The level of iron in the blood serum and the risk of increasing and decreasing the indicator. Elevated levels of iron in the blood What should be the level of iron in the blood

General information about the study

Iron is a trace element that is absorbed from food and then transported throughout the body by transferrin, a special protein produced in the liver. Iron is necessary for the formation of red blood cells. It is an essential component of hemoglobin, a protein that fills red blood cells, which allows them to carry oxygen from the lungs to organs and tissues. Iron is also a component of the muscle protein myoglobin and some enzymes.

Normally, the body contains 4-5 g of iron. About 70% of this amount is iron, “built-in” into the hemoglobin of erythrocytes, the remainder is mainly stored in tissues in the form of ferritin and hemosiderin. When iron becomes scarce, for example due to decreased intake of iron from food or frequent bleeding, and its level in the blood decreases, the body uses iron from the reserve. With prolonged deficiency, iron stores are depleted, which can lead to anemia. On the other hand, if too much iron is taken in, it can cause excessive accumulation and damage to the liver, heart and pancreas.

In the early stages, iron deficiency may be asymptomatic. If a person is otherwise healthy, then signs of the disease appear only when hemoglobin decreases below 100 g/l. Anemia is characterized by chronic weakness, dizziness, and headaches.

With severe iron deficiency anemia, a person may complain of shortness of breath, chest pain, severe headaches, and weakness in the legs. Children may have learning difficulties. In addition to the main ones, there are several more signs characteristic of iron deficiency: the desire to eat unusual foods (chalk, clay), burning of the tip of the tongue, jams (cracks in the corners of the mouth).

Symptoms of excess iron: joint pain, weakness, fatigue, abdominal pain, decreased sexual desire, heart rhythm disturbances.

About 3-4 mg of iron (0.1% of the total) circulates in the blood “in conjunction” with the protein transferrin. It is its level that is measured in this analysis.

The amount of serum iron can vary significantly from day to day and even within one day (maximum in the morning). Therefore, measurement of serum iron levels is almost always combined with other tests, such as a test for total serum iron-binding capacity (TIBC), ferritin, transferrin. Using the TBI and transferrin indicators, you can calculate the percentage of transferrin saturation with iron, which shows how much iron is transported in the blood.

The use of various tests reflecting iron metabolism in the body provides more complete and reliable information about iron deficiency or iron oversaturation than an isolated measurement of serum iron.

What is the research used for?

• To calculate the percentage of transferrin saturation with iron, that is, to determine exactly how much iron the blood carries.
• To assess iron reserves in the body.
• To determine whether anemia is caused by iron deficiency or other causes, such as a chronic illness or a lack of vitamin B12.
• To diagnose iron poisoning or hereditary hemochromatosis, a disease associated with increased absorption and accumulation of iron.

When is the study scheduled?

• If any abnormalities are detected as a result of a general blood test, test for hemoglobin, hematocrit, red blood cells.
• If you suspect iron deficiency or iron overload (hemochromatosis).
• If you suspect poisoning with tablets containing iron.
• When monitoring the effectiveness of treatment of anemia and conditions accompanied by iron overload.

The metals that make up the blood play a vital role in the life of all living organisms, without exception. They stimulate metabolic processes, influence growth, heredity, reproduction, actively participate in hematopoiesis and perform a number of other vital functions. Perhaps the most useful of these microelements for the human body is iron.

Functions of iron in the blood, what it is responsible for

In addition to the fact that iron is involved in the delivery of oxygen, it has other important functions. First of all, it is metabolism. A large number of proteins and enzymes require iron. The same applies to the process of cholesterol conversion. Thanks to iron, liver cells manage to resist poisons and destroy them. It is also important to highlight the following functions of iron in the human body:

• DNA production.
• The work of immunity.
• Generating the necessary energy.
• Hormone production.

Iron is also involved in the transmission of impulses and in the synthesis of connective tissue. At the required level of the element, growth processes proceed correctly. It is at a sufficient level that the skin maintains the desired tone, and the person does not feel tired.

As mentioned earlier, the adult body contains up to 5 g of iron, and its concentration per liter of blood serum can range from 7 to 31 µmol. In particular, normal blood should contain:

• in children under two years of age – from 7 to 18 µmol/l of iron;
• in children from 2 to 14 years old – from 9 to 22 µmol/l of iron;
• in adult men – from 11 to 31 µmol/l of iron;
• in adult women – from 9 to 30 µmol/l of iron.

The specific metal content in the body of each individual person depends not only on his age and gender, but also on height, weight, level, general health and many other objective and subjective factors.

Low iron levels in the blood: causes, symptoms and consequences

Decreased emotional tone is one of the symptoms of iron deficiency

The key cause of iron deficiency in patients of all age groups is an unbalanced or strict vegetarian diet. By the way, of the total amount of iron entering the body with meat, up to 20% is absorbed, with fish - up to 10%, and with plant products - no more than 6%. In turn, dairy products do not contain this beneficial substance. In addition, for successful absorption of iron, the diet must be enriched with vitamin C, B vitamins and proteins. Excess fat in the menu, on the contrary, reduces the absorption of iron.

