conditions iron-deficiency

RECND4984

Iron deficiency

Condition:Iron deficiency anemia
Other:Microcytic anemia
ICD-10 Codes:D50

Naturopathic Treatments

Diet
• take iron supplements with food
• cook food in cast-iron cookware

Food high in heme iron (best absorption)
• oysters
• beef
• chicken

Vegetarian sources of non-heme iron
• black-strap molasses
• tofu
• prune juice
• kidney beans
• lentils

Specific foods that help with iron absorption
• golden kiwi
• orange juice
• lemonade

Avoid taking iron or iron-rich foods with
• black tea (green tea is less of a concern)
• mint (Mentha spp.)
milk thistle (Silybum marianum)
• chili (but turmeric is fine)
• chocolate
coffee
• proton-pump inhibitors
antacids

Supplements
iron
vitamin C - increase absorption
vitamin A
• chlorophyll
• spirulina

Botanicals
bitter herbs - increase stomach acid to help with absorption
dong quai (Angelica sinesis) - increases hematopoiesis
astragalus (Astragalus membranaceus)- increases hematopoiesis

Conventional Treatments

iron supplents

Signs & Symptoms

Most common symptoms
• fatigue
• shortness of breath
• weakness
• poor concentration
• dizziness
• headaches
• pallor

Less common symptoms
• restless legs
• pica
tinnitus
• koilonychia (concave nail)
brittle nails
• tachycardia
• glossitis
• cheilosis
• dysphagia (Plummer-Vinson syndrome)

DDx

• autoimmune hemolytic anemia
gastric ulcer
• lead poisoning
• macrocytic anemia (pernicious anemia)
• sickle cell anemia
• spherocytosis
thalassemia
vitamin C deficiency
vitamin B12 deficiency

Pathogenesis

Causes:
• blood loss (e.g. occult blood, heavy menses)
• increased iron requirement (e.g. pregnancy)
• decreased iron absorption (e.g. gastrectomy, small-bowel malabsorption syndromes)

Diagnostics

Decreased
• ferritin
• hemoglobin
• MCV

Increased
• TIBC
• transferrin
• RDW

Note: reticulocytes will be increased with blood loss

References

"Show references"

"Hide references"

Suharno D, West CE, Muhilal, Karyadi D, Hautvast JG. Supplementation with vitamin A and iron for nutritional anaemia in pregnant women in West Java, Indonesia. Lancet. 1993 Nov 27;342(8883):1325-8. PubMed PMID: 7901636.

Jamieson JA, Kuhnlein HV. The paradox of anemia with high meat intake: a review of the multifactorial etiology of anemia in the Inuit of North America. Nutr Rev. 2008 May;66(5):256-71. Review. PubMed PMID: 18454812.

Bagchi K. Iron deficiency anaemia--an old enemy. East Mediterr Health J. 2004 Nov;10(6):754-60. Review. PubMed PMID: 16335761.

van den Broek N. Anaemia and micronutrient deficiencies. Br Med Bull. 2003;67:149-60. Review. PubMed PMID: 14711761.

Liu PJ, Hsieh WT, Huang SH, Liao HF, Chiang BH. Hematopoietic effect of water-soluble polysaccharides from Angelica sinensis on mice with acute blood loss. Exp Hematol. 2010 Jun;38(6):437-45. Epub 2010 Mar 27. PubMed PMID: 20347925.

Chang MS, Kim do R, Ko EB, Choi BJ, Park SY, Kang SA, Park SK. Treatment with Astragali radix and Angelicae radix enhances erythropoietin gene expression in the cyclophosphamide-induced anemic rat. J Med Food. 2009 Jun;12(3):637-42. PubMed PMID: 19627214.

Wang PP, Zhang Y, Dai LQ, Wang KP. Effect of Angelica sinensis polysaccharide-iron complex on iron deficiency anemia in rats. Chin J Integr Med. 2007 Dec;13(4):297-300. PubMed PMID: 18180896.

Liu X, Chen K, Shi H, Cai H, Li L, Lou J, Qian B. [Effect of sodium iron chlorophyllin (SIC) on CFU-E and CFU-GM yields of normal and anemic animal models]. Zhonghua Xue Ye Xue Za Zhi. 1997 May;18(5):234-6. Chinese. PubMed PMID: 15622752.

Selmi C, Leung PS, Fischer L, German B, Yang CY, Kenny TP, Cysewski GR, Gershwin ME. The effects of Spirulina on anemia and immune function in senior citizens. Cell Mol Immunol. 2011 Jan 31. [Epub ahead of print] PubMed PMID: 21278762.

