L10 - iron II

How is iron balanced?

absorption & reutilisation - excretion + losses

What is controlled for iron balance?

iron absorption is controlled and can be upregulated or downregulated when needed but iron excretion is not controlled

What are our iron losses?

epithelial cells: skin, intestinal mucosal cells, UTI cells, fluids: blood (gut, menstrual) and bile

How is iron reutilised?

the formation of erythrocytes requires more iron than we can absorb a day, majority of iron provided from the breakdown of RBCs by macrophages in the spleen and liver

What are the 2 consequences of iron deficiency?

iron deficiency anaemia, depletion of iron stores

What are the consequences of iron deficiency anaemia?

decreased growth, behavioural disturbances and decreased cognitive function, fatigue and decreased work tolerance, spoon shaped nails

What are the consequences of depletion of iron stores?

potentially decreased cognitive function, work performance and mood, fatigue and increased risk of iron deficiency anaemia

What is the difference between iron deficiency anaemia and depletion of iron stores?

depletion of iron stores doesn't decrease haemoglobin to a severe point

Who are the groups at risk of iron deficiency?

preterm infants, infants and toddlers, menstruating people, pregnant people, blood donors

Why are preterm infants at risk of iron deficiency?

fetus accumulates iron stores only in the 3rd trimester of pregnancy

Why are infants and toddlers at risk of iron deficiency?

have very high growth rates and small energy intakes

What are the causes of iron deficiency?

low intake and low bioavailability - low levels of enhancers and high levels of inhibitors, or high requirements

What are high requirements that can cause iron deficiency?

growth, blood loss, pregnancy

What are the iron supplements?

ferrous suplhate tablet, ferrous sulphate liquid, intramuscular and intramuscular/intravenous Fe

What are the effects of iron supplements?

nausea, vomiting, and constipation, pain and staining (IM Fe), anaphylaxis (IV Fe)

How to treat depletion of iron stores?

start with iron supplement to return status to healthy, then change diet to increase enhancers and reduce inhibitors

What are the 4 types of iron overload?

acute iron toxicity, hereditary haemochromatosis, african iron overload

What is acute iron toxicity?

unintentional overdose of iron tablets, common cause of poisioning deaths in children, can impact intellectual disability or cause death

What is hereditary haemochromatosis?

genetic condition affecting the HFE gene resulting in poor iron absorption and iron accumulates in liver, pancreas, and heart muscle, treatment is effective if started early

What is a symptom of hereditary haemochromatosis?

iron fist - iron builds up in joints and prevents them from bending properly

What is the treatment for hereditary haemochromatosis?

bleeding, removes blood and body recognises low haemoglobin so uses iron stores to make more

What is the African iron overload?

south african and zimbabwean blacks had excessive iron thought to be due to dietary intake of beer but actually a gene responsible

Why are the NZ recommendations for women so much higher than men?

because women are menstruating and losing varying amounts of blood