
- various diseases of the gastrointestinal tract in which normal absorption of iron is disrupted;
- detected deviations in the results of a general blood test ( red blood cells, hematocrit);
- bleeding of various etiologies ( heavy prolonged menstruation, bleeding gums, bleeding from hemorrhoids, stomach or duodenal ulcers and others).
- assessment of iron reserves in the body;
- calculating the percentage of transferrin saturation with iron ( that is, determining the concentration of iron carried by the blood);
- differential diagnosis of anemia;
- control of anemia treatment;
- control of treatment with iron preparations;
- diagnosis of genetic diseases of iron metabolism disorders.
The normal level of iron in the blood, depending on age and gender
Age | Floor | Iron norm |
female | 5.1 – 22.6 µmol/l | |
male | 5.6 – 19.9 µmol/l | |
from 1 to 12 months | female | 4.6 – 22.5 µmol/l |
male | 4.9 – 19.6 µmol/l | |
from 1 to 4 years | female | 4.6 – 18.2 µmol/l |
male | 5.1 – 16.2 µmol/l | |
from 4 to 7 years | female | 5.0 – 16.8 µmol/l |
male | 4.6 – 20.5 µmol/l | |
from 7 to 10 years | female | 5.5 – 18.7 µmol/l |
male | 4.9 – 17.3 µmol/l | |
from 10 to 13 years | female | 5.8 – 18.7 µmol/l |
male | 5.0 – 20.0 µmol/l | |
from 13 to 16 years old | female | 5.5 – 19.5 µmol/l |
male | 4.8 – 19.8 µmol/l | |
from 16 to 18 years old | female | 5.8 – 18.3 µmol/l |
male | 4.9 – 24.8 µmol/l | |
> 18 years old | female | 8.9 – 30.4 µmol/l |
male | 11.6 – 30.4 µmol/l |
When receiving tests, the doctor is guided by the gender and age of the patient. The results obtained may be within normal limits, below or above normal. If the iron level is below normal, the patient has iron deficiency. If the iron level is higher than normal, the patient has excess iron in the body. When interpreting the results obtained, many factors should be taken into account - nutrition, medication, the woman’s menstrual cycle and others. Do not forget about daily fluctuations in the concentration of iron in the blood. Thus, the maximum daily concentration of iron in the blood is observed in the morning. In women, the concentration of iron in the blood is higher before and during menstruation than after the end of menstruation. Therefore, a serum iron test should be taken after the cessation of menstruation. Random fluctuations in iron levels in the blood may also occur, for example, with a sharp increase in meat consumption in the patient’s diet.
Medicines that increase iron levels in the blood are:
- acetylsalicylic acid ( aspirin) – non-steroidal anti-inflammatory drug;
- methotrexate – antitumor agent;
- multivitamins containing iron;
- oral contraceptives – birth control pills;
- antibiotics – methicillin, chloramphenicol, cefotaxime;
- drugs containing estrogens ( female sex hormones) .
- acetylsalicylic acid in large doses - non-steroidal anti-inflammatory drug;
- allopurinol – a drug that lowers the level of uric acid in the blood;
- cortisol – glucocorticoid hormone;
- metformin – tablet hypoglycemic agent ( lowers blood sugar levels);
- corticotropin – adrenocorticotropic hormone drug;
- cholestyramine – lipid-lowering agent ( reduces blood fat levels);
- asparaginase – antitumor agent;
- drugs containing testosterone - male sex hormone.
How to properly prepare for a serum iron test?
To avoid distortion of the obtained results of serum iron concentration, it is necessary to properly prepare the patient.To properly prepare for diagnosing iron levels in the blood, you must:
- a week before taking a serum iron test, stop taking medications and iron-containing vitamin complexes;
- reschedule the serum iron test for several days after the blood transfusion ( blood transfusion);
- Explain to the patient that to analyze serum iron it will be necessary to take a blood sample, explain the essence of the procedure, and warn about unpleasant sensations when applying a tourniquet and puncture ( piercing) veins;
- describe the daily and nutritional regimen that the patient should follow.
- taking test blood on an empty stomach;
- exclusion of smoking, drinking alcohol and fatty foods, physical activity 12 hours before the test;
- taking test material before performing any diagnostic procedures ( radiography, computed tomography);
- the patient has no viral or inflammatory diseases.
What should your serum iron level be during pregnancy?
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The reasons for the increased need for iron during pregnancy are:
- an increase in blood volume by 50%, and, consequently, a 2-fold increase in the need for iron for the production of hemoglobin ( iron-containing protein that transports blood);
- significant consumption of iron from the mother's iron depot for the formation of the placenta and red blood cells ( red blood cells that transport oxygen) fruit;
- Iron-deficiency anemia ( anemia – a condition characterized by low levels of hemoglobin in the blood) before pregnancy, which aggravates iron deficiency during pregnancy.
