My Doctor Says I Am Iron Deficient. What's Up?

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My Doctor Says I Am Iron Deficient. What's Up?

I recently visited my doctor and he told me that I was borderline anemic in iron. I eat a healthy diet but I do not take an iron supplement. There are some traces of iron in the multivitamin that I take. I am 36 years old. I thought that this deficiency was only associated with women and the elderly, what's up here? Thanks in advance!

This is an interesting question and I have some research to back up my answer here. I do not think that you should try to make up for your borderline iron deficiency status. Research shows that the American diet is rich in iron. This research particularly speaks of the elderly population but I believe that you can associate it to your situation as an American.

Unnecessary iron supplementation may be a present issue for the elderly. Elderly patients were found to have an excess of iron stores rather than a deficiency in iron according to the Framingham Heart Study (FHS). Some of this study's patients are proof that iron supplementation mat be unnecessary in the elderly. It is common belief to believe that anemic patients are also deficient in iron, but Richard Wood, PhD the study's co-author says differently. He notes that one in ten elderly patients have a low hemoglobin (Hgb) lab value and are considered anemic. Furthermore, he found that a mere one in one hundred elderly patients suffer from iron deficiency anemia. Therefore, anemic patients should not be associated with suffering from iron deficiency. Additionally, Wood noted, that the elderly are not in need of iron supplementation.

This information is based off of 1,016 white study participants, which range in age from 67 to 96 years old. All subjects were patients participating in the FHS in attempt to find the prevalence in iron deficiency, its relation to anemia, and other pertinent issues associated with iron. Several measures were taken to assess the results of the study; they include, transferrin saturation, serum ferritin, mean cell volume, and Hgb. The researchers reported some interesting findings. They noted 2.7% of the 1,016 were actually iron deficient. A lower percentage, 1.2 was considered to have iron deficient anemia, and 3% were found to have depleted stores of iron. For example, a person with a depleted storage of iron would have a serum ferritin level reading of less than 12 mg/L. Unlikely to what one would imagine 13% had iron overload with serum ferritin amounts to be 300 mg/L or more for men. Additionally serum ferritin levels of 200 mg/L or above were considered iron overload status for women. Dr. Woods and his research team found 16% of the participants were unnecessarily using iron supplementation.

The RDA of iron for people in the ages of 67 to 96 years old is roughly 10 mg. Interestingly the iron supplements used by study participants contained levels of 30 mg, which is 2/3 more that the RDA suggests taking. Research results from earlier studies noted that the presence of prolonged excess iron is possibly a contributing factor associated with heart disease, diabetes, and cancer. Dr. Wood thinks that the elderly population most likely has an excess of iron. Therefore, he recommends physicians of the elderly keep an eye on the iron stores of their patients. Perhaps making this a ritual part of the yearly routine examinations that most of that population undergoes could be the answer to this dilemma. The average American's diet can be considered to be high in iron. Furthermore, the Caucasian's have a so-called genetic abnormality known to doctors as hemachromatosis, which results in an over absorption of iron.

Bcause of these facts Dr. Wood thinks that it is highly unlikely for an association of iron deficiency anemia and the American diet to be related in the diagnosis. Wood thinks that if a patient is suffering from iron deficiency anemia the cause is likely to stem from an underlying more threatening condition, which is causing the patient to lose blood. I am sorry to hear of your condition. I can not diagnose you with anything, but I can tell you that it is likely that you may have some other issue that is unknown at the time. Pay attention to your stool. If you have a dark tarry stool you are probably bleeding from your colon and may need a colostomy to see where and why you are on the iron deficient borderline. Good luck and take care of yourself.

Reference

1.) Iron supplementation is not necessary for most older adults. Geriatrics. 2001; 56: 13.

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