30% of the world’s population suffers from iron deficiency – This makes iron deficiency one of the most common deficiency conditions. An iron deficiency results in the human body not making enough hemoglobin. Hemoglobin, the red blood pigment, is found in red blood cells. Without this substance, the body cannot bind and transport enough oxygen.
How to recognize if you suffer from iron deficiency, what are the causes, and more information about iron deficiency can be found in this article.
Iron occurrence in the body
Of the three to four grams of iron in the body, some are bound to transferrin, the transport protein. Another part is found in hemoglobin, the red blood pigment of red blood cells.
How much iron does the body need?
A balanced diet should contain 10 to 15 milligrams of iron. However, the intestine can only absorb five to ten percent of it. Depending on gender, age and life situation, the body loses different amounts of iron, which must be replaced. After menopause, men and women lose about one milligram a day. Menstruating women lose up to three milligrams of iron during menstruation. The body of breastfeeding women also requires a higher amount of iron during lactation.
The German Nutrition Society recommends the following amounts for iron intake:
- 0 to 4 months: 0.5 mg
- 4 to 12 months: 8 mg
- Children up to 15 years:
- 1 to 7 years: 8 mg
- 7 to 10 years: 10 mg
- 10 to 15 years (boys): 12 mg
- 10 to 15 years (girls): 15 mg
- Adolescent/Adult Male:
- 15 to 19 years: 12 mg
- 19 to 65 years: 10 mg
- Adolescent/adult female:
- 15 to under 51 years: 15 mg
- 51 to 65+ years: 10 mg
- Pregnant and breastfeeding women:
- Pregnant woman: 30 mg
- Breastfeeding: 20 mg
Causes of iron deficiency
Iron deficiency occurs when the iron requirement is greater than the intake. It can occur, for example, when not enough iron is absorbed through food, or when the body’s iron absorption is disturbed. Increased iron loss can also be the cause of iron deficiency.
In Europe, the most common cause of iron deficiency is chronic blood loss. Bleeding in the gastrointestinal tract, e.g. due to gastritis, is one of the most common causes. Menstruation is also a common reason for the deficiency.
A meat-free or too one-sided diet can also lead to deficiency symptoms. Infants, young children, alcoholics, vegetarians and vegans are most likely to be affected.
When the body’s iron absorption is disturbed, the body cannot properly absorb iron from food. Triggers for this could be, for example, chronic inflammatory bowel diseases. Impaired iron absorption may also occur after partial removal of the stomach. Prolonged use of medications for excessive stomach acid production may interfere with iron absorption. High consumption of black tea or coffee and rhubarb also leads to inhibited iron absorption.
Our body needs iron to transport oxygen. In addition, the body needs iron for blood formation and other metabolic processes. If the body is not supplied with enough iron, this is reflected in the following complaints, among others:
- Difficulty concentrating
- Shortness of breath
- Cracked skin and torn corners of the mouth
- Brittle nails
- Brittle hair
How to diagnose iron deficiency?
If iron deficiency is suspected, it should be discussed with a doctor. It is important to take a medical history, which should include lifestyle and dietary habits, previous illnesses, and medication. In addition, the duration and severity of menstrual bleeding and, in older persons, bleeding in the gastrointestinal tract or in the urinary and genital organs should be inquired about.
A blood test can be used to determine whether a person has an iron deficiency. The ferritin level, hemoglobin level, CRP level, and transferrin saturation, among others, are measured. Serum iron and transferrin are needed to calculate transferrin saturation.
The hemoglobin value (Hb value) indicates the concentration of the red blood pigment (hemoglobin). If this value is too low, then anemia is present.
Ferritin (storage iron) is a water-soluble protein. This substance is found in the cells of the liver, bone marrow, spleen, and muscles.
It indicates how well the body’s iron stores are filled. If the value is too low, iron deficiency anemia may be present. If the body is fighting an infection or a chronic disease is causing inflammation in the body, ferritin levels may remain high even though iron deficiency is present.
To determine if inflammation is present, the CRP level is still measured. The CRP value is the parameter for the C-reactive protein.
Transferrin saturation indicates how much iron the transport proteins are loaded with. With the help of transferrin, iron is transported from cell to cell through the bloodstream from the intestinal cell. If the saturation is too low, then there is too little iron in the body. Transferrin saturation can also indicate whether one is iron deficient in the presence of inflammation. For the value to have a high significance, the blood should be taken in the morning on an empty stomach.