The normal level of serum iron in pregnant women is from 13 µmol/l to 30 µmol/l. The daily iron requirement for pregnant women is up to 30 – 38 milligrams.
For a pregnant woman and her unborn baby, both iron deficiency and excess are equally dangerous. If a pregnant woman’s body does not receive the required daily intake of iron, its reserves are quickly depleted. This leads to iron deficiency ( serum iron level) and the development of iron deficiency anemia ( pathology in which the level of hemoglobin in the blood decreases). As a result of anemia, both the fetus and mother suffer from a lack of oxygen. Iron deficiency anemia leads to weakened immunity, increased fatigue, dizziness, and weakness. The development of iron deficiency anemia in the first or second trimester of pregnancy significantly increases the risk of premature birth, low birth weight, stillbirth, or neonatal death.
Also, iron deficiency in the mother contributes to the development of iron deficiency anemia in the newborn, which can negatively affect his mental and physical development. During childbirth, a woman may lose a large amount of blood. If there was already a previous iron deficiency, then bleeding can lead to the development of severe anemia and the need for a blood transfusion. It has been scientifically proven that iron deficiency is one of the causes of postpartum depression.
Excess iron ( serum iron level > 30 µmol/l) also negatively affects the course of pregnancy and the health of the fetus. Excess iron can be observed in hereditary diseases with impaired iron metabolism and excessive intake of iron into the body ( uncontrolled intake of iron-containing medications). Excessive iron levels in the blood of a pregnant woman can cause gestational diabetes ( pathology in which there is a high level of sugar in the blood of a pregnant woman), preeclampsia ( complications of pregnancy after 20 weeks, characterized by high blood pressure and high protein in the urine), miscarriage. Therefore, iron supplements must be taken under the strict supervision of a doctor.
Iron deficiency in pregnant women is much more common than iron excess. Iron deficiency can be compensated for by eating an iron-rich diet or taking iron-containing medications. A pregnant woman's diet should include red meat ( richest source of iron), rabbit, chicken, turkey meat, as well as grains, legumes, spinach, cabbage, porridge and others.
If the intake of iron from food does not satisfy the body's needs, the doctor may additionally prescribe iron supplements. Taking iron supplements is carried out under the strict control of serum iron. The dosage of drugs is selected by the attending physician depending on the patient’s laboratory parameters ( serum iron levels, hemoglobin). Pregnant women are often prescribed calcium supplements, which impair iron absorption. Therefore, during treatment with iron supplements, it is worth stopping or limiting the use of calcium supplements. If this is not possible, then calcium should be taken in between meals and iron supplements.
Iron supplements prescribed during pregnancy are:
- Sorbifer durules. A tablet of this drug contains 100 milligrams of iron and vitamin C to improve the absorption of iron in the intestines. During pregnancy, in order to prevent iron deficiency, 1 tablet per day is prescribed, for treatment - 1 tablet in the morning and in the evening.
- Ferroplex. The pills contain 50 milligrams of iron and vitamin C. Take 2 pills 3 times a day.
- Totema. Totema is a solution containing 50 milligrams of iron. For prevention, 1 ampoule per day is prescribed orally from 4 months of pregnancy. In large doses, totem is prescribed only for laboratory-confirmed iron deficiency anemia. Prescribed 2 – 4 ampoules per day.
- Fenyuls. The capsules contain 45 milligrams of iron. For prevention, take 1 capsule per day from the 14th week of pregnancy. After taking the drug daily for 2 weeks, take a week break and then continue taking the drug again.
What diseases lead to low blood iron levels?
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Symptoms of iron deficiency in the body
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There are latent ( hidden) and clear signs of iron deficiency in the blood. Latent signs appear with minor iron deficiency. Serum iron levels are often normal or close to the borderline low value ( women – 8.9 µmol/l, men – 11.6 µmol/l). In this case, the body uses iron reserves.
Symptoms of the latent stage of iron deficiency in the blood are:
- decreased performance;
- increased fatigue;
- severe malaise, weakness;
- cardiopalmus ( tachycardia);
- increased irritability;
- depression;
- headaches and dizziness;
- difficulty swallowing;
- glossitis ( inflammation of the tongue);
- hair loss;
- brittle nails;
- pale skin;
- deterioration of memory, attention, thought processes, learning ability;
- frequent respiratory tract infections;
Symptoms of severe iron deficiency are:
- decreased immunity – the patient often suffers from viral and respiratory diseases;
- low body temperature, chilliness - body temperature is below 36.6°C, the person feels uncomfortable at low temperatures, his extremities are constantly cold;
- deterioration of memory, attention, pace of learning – with iron deficiency, it is difficult for the patient to concentrate and remember information, and frequent forgetfulness is observed;
- decreased performance – the patient constantly feels tired, “broken,” even after a full night’s sleep;
- disruption of the gastrointestinal tract - loss of appetite, difficulty swallowing, pain in the stomach, constipation, flatulence ( excessive accumulation of gases in the intestinal lumen), the appearance of belching and heartburn;
- increased fatigue, muscle weakness - the patient observes increased fatigue even after short-term activity, and also notes muscle weakness during physical activity and at rest;
- neurological disorders – increased irritability, short temper, depression, tearfulness, migrating pain ( head, in the region of the heart);
- delayed mental and physical development in children – lack of iron leads to oxygen starvation, which negatively affects the child’s central nervous system, the development of the cardiovascular system and others;
- geophagy ( food perversion) – with iron deficiency, a person may begin to eat inedible objects - chalk, earth, sand;
- dryness, pallor of the skin and mucous membranes – the skin becomes dry, begins to peel, cracks and pronounced wrinkles appear, wounds form in the corners of the mouth ( cheilitis), stomatitis ( inflammation of the oral mucosa);
- dry, brittle nails and hair – with a lack of iron, hair becomes dull, brittle, loses shine and volume, nails flake and break easily;
- dizziness, loss of consciousness ( fainting) – as a result of a decrease in the level of hemoglobin in the blood, the body suffers from oxygen starvation, this especially affects the brain, which is manifested by dizziness, short-term loss of consciousness, darkening of the eyes;
- shortness of breath, rapid heartbeat - Iron deficiency leads to a lack of oxygen, which the body tries to compensate by increasing breathing and heart rate.
How to increase iron levels in the blood?
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Before using iron-containing medications or changing your diet, you must undergo an examination and take a serum iron test. If a laboratory test confirms iron deficiency, the doctor will individually select treatment tactics for the patient. The principle of treatment will depend on iron levels, the patient’s condition ( for example, pregnancy), concomitant diseases ( Some diseases may cause increased iron loss).
If there is a slight lack of iron, it will be enough to adjust the patient’s diet by increasing the amount of iron-rich foods in the diet. In this case, it is necessary to take into account the consumption of iron in the patient’s body. In some cases ( for chronic bleeding, pregnancy, breastfeeding, intensive growth) The amount of iron you get from food may not be enough. Then the therapy is supplemented with iron supplements.
In case of severe iron deficiency, treatment begins immediately with taking medications in the form of capsules, tablets and dragees. In particularly severe cases, iron supplements are prescribed intravenously under the strict supervision of the attending physician.
Diet for iron deficiency
Heme and non-heme iron enters the human body with food. Heme iron ( the source is hemoglobin) is several times more efficiently absorbed by the body in contrast to non-heme. The body obtains heme iron from meat products, and non-heme iron from plant products.Sources of heme iron
Product (100 grams) | (mg) |
beef | 2,7 |
pork | 1,7 |
turkey | 3,7 – 4,0 |
chicken | 1,6 – 3,0 |
veal | 2,8 |
pork liver | 19,0 |
veal liver | 5,5 – 11,0 |
beef kidneys | 7,0 |
sea fish | 1,2 |
heart | 6,3 |
mackerel | 2,4 |
cod | 0,7 |
shellfish | 4,2 |
mussels | 4,5 |
oysters | 4,1 |
Sources of non-heme iron
Product (100 grams) | Iron content in milligrams (mg) |
apricots | 2,2 – 4,8 |
peas | 8,0 – 9,5 |
beans | 5,6 |
buckwheat | 8,0 |
nuts ( almonds, hazelnuts) | 6,1 |
dried mushrooms | 35 |
dried pear | 13 |
beans | 11,0 – 12,5 |
apples | 0,6 – 2,3 |
dried apples | 15,0 |
rose hip | 11,0 |
For better absorption of iron you need:
- Eat foods rich in vitamin C, B vitamins and folic acid. Vitamin C improves the absorption of iron in the intestines by 6 times. Therefore, for better absorption of this microelement, it is necessary to increase the intake of foods rich in vitamin C. These foods include spinach, cauliflower, citrus fruits, broccoli and others. Sources of folic acid include peanuts, almonds, walnuts, flax seeds and others. B vitamins are found in fermented milk products, nuts, yeast, and egg yolk.
- Reduce tea and coffee consumption. Tannin, which is found in tea and coffee, significantly reduces the absorption of iron. Therefore, you should not drink these drinks immediately after meals, as they reduce iron absorption by 62%. Do not forget that the body normally absorbs only 10% of the iron received from food.
