Iron deficiencies are more prevalent than generally thought. It is estimated that 1,62 billion people suffer from anemia, 50% of which is caused by iron deficiency. It is assumed that the correct concentration of ferritin in the blood is 20-500 μg / l (in women 10-200 μg / l). For example, the prevalence of anemia in Portugal is 19.9%, of which 84% were previously undiagnosed.
Physiologically, iron is found mainly in hemoglobin (1800-2800 mg), hepatocytes and macrophages (800-1200 mg), bone marrow (150 mg) and blood plasma (4 mg).
In the US, nine percent of children between 1 and 2 years old, 9% to 11% of teenagers and women of childbearing age had iron deficiency; iron deficiency anemia was found in 3% and 2% to 5%, respectively. This corresponds to approximately 700,000 small children and 7.8 million women with iron deficiency in the US; of these around 240,000 small children and 3.3 million women have iron deficiency anemia. Iron deficiency occurred in no more than 7% of older children or people older than 50 years and no more than 1% of teenage boys and young men. Among women of childbearing age, iron deficiency was more likely in minorities, low incomes and having many children.
In Portugal, the most common anemia occurred
In Portugal, iron deficiency occurred
Iron deficiency anemia in Portugal occurred in 92.5% of cases, if the criterion is ferritin concentration below 100 ng / ml and in 75.4% (criterion <50 ng / mL). Anemia can be determined by determining the hemoglobin concentration, a decrease below 11.0 g / dl (according to the criteria of the World Health Organization) is worrying. The daily iron metabolism is about 35 mg, of which up to 32 mg is used to produce new erythrocytes. To increase the hemoglobin concentration by 1 g / dL, the system needs about 150 mg of iron. The daily loss of iron in the urine, then and the faeces is 1 mg. Dietary needs, compensating Fe loss in healthy people, is 15 mg per day. A woman who menstruates requires about 3 mg of iron a day and is often exposed to deficiency. Very often iron deficiencies occur in pregnant women. In the body of a healthy pregnant woman, the amount of iron in the form of a backup is 0.3 g, while the demand throughout the pregnancy – 1 g.
The conclusion seems to be that the concentration of hemoglobin, hematocrit and ferritin should first be determined – then the decision about iron supplementation should be made. The more so because iron deficiency is not the only cause of anemia. They may be disorders of the iron economy, erythropoietin deficiency, bone marrow disease or vitamin B12 deficiency and folic acid.
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