Signs, symptoms & indicators of Iron Requirement
Constant fatigue
Iron supplementation may benefit fatigued women of childbearing age even if their hemoglobin level is within the normal range, a primary care study shows. However, the study indicated that the effect may be confined to those women with serum ferritin concentrations at 50 microgram/L or lower.
The randomised controlled trial found that non-anemic women presenting with unexplained fatigue improved after a month on iron supplements compared to a matched group given placebo. The study, completed by 136 women aged 18 to 55 years, was conducted in an academic primary care center and 8 general practices in Switzerland.
The level of fatigue after 4 weeks decreased by 29% in the group given 80mg/day of oral long acting ferrous sulphate (an iron supplement) and decreased by 13% in the placebo group.
The authors said they found a significant response only in the patients with low or borderline serum ferritin concentrations. This suggests that iron deficiency could be present even with a ‘normal’ concentration of serum ferritin,’ the researchers said.
Identifying iron deficiency without anemia as a potential cause of fatigue was important and may avoid the inappropriate attribution of symptoms to emotional causes or life stressors, they concluded. Women with normal hemoglobin levels, other obvious physical or psychiatric causes of fatigue, and women with chronic fatigue syndrome (CFS) were excluded from the study. [ British Medical Journal 2003; 326: p.1124]
A sore tongue
Backward-curving fingernails
Brittle fingernails
Conditions that suggest Iron Requirement
Canker Sores (Aphthous Ulcers)
Vitamin B12, folate, zinc and iron have been shown to be effective in up to 60% of patients with canker sores when such a vitamin or mineral deficiency has been documented. [Dermatologic Clinics 1996:14, pp.243-256, British Dental Journal 1985:159, pp.361-367]
Poor Memory
Research has shown that women with moderately low iron levels might be at risk for memory, attention and poor mental function. Experts stated the simple solution to this problem was recommending women take iron supplements. The study involved dividing women into three groups according to their iron levels, which were classified as either normal, iron-deficient but not anemic, or anemic. The women’s ages ranged from 18 to 35 and iron measurements were taken from each of them to determine their iron levels. During the initial stages of the study, women were given computerized tests that were used to calculate their attention, memory and learning skills, and then they were given either a daily iron supplement or placebo.
After four months, the women took the computerized tests again. The first set of test results showed women with iron levels in the normal range scored the highest compared to the scores of the iron-deficient women who didn’t have anemia, who were lower. It was also discovered that anemic women didn’t score well on the test and took a longer time to finish it. However, the results showed an improvement in the testing scores after the women took supplements and brought their iron up to healthy levels. [Yahoo! News April 19, 2004]
Restless Leg Syndrome (RLS) / Periodic Limb Movement Disorder (PLMD)
See the treatment link between RLS and iron.
Female Hair Loss
Iron deficiency anemia can in some cases contribute to hair loss.
Risk factors for Iron Requirement
(Very) low ferritin levels
Counter Indicators
Elevated/normal ferritin levels
(Past) H2-blocker antacid use
By reducing stomach acid levels, H2 blockers might interfere with the absorption of iron, zinc, and perhaps other minerals.
(Past) calcium-based antacid use
Counter Indicators
Iron supplementation
(High) coffee consumption
Research has shown that drinking coffee causes a significant loss of several vitamins and minerals, including vitamins B and C, calcium, iron, and zinc.
Menorrhagia (Heavy Periods)
Chronic iron deficiency can be a cause of menorrhagia, creating a cycle of more blood loss (iron loss) making the condition worse.
Iron Requirement can lead to
Recommendations for Iron Requirement
Caffeine/Coffee Avoidance
Research has shown that drinking coffee causes a significant loss of several vitamins and minerals, including vitamins B and C, calcium, iron, and zinc.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Mineral
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Hemoglobin
The oxygen-carrying protein of the blood found in red blood cells.
Myoglobin
An oxygen-carrying muscle protein that makes oxygen available to the muscles for contraction.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Microgram
(mcg): 1/1,000 of a milligram in weight.
Placebo
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Milligram
(mg): 1/1,000 of a gram by weight.
Chronic Fatigue Syndrome
CFS (Chronic Fatigue Syndrome) is a disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.
Cobalamin
Vitamin B-12. Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Canker Sores
Also known as Aphthous Ulcers, these are small, painful ulcers that occur on the inside of the cheek, lip or underside of the tongue. Caused by an assortment of viruses, doctors call this condition aphthous stomatitis. Canker sores usually clear up by themselves within a week or so, but they often recur, sometimes in the form of multiple sores.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
H2 Blockers
Medications in this family sharply decrease stomach acid production. They are widely used for the treatment of ulcers as well as for mild cases of esophageal reflux (heartburn). Drugs that fall into this family include cimetidine (Tagamet, Tagamet HB); famotidine (Pepcid, Pepcid AC, Pepcid RPD); nizatidine (Axid, Axid AR); ranitidine hydrochloride (Zantac, Zantac EFFERdose, Zantac GELdose, Zantac 75).
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Menorrhagia
Abnormally heavy menstrual period.