- Limit consumption of foods rich in calcium and calcium supplements. Calcium also slows down the absorption of iron by the human body. Therefore, when treating iron deficiency conditions, you should limit your consumption of hard cheese, milk, sesame seeds, herbs and others. Also, if the patient is taking calcium supplements, then their intake should be discontinued or limited. If this is not possible, calcium should be taken between meals.
Iron supplements
If it is not possible to increase serum iron levels through diet, the patient is prescribed iron supplements. The doctor selects the dosage and duration of treatment individually. Therapy with iron supplements should be carried out under the control of serum iron levels determined in the laboratory.Iron supplements prescribed for iron deficiency
A drug | Dose, duration of treatment |
Maltofer | Oral solution. To treat iron deficiency, take 1 bottle ( 100 mg iron) from 1 to 3 times a day. Duration of treatment is from 3 to 5 months. After this, continue to take 1 bottle per day for 1 to 3 months to restore iron reserves. To prevent iron deficiency, take 1 bottle for 1 to 2 months. |
Biofer | To treat iron deficiency, take 1 tablet ( 100 mg iron) from 1 to 3 times a day for 3 to 5 months. Then, for several months, take 1 tablet per day to restore iron reserves. To prevent iron deficiency, take 1 tablet for 1 to 2 months. Contains folic acid, which improves iron absorption. |
Ferro foil | To treat iron deficiency anemia, take 1 capsule ( 37 mg iron) 3 times a day. The duration of treatment ranges from 3 to 16 or more weeks ( depending on the severity of iron deficiency). For prevention – 1 capsule 3 times a day for a month. Contains vitamin B 12 and folic acid. |
Ferretab | When treating, use from 1 to 3 capsules ( 50 mg iron) per day. Treatment is continued until the level of iron in the blood normalizes. Then maintenance therapy is continued for 4 weeks. Contains folic acid. |
Hemofer | Take 46 drops orally between meals ( per drop contains 2 mg of iron) 2 times a day with juice or water. The duration of treatment is at least 2 months. |
Sorbifer Durules | 1 tablet orally ( 40 mg iron) 1 – 2 times a day. If necessary, the dose is increased to 3–4 tablets per day in 2 divided doses. The course of treatment is 3–4 months. Contains ascorbic acid. |
Tardiferon | 1 tablet orally ( 80 mg iron) 2 times a day before meals or during meals. Duration of treatment is from 3 to 6 months. |
Ferrum | The injection form of this drug is used only intramuscularly. First, a test dose is administered. If there is no reaction, the entire dose is administered. Prescribe 1 – 2 ampoules ( 100 mg iron) per day. |
Venofer | Will be used intravenously. Intramuscular administration is unacceptable. Administer slowly after test dose. The dose is selected individually depending on the severity of iron deficiency. One ampoule contains 40 mg of iron. |
Cosmopher | The drug is for intramuscular and intravenous administration. One ampoule contains 100 mg of iron. The dose and duration of treatment are selected individually. |
Totema | Oral solution. 1 ampoule contains 50 mg of iron. Prescribe 1 ampoule orally 2-3 times a day for a course of treatment of up to six months. |
Hematogen | In the form of chewable lozenges or bars. Iron content varies. Take 1 - 2 lozenges 2 - 3 times a day. |
Iron supplements are prescribed intravenously for extremely severe iron deficiency conditions. Also indications for intravenous administration are diseases of the gastrointestinal tract, in which the absorption of iron is significantly reduced. First, a test dose is administered to exclude adverse reactions. The drug is administered only in the presence of a doctor.
Syrups, tablets and chewing strips are used to treat and prevent iron deficiency in children.
What does an elevated blood iron level indicate?
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Depending on the cause of its appearance, excess iron is divided into primary and secondary. Primary excess iron is caused by a hereditary pathology - hemochromatosis. Diseases of internal organs and many external factors lead to secondary excess iron.
Elevated levels of iron in the blood can occur with:
- Hemochromatosis. Hemochromatosis is a hereditary disease in which the normal metabolism of iron is disrupted with its accumulation in organs and tissues. The accumulation of iron in organs leads to disruption of their structure and function. Subsequently, various diseases develop - liver cirrhosis ( replacement of healthy liver tissue with scar tissue), arthritis, diabetes and others.
- Various types of anemia ( hemolytic, hypoplastic, aplastic, sideroblastic and others). An increase in iron content in various types of anemia occurs for many reasons. It depends on the type of anemia. For example, with hemolytic anemia, increased destruction of red blood cells occurs. In this case, iron from red blood cells enters the blood. In sideroblastic anemia, the utilization of iron by the bone marrow for the synthesis of hemoglobin is impaired.
- Thalassemias. Thalassemia is a hereditary pathology characterized by impaired synthesis of components ( chains) structure of hemoglobin. As a result, less iron is consumed for hemoglobin synthesis.
