Abstract
Iron deficiency, the most common cause of anaemia, is seemingly easy to manage. However, in many cases the nutritional deficiency is complicated by concurrent gastro-intestinal disease and/or inefficient absorption. In addition, iron absorption and mobilisation from physiological storage sites is regulated by the peptide hormone hepcidin, which is upregulated in anaemia associated with chronic inflammation. Successful patient management requires the continuous evaluation of iron status as well as monitoring of haemoglobin levels to measure treatment outcomes. Iron requirements change with patient physiological status and this must be taken into consideration when making clinical decisions. Provided that there is no underlying problem most patients respond rapidly to oral iron therapy. In non-responsive patients, and patients with concurrent gastro-intestinal disease, parenteral therapy must be considered. This brief review provides a summary of some of the problems that may be encountered with the management of iron deficiency and iron deficiency anaemia.
Highlights
In the management of anaemic patients, the type and severity of the anaemia will dictate the appropriate therapeutic strategy
Patients with an inadequate intake of nutritional iron are at risk of developing iron deficiency anaemia, which is characterized by microcytic hypochromic red blood cells
Several factors decrease the absorption of iron from the gastro-intestinal tract (GIT) and complicate the management of iron deficiency anaemia:
Summary
In the management of anaemic patients, the type and severity of the anaemia will dictate the appropriate therapeutic strategy. Iron deficiency is the most common cause of anaemia.[1] Once iron therapy is initiated, regular follow-up visits are essential to monitor the therapeutic response, and to manage unpleasant adverse effects which may compromise patient compliance. Irrespective of the presence or absence of anaemia, iron deficiency decreases the quality of life and increases the risk of serious health issues.[2]. Cytochromes, essential for the process of oxidative phosphorylation and generation of ATP in all cells, require iron to function effectively.[3] iron deficiency has a negative impact on cellular respiration and ATP production, which in turn, decreases DNA synthesis and cell division.[4]
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