IRONIN G OUT THE PROB­LEM

Al­most 50 per cent of the popu la­tion is iron de­fi­cient. Re­search is on to treat it in a con­ve­nient and cost- ef­fec­tive man­ner.

India Today - - HEALTH SPECIAL -

Kal­pana Ayyer, 44, a busi­ness ex­ec­u­tive weigh­ing 82 kg, was suf­fer­ing from ex­treme fa­tigue, breath­less­ness and oc­ca­sional chest pain. Fears of angina forced her to rush to a car­di­ol­o­gist. He found her heart to be in per­fect con­di­tion but the haemoglobin ( Hb) count— the mea­sure of blood in the hu­man body— to be 7 g/ dl whereas the nor­mal Hb count for a woman is 12 g/ dl. Fur­ther di­ag­no­sis re­vealed that Ayyer had re­cently de­vel­oped a per­verted ap­petite, med­i­cally known as PICA, where she feels the de­sire to eat raw, un­cooked rice, suck on ice cubes and even eat pen­cil and chalk. Ayyer had also been suf­fer­ing from un­nat­u­rally heavy, men­strual bleed­ing over the last five years. It was con­firmed that she was suf­fer­ing from se­vere iron de­fi­ciency.

Amol Naik, 18, a col­lege stu­dent, of­ten felt un­well and looked pale. When he con­sulted the fam­ily physi­cian, the doc­tor noted that his nails were dis­fig­ured. In­ves­ti­ga­tions showed that his Hb was 4 g/ dl whereas the nor­mal for a man is 14 g/ dl.

As doc­tors, we come across such cases ev­ery other day. Anaemia, the lack of blood, af­fects 30 to 50 per cent of the pop­u­la­tion in our coun­try. The most com­mon cause is iron de­fi­ciency. Iron, to­gether with the two vi­ta­mins— folic acid and vi­ta­min B12— are the most im­por­tant raw ma­te­ri­als for syn­the­sis­ing blood in the body.

Al­though iron is ubiq­ui­tous in its ex­is­tence, it is very dif­fi­cult to ob­tain it in ad­e­quate quan­tity through our daily diet. We need about 1 mg of iron daily. Ten per cent of the to­tal iron con­tent in our diet gets ab­sorbed by the in­tes­tine.

Hence, our diet must have about 10 mg of iron and for that we must have about 2,000 calo­ries a day.

Also, there are cer­tain in­hibitors af­fect­ing iron ab­sorp­tion. The most im­por­tant in­hibitors are ce­re­als which form the back­bone of our diet ( wheat and rice). Ex­cess of tea and cof­fee, too, af­fect iron ab­sorp­tion as th­ese bev­er­ages con­tain tan­nic acid which in­ter­feres with iron ab­sorp­tion. To­bacco con­sump­tion af­fects iron and vi­ta­min B12 ab­sorp­tion. Also, iron from veg­eta­bles is not eas­ily ab­sorbed.

Once you de­velop iron de­fi­ciency, no amount of diet can help and med­i­ca­tion be­comes es­sen­tial. Var­i­ous oral iron prepa­ra­tions are avail­able in the form of syrups, tablets and cap­sules. How­ever, th­ese have to be taken twice a day for four to six months. About 30 per cent of peo­ple can­not di­gest oral iron due to gas­tric prob­lems. In­jectable iron is an al­ter­na­tive. But if given by the in­tra­mus­cu­lar route, it is painful and can dis­colour skin. But re­cently, very safe in­tra­venous iron prepa­ra­tions have been in­tro­duced where the full dose can be given in a sin­gle sit­ting and it takes about 15 min­utes.

While diet alone can’t be a so­lu­tion, eat­ing food rich in iron is ad­vised. Leafy veg­eta

bles, dates, dry fruits and meat are rich sources of iron.

Dr M. B. Agar­wal Prac­tic­ing hae­ma­tol­o­gist,

ex- pres­i­dent of In­dian So­ci­ety of Haema­tol­ogy

REUBEN SINGH/ www. in­di­a­to­day­im­ages. com

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