After that, the search for the cause is on. To rule out bleeding, the stool must be examined for blood. Gastrointestinal endoscopy may also be necessary if bleeding remains suspected. In women, a gynecological examination could also be beneficial.
Consequences of iron deficiency
In the case of iron deficiency, the body empties the iron stores. This is emptied until all reserves are exhausted. By then, for example, symptoms of exhaustion appear. This is followed by iron deficiency anemia.
The body cannot work properly with iron deficiency – the immune system also suffers. In addition to the symptoms of iron deficiency, such as brittle nails and hair loss, iron deficiency can also lead to a higher susceptibility to infections.
With an iron deficiency, not enough oxygen can be transported, the heart beats faster and breathing is accelerated. In this way, the body tries to compensate for the lack of oxygen. During physical exertion, this can lead to palpitations as well as shortness of breath. If the body has to do this for a long period of time, it can lead to heart muscle weakness.
Iron deficiency can also promote postpartum depression. During pregnancy, the body has a higher additional requirement, which is 1,000 milligrams of iron. In addition, there is often blood loss during and after birth. However, postpartum depression can also be triggered by hormonal or social circumstances, lack of sleep, or anxiety.
In child development, iron deficiency can also lead to developmental disorders. Iron deficiency in the unborn child can lead to premature birth, low birth weight or growth retardation. In growing children and adolescents, to concentration disorders, impaired brain development or a disturbed menstrual cycle.
Prevent and treat iron deficiency
Those who belong to the risk group should have their blood values checked regularly. Particular attention should be paid to ferritin levels, transferrin saturation and CRP levels.
If iron deficiency is present, more iron should be incorporated into the diet. The bivalent iron contained in meat can be processed particularly well by the body. However, if a change in diet is not sufficient because, for example, anemia is already present, iron therapy may be needed.
There are several possibilities. On the one hand, iron can be supplied to the body via tablets or suspensions (oral iron therapy), on the other hand by iron infusions (intravenous iron therapy).
However, larger amounts of iron in the form of dietary supplements should not be taken without medical advice, even if iron supplements are available over-the-counter. This is because the body cannot excrete excess iron and stores it in the organs. When iron stores are overfilled, organ damage can result.
Who is most often affected by iron deficiency?
In Europe, about 5-10% of the population is affected by iron deficiency. Women and children are most frequently affected. It occurs in 20% of women of childbearing age. During the period, the body loses between five and 80 ml of blood per month. Between 2.5 and 40 ml of iron is lost in the process. During pregnancy, the iron requirement doubles.
In the female body, the blood volume increases and, as a result, the amount of iron needed also increases. The extra iron is needed, among other things, for the continued normal blood circulation of the body, for that of the fetus, the placenta, and the umbilical cord. Therefore, during pregnancy, you should also avoid substances that limit the absorption of iron. Pregnant women who have previously had heavy menstrual periods or several pregnancies in quick succession belong to the risk group for iron deficiency.
Vegetarians and vegans also belong to the risk group for iron deficiency. This is because the iron from meat is more easily absorbed. Indeed, plant iron is transported with other metals (zinc, magnesium, calcium), while animal iron is transported separately. However, iron intake from plant sources can be increased up to fourfold by vitamin C.
People with pre-existing health conditions are also at higher risk for iron deficiency. People suffering from kidney disease, heart problems, or tumors, for example, usually have a functional iron deficiency. As a result, the iron present in the body cannot be used by the body. In addition, high-performance athletes also have an increased risk of developing iron deficiency.
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Iron-rich foods, such as red meat, legumes like chickpeas or lentils, oatmeal, nuts, or sesame seeds can help replenish iron stores. The additional intake of vitamin C, e.g. through fruits, vegetables, or juices, can improve the body’s absorption of iron. If dietary changes are not enough, iron supplements will probably need to be taken. However, this should be discussed with a doctor beforehand.
When you have iron deficiency, your body can’t work properly. Not enough oxygen is transported and the body is more susceptible to infections. Symptoms of fatigue, brittle nails, torn corners of the mouth, and difficulty concentrating may occur. When the body’s iron reserves are depleted, anemia results.
- Tannins, in red wine or black tea
- Oxalic acid, in spinach or rhubarb
- Phytate, in cereals
- Wheat bran
- Milk and soy products