Iron Deficiency

General text about anemia can be found here and general article about the lack of minerals can you find here.


Iron deficiency is probably the most common cause of anemia. Iron is an essential component of hemoglobin, which is a blood pigment located in all red blood cells that allows transport of breathing gases. Our body contains only about 6 grams of iron, which is approximately the weight of an average nail. It is a very little amount and that is why our organism pays a great effort to conserve the iron ant to prevent its losses. The molecules of iron are deposited within cells bound to protein ferritin (reservoir form) and transported in blood bound to protein transferrin (transport form).


The cause is usually a combination of more factors. The patients may have insufficient dietary intake of iron due to improper diet. This may be combined with excessive blood loss, typically by menstrual bleeding in fertile women. Similarly, anemia in iron deficiency may occur in patients with chronic losses of blood in urine or in stool. Iron deficiency may also accompany chronic diseases with malabsorption of nutrients (see related text!) such as untreated celiac disease or Crohn's disease.


Anemia is the most visible trouble in iron deficiency. The patient suffers from anemic syndrome, which is related to reduced capacity of blood to transport breathing gases to the brain and muscles. Its symptoms include fatigue, dizziness, exertional shortness of breath, pallor and fainting. The pallor is due to lower concentration of hemoglobin in peripheral blood and it can be visible on the skin, mucous membranes and conjunctiva.


The patient with any of the above mentioned symptoms is usually examined by a physician including at least basic blood tests. The blood tests show decreased level of hemoglobn a lower number of erythrocytes. The serum level of iron is decreased, serum level of ferritin is also decreased and there is high binding capacity of transferrin. This outcome reflects the lack of stored iron (low ferritin) and the effort of the body to transport any precious molecules of iron to cells (high binding capacity of transferrin). It should be emphasized that it is not right just to confirm the iron-deficiency anemia, but we should also try to know its cause, i.e. to exclude chronic blood losses by gynecological bleeding, blood in stool and blood in urine.


The best prevention is adequate intake of food with a high amount of iron. This is animal meat and especially the liver tissue. However, even many vegetarian foods including peas and beans are rich in iron. Iron is present also in spinach, but the amount is considerably lower than it used to be expected. Iron absorption in digestive tract is potentiated by vitamin C, and therefore it is advisable to eat foods containing this vitamin (potatoes and citrus fruits such as oranges, lemons, mandarins).


The iron may be supplemented in oral forms and in some cases of serious malabsorption; there is even intravenous form of iron-rich solutions. It is advisable to tell the patient that iron supplements in tablet forms may cause change of stool color to green or even black.


Note: In a disease called hemochromatosis, the problem is quite the opposite. It is a congenital genetic defect causing uncontrollable absorption of iron from the intestines and its accumulation in the body. As it is mentioned in the beginning of this text, our body has practically no efficient means of iron elimination.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources