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.
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