Ferritin- Marker of Iron Deficiency Anemia

Question 1. What is iron deficiency anaemia?

Iron is required for replenishing adequate level of haemoglobin in blood. Haemoglobin is the protein in blood cells that carries oxygen to body tissues. Lack of iron causes low haemoglobin level or anaemia (iron deficiency anaemia).

Question 2. What is ferritin?

Ferritin is stored iron and present throughout the body particularly in the liver and bone marrow. When measured in blood, it reflects stored iron statsus so that when iron level is low, blood ferritin is low and when iron level is high, ferritin is high. It is useful early indicator of iron deficiency anaemia and ferritin level drops first even before there is obvious symptoms of anemia such as pallor and low hemoglobin..

 Question 3. Why is iron important?

Iron is a mineral that is important to all body cells. It is particularly important for blood cells because iron is needed to make haemoglobin responsible for carrying oxygen from lungs to tissues. Iron is also needed to help certain chemical processes in the body.

 Question 4. When do I know if I am at risk of having iron problem?

The following individuals are at increased risk of developing iron deficiency anaemia and you should review with your doctor for blood iron tests.

¨ Children

¨ Menstruating females

¨ Pregnancy

¨ Elderly

¨ Individuals on poor diet

¨ Cancer patients

 Questions  5. Why do I have iron problem?

Here are some reasons why you may have iron problem.

Not having enough iron in your diet (children/malnutrition)

Problem in absorption in intestinal (Diseased intestines, worm infections)

Loss of iron from body (blood loss)-for example due to an injury or menstruation, or you can lose small amounts often from a hidden source of bleeding within your body e.g. intestinal bleeding from ulcer or cancer.

Inadequate iron in diet to meet increased demand. I.e. If you are women of childbearing age, you need twice as much iron in their diet as older women because you lose blood during menstruation. Pregnant women need extra iron for the development of the baby. Iron supplements are for these reason given during pregnancy.

 Question 6. What are the symptoms?

All persons at risk of developing iron deficiency (pregnancy, menstruating girls) should have their iron levels checked. In early iron deficiency, you will not have any symptoms. In advanced cases, symptoms include:

¨ tiredness and lack of energy

¨ headaches

¨ sore mouth or tongue

¨ brittle nails

¨ shortness of breath

¨ pale skin, gums, and nail beds

¨ Pain in the chest.

¨ Pounding heart rate (palpitation)

¨ Poor appetite

¨ Dizzy or fainting episodes

 Question  7. How is it diagnosed?

Iron deficiency is detected by checking iron status of your blood. Low iron state may be the early sign in blood before any symptoms occur. Iron studies are also helpful as it can diagnose high iron diseases as too much iron is also dangerous for your body. Various iron parameters called iron saturation, transferring and iron-binding capacity as well as ferritin are all measured to determine your iron status from a single sample of blood.

 Question  8. What is the blood picture of iron deficiency?

When your blood lacks iron, your blood test shows low iron level, low ferritin, high transferring (increased iron binding protein), low % saturation (% iron bound to protein), high TIBC (capacity to bind iron) and in later stages when anaemia develops your blood film shows microcytosis (plenty of smaller sized red cells than normal) and hypochromia (red cells stain lighter than normal).

 Question 9. How is it treated?

Iron supplements can be prescribed that will build up your body stores of iron. However, you will need to change your eating habits to be sure of a well-balanced diet in the future. Your healthcare provider may refer you to a nutritionist for dietary advice. If you have a bleeding problem, you will need special treatment.

Meat, fish, and poultry are excellent sources of dietary iron. It is also present in liver, eggs, green leaf vegetables, nuts, peas, beans, and whole-grain bread. A well-balanced diet contains enough iron for your daily needs.

 Iron tablets may have side effects such as abdominal cramps; nausea; constipation; and dark stools. To lessen side effects, your healthcare provider will start you on a low dose of iron and slowly increase your dose to the necessary amount. He or she may suggest that you take vitamin C with the iron pills to help your body absorb the iron. Taking the iron at mealtimes can help prevent stomach and intestinal upset.

 Do not take antacids and do not eat or drink any dairy products at the same time you take the iron pills. Antacids and dairy products prevent the body from absorbing iron.

Only rarely are iron shots needed.

 Question 10. How long will it take for my iron to be restored?

You will have progressive improvement in your symptoms over weeks on treatment.  You would normally continue your iron tablets to build up your body’s stores for few more weeks after your anaemia is corrected. If you don’t do this, your iron problem will come back quickly after you stop your medicine.

 Question 11. How can I take care of myself?

Follow your healthcare provider's or nutritionist's advice for treating iron deficiency anaemia. Eat a well-balanced, varied diet. Eat regularly at least 3 times each day. See your healthcare provider if you feel tired all the time or notice any of the other symptoms of iron deficiency anaemia.

 Question 12. How can I help prevent iron deficiency anaemia?

Eating foods rich in iron and/or taking an iron supplement will help to prevent a recurrence. If you have excessive menstrual flow, or pregnant you are at increased risk of iron deficiency anaemia. Visit your doctors for review and prescription for iron supplements.