- Acute iron poisoning. Acute iron poisoning occurs with a significant overdose of iron preparations - taking up to 200 milligrams of iron. This can be caused by uncontrolled intake of iron supplements, self-medication, and children taking iron-containing medications in large quantities ( whole package).
- Liver diseases ( viral hepatitis, liver necrosis), spleen, pancreas. Diseases of various organs lead to metabolic disorders, impaired absorption of vitamins and microelements, and hormonal imbalances. One of the consequences is excessive accumulation of iron in the blood.
- Iron metabolism disorders. Various diseases and pathological processes can lead to impaired iron metabolism. This can manifest itself either as a decrease in its level or as an increase.
- Excessive intake of iron into the body. Excessive intake of iron into the body is possible with self-treatment with iron supplements. Also, with a normal intake of iron into the body and a disturbance in its metabolism, an increase in serum iron may be observed.
- Premenstrual period. An increase in iron levels in the premenstrual period is normal. Therefore, it is better to take a serum iron test after the end of menstruation.
- Frequent blood transfusions. With frequent blood transfusions and a short interval between them, an increase in serum iron levels is possible.
Symptoms of high iron levels in the blood include:
- nausea, vomiting, heartburn, constipation, or diarrhea;
- damage to the intestinal mucosa;
- loss of appetite, weight loss;
- apathy, decreased performance;
- the appearance of pain, swelling in the joints;
- the appearance of arthritis inflammatory process in joints), atherosclerosis ( deposits of atherosclerotic plaques on the walls of the vessel), diabetes ( elevated blood sugar);
- decreased immunity;
- hyperpigmentation of the skin, gray-brown tint of the skin and mucous membranes;
- hair loss;
- muscle pain;
- delayed physical and mental development of the child;
- decreased libido ( sexual desire).
How to lower iron levels in the blood?
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Helps reduce iron levels in the blood:
- Use of special medications. Medicines that accelerate the excretion of iron include hepatoprotectors, zinc preparations, drugs that bind iron - deferoxamine ( desferal), thetacin calcium.
- Following a special diet. If there is an excess of iron, foods rich in this microelement are excluded from the diet. These are meat, beans, dried mushrooms, dried apples and pears, seafood and others. Also, you should not take vitamins that help improve iron absorption - B vitamins, vitamin C, folic acid. It is recommended to consume more foods that impair iron absorption - coffee, tea, foods rich in calcium, calcium and zinc supplements.
- Periodic bleeding. The procedure involves taking about 350 milliliters of blood from the patient weekly. If desired, the patient can become a blood donor.
- Hirudotherapy ( treatment with leeches). Leech treatment can also help lower blood iron levels. This happens as a result of leeches feeding on human blood. In this case, hemoglobin and iron in its composition are lost.
- Exchange blood transfusion. Exchange transfusion is used for severe iron poisoning. The procedure involves simultaneous collection of blood from the patient's bloodstream and transfusion of donor blood.
Why is hemoglobin low when serum iron levels are normal?
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One of the reasons for low hemoglobin with normal serum iron levels is a lack of vitamin B 12 and folic acid in the body, which are involved in the process of red blood cell formation.
The treatment method is intramuscular injection of a solution of vitamin B 12 at a dose of 500-1000 mcg daily for 10 days, and then use of the drug 2-3 times a month for prophylactic purposes. Folic acid is used in a dose of 50 - 60 mg per day.
Another reason for the development of anemia with normal iron content is the problem of an insufficient number of red blood cells or inferior hemoglobin protein.
The causes of an insufficient number of red blood cells or inferior hemoglobin protein are:
- Sickle cell anemia. Sickle cell anemia is a congenital disease associated with a disorder in the structure of hemoglobin, in which it takes on a characteristic sickle shape. Clinical manifestations of sickle cell anemia are thrombosis of blood vessels of various organs with sickle-shaped erythrocytes, hemolytic anemia, pallor and jaundice of the skin, repeated thrombosis of various organs, splenomegaly ( pathological enlargement of the spleen in size), hepatomegaly ( liver enlargement), shortness of breath, general weakness and malaise. Sickle cell anemia is an incurable disease. Symptomatic treatment during a crisis is adequate hydration ( saturating the body with fluid), red blood cell transfusion ( blood product consisting of red blood cells), as well as intravenous antibiotics.
- Destruction of red blood cells under the influence of certain chemicals. Destruction of red blood cells occurs when exposed to compounds of arsenic, lead, nitrites, amines, some organic acids, foreign serums, insect and snake poisons. The mechanism of the damaging effect is due to the destruction of red blood cell membranes and the release of large amounts of hemoglobin into the plasma. This leads to intense protein breakdown with subsequent damage to the excretory organs - the kidneys and liver. First aid consists of administering specific antidotes, for example, for snake bites - antisnake serums.
