According to the World Health Organization, as many as 80% of the world's population is iron deficient, while 30% of people may suffer from iron deficiency anemia.
Iron deficiency and iron deficiency anaemia are important health problems that affect people around the world in a wide range of countries around the world, and are the only common nutritional deficiencies in developed countries, as well as the most common type of anemia in developing countries.
Stage 1: Puberty.
During puberty, growth and development are vigorous, the body's demand for iron is large, coupled with menstrual cramps, resulting in anemia.
Stage 2: Gestation and lactation.
During pregnancy and lactation, it is necessary to meet its own iron needs, but also to supply the baby with nutrients, which greatly increases the iron demand, and if it is not supplemented, anemia is almost inevitable.
The prevalence of iron deficiency anemia in pregnant women in China is 19. 1%, especially the prevalence of iron deficiency anemia in the third trimester of pregnancy can reach 33.8%.
Phase 3: Middle age.
Middle-aged women are affected by intrauterine contraceptive rings, uterine fibroids, etc., menstrual volume is more, and iron loss has become inevitable.
Stage 4: Old age.
Elderly women have decreased gastrointestinal absorption function, hematopoietic failure, and the occurrence of anemia has also increased.
Of course, in addition to women's own physiological characteristics, women have many misunderstandings and behavioral habits in diet, such as many women dieting or unreasonable diet structure (mainly vegetarian), which also leads to women's easy iron deficiency.
For non-pregnant women, iron deficiency can lead to symptoms such as tiredness, pallor, shortness of breath, headaches, anxiety, hair loss, and may even induce serious diseases such as heart failure.
For pregnant women, iron deficiency will endanger two generations, not only making them more likely to get pregnancy hypertension, premature rupture of membranes, and puerperal infections, but even miscarriage, stillbirth, premature birth and other hazards.
In addition, maternal iron deficiency leads to neonatal iron deficiency, which further affects the intellectual development and resistance of infants and young children.
Therefore, it is crucial for women to supplement iron properly, and we must have a basic understanding of iron deficiency before learning how to supplement iron.
We all know that iron deficiency and anemia are closely related, and many people equate iron deficiency with anemia. Not really. First of all, anemia is not necessarily iron deficiency, there are many causes of anemia, such as folate deficiency, viral infection, erythrocytose deficiency, etc. can cause anemia. Secondly, iron deficiency does not necessarily lead to anemia, and iron deficiency anemia is the most serious stage of iron deficiency.
Clinical iron deficiency is divided into three stages:
1. Iron deficiency phase: in the early stage of the disease, the storage of iron in the body is reduced, but the iron supplied to red blood cells to synthesize hemoglobin has not been reduced, and laboratory tests show a decrease in serum ferritin.
Serum ferritin is the most effective and simple indicator of iron reserves in the body, while serum iron, transferrin saturation, etc. are affected by diurnal changes and recent diet, and are not suitable as indicators for judging iron deficiency.
In general, we can simply think that the serum ferritin during pregnancy < 20 μg/L; in addition to pregnancy, the serum ferritin < 15 μg/L in healthy people, the body has iron deficiency.
2. Iron deficiency erythropoiesis phase: If iron deficiency continues to worsen, the stored iron is further depleted, and the iron required to produce red blood cells will be insufficient.
As we all know, hemoglobin is composed of heme and globin, and heme is formed by the combination of protoporphyrin and iron, and when iron is deficient, protoporphyrin can only accumulate in red blood cells. Therefore, the laboratory test at this stage is mainly an increase in free porphyrin, and the amount of hemoglobin in the body has not been reduced.
3. Iron deficiency anemia period: In addition to the characteristics of stages 1 and 2, there is a significant decrease in red blood cells and hemoglobin in the body, and a variety of anemia symptoms are shown.
