How We Can Prevent Anemia?
Consider
the following groups
i)
Pregnant women, women with menorrhagia,
ii)
Consumers of a strict vegetarian diet.
iii)
Infants,
iv)
Adolescent girls,
v)
and regular blood donors.
Pregnant
women have been given supplemental iron often in the form of all-purpose
capsules containing vitamins, calcium, and iron. If the patient is anemic
(hemoglobin < 11 g/dL), administer the iron at a different time of day than
calcium because calcium inhibits iron absorption.
Iron supplementation of
the diet of infants is advocated. Premature infants require more iron
supplementation than term infants. Infants weaned early and fed bovine milk
require more iron because the higher concentration of calcium in cow milk
inhibits absorption of iron. Usually, infants receive iron from fortified
cereal. Additional iron is present in commercial milk formulas.
Iron supplementation in
populations living on a largely vegetarian diet is advisable because of the
lower bioavailability of inorganic iron than heme iron.
How Is Iron Deficiency Anemia
Treated?
Diets high that
include the following foods can help treat or prevent iron deficiency:
i)
dark green, leafy vegetables
ii)
dried fruits
iii)
nuts
iv)
iron-fortified cereals
Additionally, vitamin
C helps our body absorb iron.
Of the
various iron salts available, ferrous sulfate is the one most commonly used.
Although the traditional
dosage of ferrous sulfate is 325 mg (65 mg of elemental iron) orally three
times a day, lower doses (eg, 15-20 mg of elemental iron daily) may be as
effective and cause fewer side effects. To promote absorption, patients should
avoid tea and coffee and may take vitamin C (500 units) with the iron pill once
daily.
Claims are made that other iron salts (eg, ferrous gluconate) are
absorbed better than ferrous sulfate and have less morbidity.
If possible, one should take iron tablets on
an empty stomach, which helps the body absorb them better. If they upset the
stomach, one can take them with meals. One may need to take the supplements for
several months. Iron supplements may cause constipation or stools that are
black in color.
What about Parenteral Iron Therapy?
Reserve parenteral iron
for patients who are either unable to absorb oral iron or who have increasing
anemia despite adequate doses of oral iron.
What are Causes of Iron
Poisoning or Toxicity?
1. Acute iron poisoning from accidental ingestion of iron containing
dietary supplements is the most common cause of acute toxicity. It most often
occurs in children. Severe toxicity occurs after the ingestion of more than 0.5
g of iron or 2.5 g of ferrous sulfate. Toxicity occurs about 1–6 hours after
ingestion.
2. Inhalation of iron oxide fumes or dust may cause pneumoconiosis
in occupational settings.
3. Chronic iron toxicity from iron overload in adults is a
relatively
common
problem.
There are three basic ways
in which excessive amounts of iron can accumulate in the body.
1.
Hereditary hemochromatosis
due to abnormal absorption of iron from the intestinal tract. Hereditary
hemochromatosis is an autosomal recessive disorder attributed to mutation in
the hemochromatosis gene.
2.
Excess intake of iron
through diet or from oral iron preparations.
3.
Repeated blood
transfusions body iron can increase 10 times higher than normal
Symptoms of Toxicity
abdominal pain,
diarrhea, and vomiting.
pallor or cyanosis,
metabolic acidosis,
and cardiac collapse.
Death may occur in
severely poisoned children within
24 hours.
How We can Treat those Who get Toxicity Due to
Iron?
- Consult the physician
General and specific treatment include:
- Supportive therapy to maintain
adequate blood pressure and electrolyte balance is essential
- I.V. fluid resuscitation 20
mL/kg
- Potassium and glucose
administration as necessary
- Desferrioxamine is a chelating agent that forms a water soluble
desferrioxamine-iron complex
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