- Diseases of the hematopoietic organs. An insufficient number of red blood cells can be observed in some diseases of the hematopoietic organs, in particular in blood cancer - lymphosarcoma, lymphogranulomatosis and others. In such cases, pathological cells develop faster and replace the precursor cells of red blood cells and other blood cells.
What are the consequences of iron deficiency?
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With a lack of oxygen, chronic oxygen starvation of tissues and organs occurs at the cellular level. This leads to functional and structural changes in these organs. Iron is also part of many enzyme systems and is found in the cells of the liver, spleen, muscles, and bone marrow. That is why its deficiency affects a person’s general well-being - general weakness, malaise, dizziness, and decreased performance appear ( as a result of metabolic disorders). Functional and regenerative functions also deteriorate ( restorative) abilities of organs and tissues, the production of enzymes and hormones decreases. Immunity is noticeably reduced, which is manifested by frequent colds.
At the level of the skin and its appendages, iron deficiency manifests itself in pallor and dryness of the skin and mucous membranes, which leads to dermatitis and eczema ( inflammatory and allergic skin diseases), stomatitis ( ulcerative lesions of the oral mucosa), cheilitis ( cracks in the corners of the mouth).
With iron deficiency, the patient often suffers from bronchitis ( inflammation of the bronchi), tracheites ( inflammatory processes in the trachea), rhinitis ( inflammation of the nasal mucosa). At the level of the cardiovascular system, stabbing pain in the heart, low blood pressure, and shortness of breath during exercise appear.
With a lack of iron, thinning and atrophy of the mucous membrane of the gastrointestinal tract occurs, which is manifested by pain or burning in the tongue, perversion of taste ( patients eat chalk, clay, earth, lime), the acidity of gastric juice decreases with the formation of erosions and ulcers.
Muscle weakness due to iron deficiency leads to a false urge to urinate, urinary incontinence when coughing, laughing, or physical stress.
In children, chronic iron deficiency anemia leads to growth retardation, impaired memory, attention, learning disabilities, and nocturnal diuresis ( spontaneous urination during sleep).
In pregnant women, iron deficiency leads to premature birth, miscarriage, and stillbirth.
Iron is a vital microelement. Its deficiency or excess leads to damage to absolutely all organs and tissues. This negatively affects a person's quality of life. In some cases, iron deficiency can lead to irreversible consequences. And severe cases of excess or deficiency of iron can lead to death.
For the normal functioning of the body, not only protein, fat compounds and carbohydrates are needed. Microelements are of great importance. Iron in the blood, in muscle tissue, and in the liver performs important tasks. Changes in content lead to pathological conditions.
Biochemical analysis allows you to find out the level of iron in the blood and prevent the development of the disease in a timely manner.
Why do you need iron?
The peculiarity of this microelement is that it is not formed inside the body; no organ is able to synthesize iron. A person is dependent on the intake of this mineral from food.
In total, the body of an adult contains 2.5-3.5 g of iron. Of these, 2.1 g (70%) is part of hemoglobin. The remaining amount is distributed in the form of other proteins - ferritin and hemosiderin, and is stored as a reserve in the liver, spleen and muscles. Their color is due to the presence of iron.
If necessary, the body uses its savings.
The main functions of this microelement:
- ensuring the necessary structure of the protein molecule of hemoglobin in red blood cells to retain oxygen;
- participation in oxidative reactions in cells (helps absorb oxygen).
How iron is “extracted” from food
Fe molecules are first bound in the upper parts of the small intestine with the help of the transferrin transport protein and in this state it is delivered to the bone marrow, where red blood cell synthesis continues. The mineral is integrated into the hemoglobin complex.
Picture of a bone marrow section: ready-made red blood cells inside
It has been proven that iron from protein foods is absorbed by only 25-40%, and from carbohydrates (vegetables, fruits) by 80%. The explanation is the mandatory combination with vitamin C, which helps digestion.
In the absence of sufficient iron in the blood, the formation of the required amount of hemoglobin will be impaired. Other reactions are inhibited, and the transfer of oxygen by red blood cells from the lung tissue to the periphery is affected. This means the development of oxygen starvation or hypoxia.
Rules for taking the analysis
Before performing a blood test for iron, you need to avoid eating fatty and fried foods and drinking alcohol for one day. It is advisable to stop taking medications. It is not recommended to perform heavy physical work or attend sports training.
If the patient is treated with iron supplements, they must be stopped 2 weeks in advance.
Donate blood in the morning on an empty stomach. For a reliable analysis, venous blood is needed.