Wang MS, Li J, Di HX, Li ZL, Yang SL, Hou W, Yan JY, Zhao XM. Clinical study on effect of Astragalus Injection and its immuno-regulation action in treating chronic aplastic anemia. Chin J Integr Med. 2007 Jun;13(2):98-102. PubMed PMID: 17609906.

Lv Y, Feng X, Zhu B. [Study on effect of Astragalus membranaceus injection on hematopoiesis in anemic mice with myelosuppression]. Zhong Yao Cai. 2005 Sep;28(9):791-3. Chinese. PubMed PMID: 16447871.

Dreyfuss ML, Stoltzfus RJ, Shrestha JB, Pradhan EK, LeClerq SC, Khatry SK, Shrestha SR, Katz J, Albonico M, West KP Jr. Hookworms, malaria and vitamin A deficiency contribute to anemia and iron deficiency among pregnant women in the plains of Nepal. J Nutr. 2000 Oct;130(10):2527-36. PubMed PMID: 11015485.

Mazza J, Barr RM, McDonald JW, Valberg LS. Usefulness of the serum ferritin concentration in the detection of iron deficiency in a general hospital. Can Med Assoc J. 1978 Oct 21;119(8):884-6. PubMed PMID: 737638; PubMed Central PMCID: PMC1819106.

Kis AM, Carnes M. Detecting iron deficiency in anemic patients with concomitant medical problems. J Gen Intern Med. 1998 Jul;13(7):455-61. PubMed PMID: 9686711; PubMed Central PMCID: PMC1496985.

Beck K, Conlon CA, Kruger R, Coad J, Stonehouse W. Gold kiwifruit consumed with an iron-fortified breakfast cereal meal improves iron status in women with low iron stores: a 16-week randomised controlled trial. Br J Nutr. 2011 Jan;105(1):101-9. Epub 2010 Aug 23. PubMed PMID: 20727238.

Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010 May;91(5):1461S-1467S. Epub 2010 Mar 3. PubMed PMID: 20200263.

Nair KM, Iyengar V. Iron content, bioavailability & factors affecting iron status of Indians. Indian J Med Res. 2009 Nov;130(5):634-45. Review. PubMed PMID: 20090120.

Balay KS, Hawthorne KM, Hicks PD, Griffin IJ, Chen Z, Westerman M, Abrams SA. Orange but not apple juice enhances ferrous fumarate absorption in small children. J Pediatr Gastroenterol Nutr. 2010 May;50(5):545-50. PubMed PMID: 20639713.

Beck K, Conlon C, Kruger R, Coad J, Stonehouse W. The effect of gold kiwifruit consumed with an iron fortified breakfast cereal meal on iron status in women with low iron stores: a 16 week randomised controlled intervention study. BMC Public Health. 2010 Jan 26;10:36. PubMed PMID: 20102633; PubMed Central PMCID: PMC2823703.

McColl KE. Effect of proton pump inhibitors on vitamins and iron. Am J Gastroenterol. 2009 Mar;104 Suppl 2:S5-9. Review. PubMed PMID: 19262546.

Atanassova BD, Tzatchev KN. Ascorbic acid--important for iron metabolism. Folia Med (Plovdiv). 2008 Oct-Dec;50(4):11-6. Review. PubMed PMID: 19209525.

Haro-Vicente JF, PÉrez-Conesa D, RincÓn F, Ros G, MartÍnez-Graci Á C, Vidal ML. Does ascorbic acid supplementation affect iron bioavailability in rats fed micronized dispersible ferric pyrophosphate fortified fruit juice? Eur J Nutr. 2008 Dec;47(8):470-8. Epub 2008 Oct 24. PubMed PMID: 18953478.

Olivares M, Pizarro F, Hertrampf E, Fuenmayor G, EstÉvez E. Iron absorption from wheat flour: effects of lemonade and chamomile infusion. Nutrition. 2007 Apr;23(4):296-300. Epub 2007 Mar 13. PubMed PMID: 17350803.

Hutchinson C, Bomford A, Geissler CA. The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr. 2010 Oct;64(10):1239-41. Epub 2010 Jul 14. PubMed PMID: 20628405.

Thankachan P, Walczyk T, Muthayya S, Kurpad AV, Hurrell RF. Iron absorption in young Indian women: the interaction of iron status with the influence of tea and ascorbic acid. Am J Clin Nutr. 2008 Apr;87(4):881-6. PubMed PMID: 18400710.

Mennen L, Hirvonen T, Arnault N, Bertrais S, Galan P, Hercberg S. Consumption of black, green and herbal tea and iron status in French adults. Eur J Clin Nutr. 2007 Oct;61(10):1174-9. Epub 2007 Feb 7. PubMed PMID: 17299492.

Ullmann U, Haller J, Bakker GC, Brink EJ, Weber P. Epigallocatechin gallate (EGCG) (TEAVIGO) does not impair nonhaem-iron absorption in man. Phytomedicine. 2005 Jun;12(6-7):410-5. PubMed PMID: 16008116.

