Iron deficiency is widespread and responsible for many different disorders. Nevertheless, it is not always studied in routine blood tests. Many conditions that may be associated with iron deficiency (along other vitamin and nutritional deficiencies) are not considered in diagnosis and treatment. A distinction is made between the lighter form of iron deficiency syndrome and the more severe form of iron deficiency anemia. In the first form, iron deficiency syndrome, the values of when a patient become symptomatic, are different from patient to patient.

What is the role of iron in our body

The most important function of iron is the formation of blood cells. The blood transports oxygen and important nutrients to the organs and tissues.

Energy production. Mitochondria (human cell power plants) use iron to produce energy. Reduced energy production due to iron deficiency can lead to chronic fatigue and reduced brain performance. Hormone production. The formation of all hormones in the human body requires iron. Hormones fulfill many important functions in the organism. There are hormones that are responsible for mental well-being (so called happiness hormones). If these are not produced in a sufficient quantity it could lead to a depressed mood. Other hormones are responsible for concentration. Still others for a healthy sleep. Difficulties to concentrate and sleep disorders are the results.Myoglobin formation. Myoglobin transports oxygen to our muscles. Iron deficiency can therefore lead reduced physical performance and a longer recovery time. Immune system: For an optimally functioning immune defense the immune system needs iron as well as vitamins and other nutrients. Iron deficiency can lead to an increased susceptibility to infections. Hair and nails: In case of iron deficiency, the nails become brittle and hair loss is observed

What kind of symptoms and disorders can be caused by iron deficiency

From the above described functions of iron one can derive the resulting symptoms: physical and mental exhaustion (burn-out), lower levels of muscle strength, impaired concentration, increases susceptibility to infections, hair loss, brittle nails, sleep disorders, depressed mood, frequent headache and dizziness. The symptoms can be so severe that they can be confused with some pathologies such as depression, ADHD (attention deficit syndrome, especially in children), muscular pathologies, immune defects. If one of this conditions is suspected, iron deficiency and other nutritional deficiencies should be investigated prior to diagnosis and treatment. Many patients suffer iron deficiency. Once treated the symptoms disappear and there is no further investigation and therapy is necessary.

Which individuals are at risk of developing iron deficiency

First and foremost, woman in menstrual age due to monthly blood less. Children are at risk because they have a much higher iron demand because of growth, which cannot always be covered by diet. Athletes needs more iron than non-athletes. Elderly people can suffer from iron deficiency because they may be not optimally nourished because of social withdrawal, loneliness or economic problems. However in case of severe iron deficiency in elderly people other reasons, e.g. gastrointestinal bleeding should be investigated.

The diagnosis of iron deficiency

he diagnosis of iron deficiency is not easy to do. The symptoms can also have other causes. The older the patient, the more likely that the symptoms are (also) caused by other pathologies. It is therefore very important to associate the clinical symptoms with the blood values and to interpret correctly the overall situation. If the patient suffer from the previously described symptoms while having a low level of ferritin at normal hemoglobin levels, he is suspected of having iron deficiency syndrome. However, the diagnosis can definitely be made only after the administration of iron. If the patient is symptom free about 2-3 weeks after iron administration, then he has suffered from iron deficiency syndrome. If the disorders persists then there should be looked for other causes. The diagnosis should be done in several steps. First, the appropriate symptoms should be asked. Subsequently, a laboratory examination must be carried out. It is important to note that different laboratories use different scales and the values of different laboratories cannot be compared.

Therapy for iron deficiency syndrome

Experience has shown that oral iron supplements do not increase iron levels sufficiently. Especially in woman, income and monthly losses are practically the same. In addition they are not well tolerated by many patients because of gastrointestinal side effects. Therefore, the most effective therapy is the intravenous iron substitution. For each patient the individual single dose has to be calculated: as much as necessary, as little as possible. First, a saturation therapy is performed, in which the ferritin level is sufficiently raised. A laboratory check should be carried out 2-3 weeks after the administration. Subsequently, a second laboratory check should take place about 3 months later. For risks groups, the individual maintenance therapy should be calculated. For all others, it is advisable to have a check in one year or in case of recurrence of the symptoms. Intravenous iron substitution should only be carried out under the supervision of a physician or in specialized centers because of the (very small) risk of an allergic reaction.