What can be determined in a blood test
An indirect sign of iron deficiency is a change in blood hemoglobin. The analysis is carried out even in small laboratories. He can tell the doctor the need for more detailed studies:
- serum iron concentrations;
- serum ferritin level;
- general ability to bind iron.
Ferritin shows iron reserves in tissues, so its determination indicates the body’s ability to independently compensate for the deficiency. Normal is considered to be from 58 to 150 mcg/l.
The ability to bind iron is determined by the maximum amount of the trace element that can be retained by blood proteins. Its standard value is from 50 to 84 µmol/l. The indicator decreases with an excess of iron and increases with a deficiency.
Serum iron standards
The norms depend on the person’s age and gender.
Immediately after birth and in the first month, newborns have the highest iron levels - from 17.9 to 44.8 µmol/l.
Then, up to the age of one year, the norm decreases and ranges from 7.16 to 17.9.
For teenagers - corresponds to adult standards:
- for men - from 11.64 to 30.43 µmol/l;
- for women - from 8.95 to 30.43.
Causes of iron deficiency
Iron deficiency can occur due to:
- low amount of iron-containing foods in the diet;
- vitamin deficiency;
- uncompensated increased consumption;
- disruption of the absorption process in the small intestine;
- growing need.
The main products from which the body receives iron: meat, buckwheat, beets, walnuts, chocolate, red wine.
The absence or deficiency of these products in human nutrition causes a typical pathology - anemia (anemia). It is typical for vegetarians and women who are addicted to fashionable starvation diets.
Iron-Rich Foods
The need for iron increases significantly when performing heavy work, during sports training and competitions.
Even if you eat a lot of meat products, low levels of vitamins can cause anemia.
Intestinal diseases that impair absorption contribute to the excretion of iron in feces (chronic enterocolitis, gastritis, pancreatitis).
Excessive blood loss leads to a decrease in red blood cells, and therefore iron. Most often these are nasal and gastrointestinal bleeding. Chronic blood loss is important, for example, in women with heavy periods.
What happens during pregnancy
During pregnancy, the fetus takes the required amount of iron from the mother's body. It is used to build the baby's internal organs.
In the absence of compensation for consumption, the mother develops iron deficiency anemia. The condition is aggravated by breastfeeding.
First symptoms:
- increased fatigue, weakness;
- change in the taste of food;
- dizziness;
- pale skin;
- decrease in blood pressure.
Therefore, doctors require careful nutrition of women during pregnancy and the postpartum period.
Causes of increased iron
The causes of high iron levels do not always indicate pathology.
- An increase is possible with long-term uncontrolled treatment of anemia with special drugs. All prescriptions, dosage, course duration must be agreed with your doctor.
- In the case of repeated blood or red blood cell transfusions in a state of shock, as well as with extensive burns, there may be an increased serum iron content.
This is what blood looks like in hemolytic anemia: there is no usual sediment from red blood cells, they are dissolved
Various types of anemia can be a manifestation of high iron:
- aplastic - the process of building red blood cells and other blood elements is disrupted under the influence of the use of drugs (barbiturates, antibiotics, sulfonamides, cytostatics), acute infections, poisoning, X-ray irradiation;
- hemolytic - autoimmune destruction of one's own red blood cells or under the influence of toxic toxic substances;
- anemia associated with a lack of vitamin B 12 - most often a consequence of surgery to remove part of the stomach for peptic ulcers or malignant tumors;
- Anemia due to impaired synthesis of porphyrin and heme is associated with a lack of enzymes in the bone marrow.
In all anemias, excess iron is formed from destroyed, defective red blood cells. In addition to the increase in iron content, other blood parameters are important in diagnosis.
Wilson-Konovalov disease is a hereditary lesion of the nervous system. It leads to a disruption in the absorption of iron: to its excessive accumulation, deposition in the retina and nerve cells. Brain functions suffer.
A blood test for iron levels allows you to establish the correct diagnosis and prescribe timely treatment.
Content
This substance plays an important role in the life support of the body. In human blood there is so-called bound serum iron, which for various reasons can increase or decrease, which, as a rule, indicates the presence of a variety of pathological conditions. Find out what this element is and what its significance is for the body.
What is serum iron
The correct ratio of all substances necessary for a person is the key to good health. At the same time, iron (Fe) is considered one of the most important metals for the body. This microelement is part of pigment proteins, cytochromes and acts as a coenzyme for many chemical reactions. The body contains about 4-7 mg of iron. In the bone marrow, liver and spleen, Fe is found in the form of intracellular ferritin. Only the plasma concentration of this protein complex is a reliable reflection of metal reserves.
Serum ferritin serves as a kind of “iron depot”, which is used both in case of excess and deficiency of this microelement. In tissues, Fe is in the form of hemosiderin. Serum iron is determined in combination with the transport protein transferrin. This complex is used by the body as needed, while tissue and intracellular reserves remain untouched.