Akdogan M, Gultekin F, Yontem M. Effect of Mentha piperita (Labiatae) and Mentha spicata (Labiatae) on iron absorption in rats. Toxicol Ind Health. 2004 Sep;20(6-10):119-22. PubMed PMID: 15941008.

Samman S, SandstrÖm B, Toft MB, Bukhave K, Jensen M, SØrensen SS, Hansen M. Green tea or rosemary extract added to foods reduces nonheme-iron absorption. Am J Clin Nutr. 2001 Mar;73(3):607-12. PubMed PMID: 11237939.

Benkhedda K, L'abbÉ MR, Cockell KA. Effect of calcium on iron absorption in women with marginal iron status. Br J Nutr. 2010 Mar;103(5):742-8. Epub 2009 Oct 28. PubMed PMID: 19860985.

Johnson JM, Walker PM. Zinc and iron utilization in young women consuming a beef-based diet. J Am Diet Assoc. 1992 Dec;92(12):1474-8. PubMed PMID: 1333500.

Tuntipopipat S, Judprasong K, Zeder C, Wasantwisut E, Winichagoon P, Charoenkiatkul S, Hurrell R, Walczyk T. Chili, but not turmeric, inhibits iron absorption in young women from an iron-fortified composite meal. J Nutr. 2006 Dec;136(12):2970-4. PubMed PMID: 17116705.

Hurrell RF, Reddy MB, Juillerat M, Cook JD. Meat protein fractions enhance nonheme iron absorption in humans. J Nutr. 2006 Nov;136(11):2808-12. PubMed PMID: 17056805.

Zimmermann MB, Biebinger R, Rohner F, Dib A, Zeder C, Hurrell RF, Chaouki N. Vitamin A supplementation in children with poor vitamin A and iron status increases erythropoietin and hemoglobin concentrations without changing total body iron. Am J Clin Nutr. 2006 Sep;84(3):580-6. PubMed PMID: 16960172.

Zimmermann MB, Winichagoon P, Gowachirapant S, Hess SY, Harrington M, Chavasit V, Lynch SR, Hurrell RF. Comparison of the efficacy of wheat-based snacks fortified with ferrous sulfate, electrolytic iron, or hydrogen-reduced elemental iron: randomized, double-blind, controlled trial in Thai women. Am J Clin Nutr. 2005 Dec;82(6):1276-82. PubMed PMID: 16332661.

Walczyk T, Davidsson L, Rossander-Hulthen L, Hallberg L, Hurrell RF. No enhancing effect of vitamin A on iron absorption in humans. Am J Clin Nutr. 2003 Jan;77(1):144-9. PubMed PMID: 12499334.

Hurrell RF, Reddy M, Cook JD. Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. Br J Nutr. 1999 Apr;81(4):289-95. PubMed PMID: 10999016.

Mascitelli L, Pezzetta F, Sullivan JL. Inhibition of iron absorption by coffee and the reduced risk of type 2 diabetes mellitus. Arch Intern Med. 2007 Jan 22;167(2):204-5; author reply 205. PubMed PMID: 17242323.

Zijp IM, Korver O, Tijburg LB. Effect of tea and other dietary factors on iron absorption. Crit Rev Food Sci Nutr. 2000 Sep;40(5):371-98. Review. PubMed PMID: 11029010.

Kuligowski J, Halperin KM. Stainless steel cookware as a significant source of nickel, chromium, and iron. Arch Environ Contam Toxicol. 1992 Aug;23(2):211-5. PubMed PMID: 1514841.

Sharieff W, Dofonsou J, Zlotkin S. Is cooking food in iron pots an appropriate solution for the control of anaemia in developing countries? A randomised clinical trial in Benin. Public Health Nutr. 2008 Sep;11(9):971-7. Epub 2007 Oct 15. PubMed PMID: 17935647.

Geerligs PD, Brabin BJ, Omari AA. Food prepared in iron cooking pots as an intervention for reducing iron deficiency anaemia in developing countries: a systematic review. J Hum Nutr Diet. 2003 Aug;16(4):275-81. PubMed PMID: 12859709.

Heath AL, Skeaff CM, O'Brien SM, Williams SM, Gibson RS. Can dietary treatment of non-anemic iron deficiency improve iron status? J Am Coll Nutr. 2001 Oct;20(5):477-84. PubMed PMID: 11601562.

Disclaimer: This content is subject to change. The information is intended to inform and educate; it does not replace the medical evaluation, advice, diagnosis or treatment by a healthcare professional. www.healthydigestionclinic.com © 2015 NDAssist Inc. and/or its affiliates. All rights reserved.