Specifically, iron deficiency anemia is based on iron deficiency and iron deficiency erythropoiesis, with hemoglobin values (Hb) < 120 g/L for men and 110 g/L< for women, 110 g/L for children aged 6 months< to 5 years, 115 g/L < 5-12 years, and 120 g/L < 120 g/L for children aged 6 months to 5 years, and 120 g/L < 12-15 years.
The above is the reference range for sea level dwellers, and for every 1000 meters increase in altitude, hemoglobin values should rise by about 4%.
Treatment includes both etiological therapy and iron supplementation, and is often based on etiological therapy. It is not difficult to diagnose iron deficiency anemia, but how to find the cause after diagnosis. Once the cause is removed and the body's supply and demand balance for iron is restored, it is possible that additional iron supplementation will no longer be required.
2. Iron Supplementation Treatment:
1) Improve diet: eat more iron-rich foods, such as lean meat, animal liver, kelp, black fungus, beans, etc., animal source subway absorption efficiency is higher than plant iron. Eat less foods that inhibit iron absorption, such as strong tea, coffee, etc.
2) Oral iron: the first choice for iron supplementation is food supplementation, and when there is insufficient food supplementation, oral iron is required under the guidance of a doctor.
Pregnant women with a clear diagnosis of iron deficiency anemia should be supplemented with elemental iron 100-200 mg/day, and hemoglobin should be reviewed 2 weeks after treatment to evaluate efficacy. After treatment until hemoglobin returns to normal, continue oral iron for 3-6 months or up to 3 months postpartum.
For pregnant women with non-anemia, serum ferritin < 30 μg/L, and elemental iron should be supplemented with 60 mg/day, and efficacy should be evaluated after 8 weeks of treatment.
For ordinary women in non-pregnant periods, after diagnosis of iron deficiency anemia, 100 mg of elemental iron is taken orally daily for 4-6 weeks of treatment to observe changes in hemoglobin.
At present, there are two major categories of inorganic iron and organic iron on the market, inorganic iron is represented by ferrous sulfate, organic iron includes dextran iron, ferrous gluconate, ferrous sorbitol, ferrous fumarate, ferrous succinate, protein ferruccinate and polysaccharide iron complex.
Among them, iron-dextran, also known as iron dextran, is one of the important derivatives of low molecular weight dextran, which is a complex of dextran and iron hydroxide with a weight average molecular weight (Mw) of 5000 to 7500, with an iron content of 40 to 45%. Dextran iron is an organic trivalent iron complex, is a water-soluble hydrophilic colloid, easy to be absorbed by the intestine, without the need to reduce trivalent iron to divalent iron, because it does not produce free iron ions, almost no general iron gastrointestinal reaction, good taste, easy to accept in children.
Animal experiments have shown that organic trivalent iron is more easily absorbed by the intestine and its bioavailability is not lower than that of ferrous. Trivalent iron uptake has also been reported to be achieved through the integrin-swimming ferritin-ferritin-ferritin pathway.
Dextran iron oral solution is the third generation of iron, used for iron deficiency anemia caused by chronic blood loss, malnutrition, pregnancy, child development, etc., and is currently a common drug for the prevention and treatment of iron deficiency and iron deficiency anemia. Studies have shown that dextran iron has the characteristics of significant efficacy, rapid absorption, high bioavailability, few adverse reactions, good taste and convenient to take, and is suitable for patients of all ages in school-age children, infants, pregnant women and the elderly.
Finally, if the stool turns black during iron supplementation, it is normal and do not be nervous. Long-term iron supplementation may also stain black teeth, oral solution can be taken with a straw or gargling after taking, oral tablets can put the drug on the tongue, directly drink with water to avoid chewing, can also be combined with vitamin C or juice, easy to absorb iron.
Finally, if the clinical symptoms are improved and the hemoglobin is normal after taking the dextran iron oral solution, iron supplementation is also needed for 2 months to facilitate the storage of iron in the body and prevent the recurrence of the disease.
bibliography:
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