I r o n the Element of Vitality Shannon Emmett (Clinical Haematologist), Herman Lee (Clinical Haematologist) and Hanlon Sia (Clinical Haematologist) We are all aware of the prevalence and importance of water. Similarly, iron is the most common element on earth and is critical to the healthy functioning of our bodies. Despite this, iron deficiency is the most common micronutrient deficiency in the world and affects billions of people, particularly women of childbearing age. The World Health Organization has defined health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Many people with low iron levels do not have a diagnosable disease but the physical, mental and social effects of low iron prevent them from living with complete health. Poor iron status has been shown to affect cognition (attention, memory, spatial ability and executive functioning), mood (irritability, apathy and depression), work productivity, athletic performance and immunity. Why do we need iron? Approximately 65% of all the body’s iron is found in red blood cells where it forms part of the haemoglobin structures. These complexes carry oxygen from the lungs to the rest of the body’s tissues. If there is inadequate iron then haemoglobin production is reduced (anaemia) and the ability of red cells to transport oxygen drops. The result is fatigue and reduced physical performance. But one doesn’t have to develop anaemia to be affected by low iron levels. Every organ and tissue in our bodies is made up of cells and each cell contains mitochondria, which are the powerhouses of cells. These organelles use the breakdown products of carbohydrate (glucose), fat or protein to fuel the production of energy for cells to function. They are like the solar panels of every cell that provide energy for muscles (including those in our limbs, hearts, blood vessels and guts) to contract and relax, for nerves to transmit messages, and for the lining of our guts to absorb nutrients. Iron is needed to produce substrates and enzymes needed for mitochondria to function. The cells of our hearts and skeletal muscles have particularly high energy demands and are very sensitive to iron deficiency. How much iron do we need? Pregnant women have the greatest need for iron at approximately 27milligrams of iron per day. This is due to 50% more red cells being made during pregnancy and the iron requirements of the developing baby and placenta. Many women develop iron deficiency during pregnancy or struggle to regain their iron stores after pregnancy, meaning that they enter into another pregnancy iron deficient. The effects on the growing baby can be significant. Maternal iron deficiency is associated with intrauterine growth restriction and prematurity. Of further concern is that babies who are born iron deficient may experience delayed growth and development and there is an association with cognitive and behavioral problems for some of these children later. Women of childbearing age need 18 milligrams per day, due to menstrual blood loss. This is more than double the requirement for men at eight milligrams per day. Many women are not able to keep up with this high daily requirement and develop iron deficiency. Interestingly, even growing children as young as one to three years old need more iron per day than their fathers. This highlights the importance of nutrient-rich foods for our children.
Pindara Private Hospital Magazine - Issue Eight
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