Iron is a vital mineral which helps in maintaining healthy blood. It makes up the major component of haemoglobin, the red blood cell protein that carries oxygen from the lungs to other parts of the body¹. Iron is also part of myoglobin in muscle cells that supports muscle metabolism and healthy connective tissue. It plays important role in promoting physical growth, neurological development, cellular functioning and hormone synthesis²⁻³.
Most of the elemental iron in adults is present in haemoglobin². The remaining iron is stored in the form of ferritin (the main protein in blood that binds to iron) or hemosiderin (a degradation product of ferritin) in the liver, spleen, and bone marrow or is located in myoglobin in muscle tissues¹,⁴. People who are prone to iron deficiency include pregnant women, infants and young children, women with heavy menstrual bleeding, frequent blood donours, cancer patients, those with certain health condition like gastrointestinal disorders or surgery and heart condition.
Iron can be obtained through diet or supplementation. Dietary iron are present in two forms, namely heme and non-heme. Animal such as meat, seafood and poultry are rich in both heme and non-heme iron whereas plants, beans and iron-fortified foods contain non-heme iron only.
The World Health Organisation (WHO) estimates about half of the 1.62 billion cases of anaemia in global is caused by iron deficiency⁵. Signs and symptoms of deficiency include microcytic and hypochromic anaemia, lethargy, cognitive impairment, developmental delay, amenorrhea, hair loss and enlarged liver. In pregnancy, iron deficiency is associated with adverse pregnancy outcomes such as heightened infant’s low birthweight risk, premature birth, low iron stores, impaired cognitive and behavioural development as well as increased perinatal maternal mortality6. Studies reported iron supplementation can prevent IDA in pregnant women and associated adverse impacts in their newborns⁷,⁸.
Some clinical conditions with inflammatory, infectious and neoplastic diseases (rheumatoid arthritis, inflammatory bowel disease, and hematologic malignancies) are at risk of anaemia of chronic disease (also known as anaemia of inflammation)²,⁹. It is the second most common type of anaemia after IDA¹⁰. This happens when inflammatory cytokines upregulate the hormone hepcidin (a circulating peptide hormone is the main regulatory of absorption and distribution of iron in the body) and resulted in disruption of iron homeostasis. When the main therapy for treating the underlying disease is not possible, iron supplementation in the form of oral, intravenous, or parenteral and/ or erythropoiesis-stimulating agents (EFSAs) are used¹⁰.
Iron is generally well tolerated when taken in doses below the tolerable upper intake level (UL) of 45mg daily. The most common adverse reactions include abdominal pain, constipation, diarrhea, gastrointestinal irritation, nausea and vomiting. In some rare cases, oral or gastric ulcerations may occur.
Recommended dietary allowances (RDAs) for iron
– Bisphosphonates (for osteoporosis)
Iron reduces the absorption of this drug
– Chloramphenicol (for serious infections)
This drug might reduce response to iron therapy in iron deficiency anaemia
– Dolutegravir (for HIV treatment)
Iron might reduce drug level by decreasing its absorption
– Levodopa (for Parkinson’s disease)
Iron might reduce drug level by decreasing its absorption
– Tetracycline and quinolone antibiotics
Iron might reduce drug level by decreasing its absorption
– Acacia
Taking iron along with acacia might result in decreased absorption of iron or acacia
– Betacarotene and vitamin A
This might enhance dietary non-heme iron absorption in those with anaemia and vitamin A deficiency
Iron is generally well tolerated when taken in doses below the tolerable upper intake level (UL) of 45mg daily. The most common adverse reactions include abdominal pain, constipation, diarrhea, gastrointestinal irritation, nausea and vomiting. In some rare cases, oral or gastric ulcerations may occur.
Recommended dietary allowances (RDAs) for iron
– Bisphosphonates (for osteoporosis)
Iron reduces the absorption of this drug
– Chloramphenicol (for serious infections)
This drug might reduce response to iron therapy in iron deficiency anaemia
– Dolutegravir (for HIV treatment)
Iron might reduce drug level by decreasing its absorption
– Levodopa (for Parkinson’s disease)
Iron might reduce drug level by decreasing its absorption
– Tetracycline and quinolone antibiotics
Iron might reduce drug level by decreasing its absorption
– Acacia
Taking iron along with acacia might result in decreased absorption of iron or acacia
– Betacarotene and vitamin A
This might enhance dietary non-heme iron absorption in those with anaemia and vitamin A deficiency
The material is prepared for informational purposes only and should not be construed as a piece of personal medical advice. Owing to each person’s varying health needs, a physician should be consulted before acting on any information provided in this material. Although every effort is made to ensure that this material is accurate, it is compiled for internal use only and should not be considered definitive. Neither VitaHealth nor its employees, or information providers shall be responsible or liable for any errors, inaccuracies, or other defects in the information contained in this publication.
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