Functions
Iron is of paramount importance for the body. In plasma, this element is complexed with a transport protein. Thanks to this “tandem”, free oxygen entering during breathing is bound, which is subsequently supplied to all organs and tissues. Iron in serum is involved in many energy processes and redox reactions:
- DNA synthesis;
- cholesterol metabolism;
- process of hematopoiesis;
- detoxification processes.
Serum iron norm
When assessing the serum concentration of a microelement, the nutritional-dependent nature of this indicator should be taken into account. Iron enters the body with food, so a moderate decrease in the concentration of bound transferrin during a non-strict diet or taking drugs that interfere with the absorption of Fe is considered a physiological phenomenon that can easily be eliminated by correcting the diet.
If severe iron deficiency is detected, appropriate drug treatment is prescribed. It is worth considering that in the morning the serum contains slightly more of this microelement than in the evening. With all this, serum Fe may vary in patients belonging to different age categories.
Among women
In the body of representatives of the fairer sex, iron metabolism occurs under the influence of constantly changing hormonal levels, therefore the norm of serum iron in the blood of women is slightly underestimated and is about 10.7-21.5 µmol/l, which is mainly due to menstruation. During pregnancy, plasma Fe levels can also decrease significantly. So, during gestation, this indicator should not fall below 10.0 µmol/l.
In men
Subject to a balanced diet and adherence to a daily routine, iron reserves in the stronger sex are consumed optimally. A decrease in ferritin inside cells in men occurs as a result of liver disease, which often occurs against the background of abuse (or even poisoning) of alcoholic beverages and their surrogates. The normal level of serum iron in men ranges from 14.0 to 30.4 µmol/l.
In children
The Fe content in the blood of young patients varies depending on their age, weight and height. Children under one year old who are exclusively breastfed are susceptible to a slight decrease in hemoglobin. This fact is due to the limited content of so-called heme iron in the body of babies, which is not a cause for concern. The norm of serum Fe in children under one year of age is 7-18 µmol/l, and in older children this figure can reach 9-21 µmol/l.
Serum iron is low
Most patients tend to suffer from Fe deficiency. This condition often manifests itself as a latent deficiency. In other cases, iron deficiency is accompanied by pronounced symptoms. People suffering from anemia experience severe headaches, muscle weakness, and fatigue. Serum Fe in such patients is less than 9 µmol/L. The reasons for the decrease in iron concentration are as follows:
- chronic diseases;
- malnutrition and vitamin deficiency;
- renal failure;
- Iron-deficiency anemia
- pregnancy, lactation;
- destruction of red blood cells;
- impaired iron absorption in intestinal diseases;
- oncology.
Serum iron increased
This condition is very rare. In patients with high levels of plasma iron, or hemochromatosis, yellowing of the eyeballs and skin, heart rhythm disturbances, and weight loss are noted. During instrumental studies, such patients are found to have liver enlargement, myocardial dystrophy, and pancreatic dysfunction. Excess iron (about 50-70 µmol/l) negatively affects the functioning of all organs and systems. Iron in the blood serum is increased, as a rule, against the background of the following pathologies:
- subcutaneous hemorrhages;
- primary hemochromatosis;
- taking iron-containing medications;
- metabolic disorders;
- lack of folic acid;
- chronic liver diseases.
Blood test for serum iron - explanation
This laboratory test is prescribed not only for patients with various pathologies, but also for ordinary patients during an annual preventive examination. The degree of iron absorption directly affects the functioning of the entire body, therefore it is very important to periodically check the accumulation of this element. This is especially true for women during pregnancy and breastfeeding.
What does it show
Plasma iron is in a bound state. Diagnosis of anemia is based on determining the concentration of transferrin. The iron-binding ability of serum is reflected by the so-called TIBI index. In order to identify tissue deficiency, the ferritin content inside cells is determined. Any abnormalities identified during a biochemical blood test are grounds for prescribing additional laboratory tests.
How to take it
Considering that early morning is characterized by slightly increased serum Fe, experts recommend checking the degree of saturation with this element a little later. As a rule, plasma testing for iron content is carried out from 8 to 10 am. The test is taken on an empty stomach. The day before blood sampling, you should refrain from eating fatty foods and drinking alcohol.
How to increase serum iron in the blood
Loss of protein (enzymes) and lack of vitamins negatively affects the absorption of Fe, so if you are on a strict diet, pay special attention to eating foods rich in this microelement (meat, liver, eggs, sea fish). In case of significant iron deficiency, tablets are prescribed. The intestines absorb about 1 g of Fe. Excess is excreted through sweat and feces. By eating a balanced diet, you provide your body with approximately 15 mg of heme (easily absorbed) iron.
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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.
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