Endogenous (internal) causes of iron deficiency in the body include:

• rapid growth with simultaneous depletion of iron reserves in the bone marrow and liver;
• physiological blood loss;
• the inhibitory effect of estrogens on iron intake;
• pregnancy and breastfeeding;
• chronic intestinal inflammation;
• low acidity of gastric juice;
• the presence of bleeding ulcers of the stomach and intestines.

The main symptoms of iron deficiency are:

• brittle nails and hair;
• bluish lips;
• pallor of the mucous membranes and skin;
• frequent acute respiratory infections and stomatitis;
• dyspnea;
• muscle hypotonia;
• decreased emotional tone;
• unstable stool, indigestion;
• constant feeling of fatigue;
• loss of appetite;
• urinary incontinence during sneezing and laughing, as well as enuresis in children.

A lack of iron in the human body leads to a disruption in the supply of oxygen to cells and, as a result:

• the occurrence and development of iron deficiency anemia (anemia);
• a number of pathological changes in tissues and organs;
• weakening of the body’s immune forces, increasing the risk of developing infectious diseases;
• increased fatigue;
• delayed mental development and growth of children.

Epithelial tissues are the most affected by pathological changes during iron deficiency: skin, mucous membranes of the gastrointestinal tract, mouth and respiratory tract. That is why a low level of iron in the blood often becomes a key cause of various dermatitis, eczema and other skin diseases.

Involvement of the central nervous system in the iron deficiency pathological process is manifested by:

• in the impoverishment of the patient’s emotional sphere with a predominance of bad, depressive mood;
• lethargy, decreased ability to concentrate;
• in tearfulness, irritability.

In addition, a lack of iron in the blood can lead to low blood pressure, rapid heartbeat and frequent dizziness.

Currently, a deep lack of iron in the body is eliminated with specialized iron preparations and diet therapy.

Elevated level: causes, symptoms and consequences

Elevated iron levels, among other things, are fraught with pain in the right hypochondrium

Under normal conditions, the body has a constant supply of iron in the form of water-insoluble hemosiderin and soluble ferritin. In this case, the first serves as a form of deposition of excess metal in tissues, and the second serves as a temporary storage of its reserves. As a rule, a constant level of iron in the blood is maintained due to the regulation of its absorption. Thus, the metal supplied with food is first deposited in the intestinal mucosa, and then, as necessary, is moved by the transport protein transferrin to the liver and bone marrow. In turn, intestinal cells are regularly replaced with new ones every three days, and excess iron is removed from the body along with exfoliated epithelium.

Meanwhile, in some cases, the described process is disrupted: the intestines lose their regulatory function and all the iron that enters the body with food begins to be absorbed into the blood. The first symptoms of this pathology, which in medicine is called hemochromatosis (bronze diabetes, pigmentary cirrhosis), are:

• increase in hemoglobin level to 130 g/l and above;
• redness of the skin;
• decrease in the number of red blood cells;
• pain in the right hypochondrium.

Currently, hemochromatosis is successfully treated with medications that can capture iron, convert it into a soluble state and remove its excess along with urine.

How to increase iron in the blood

In order for all processes to proceed correctly, it is important to maintain the required level of iron. For a child it is 8-9 mg, for men 10-11 mg, but for women up to 20 mg. You can increase your iron levels in different ways. Naturally, the drugs must be prescribed by a doctor. Traditional recipes are also used with the permission of a specialist. On your own, you can influence the level of the element through a well-designed diet.

Medicines

The totem can be used even during pregnancy

If the study reveals that the iron level is too low, the doctor prescribes medications. The following items are highly effective:

• Totema – suitable for children and women during pregnancy.
• Hemofer - helps not only increase hemoglobin, but also immunity.
• Tardiferon is especially effective for large blood losses. Approved for use in pediatrics.
• Ferroplex - used to increase iron levels and also enriches the body with folic acid.

There are other drugs and they should be used only for their intended purpose.

Important: Excess iron levels can also be dangerous.

Folk remedies

Nettle tea is one of the most effective folk remedies for increasing iron levels

Traditional therapy is often used as a complement to traditional therapy. But in mild cases, it can significantly improve your well-being. It is better to use the following recipes:

• A mixture of St. John's wort and plantain. The herbs are mixed in equal quantities and used to prepare a decoction (2 tbsp per 250 ml). Take 10 ml. within a month.
• Nettle tea does the job perfectly. It can be drunk with honey or sugar.
• Clover is used to prepare an infusion. A spoonful of raw materials is poured with a glass of boiling water. The entire volume is drunk within 24 hours.
• Rowan can be used either independently or as an additive to rose hips. Together, these berries will make a delicious and healthy tea.

Don't forget about parsley and dill. They can be used not only as a spice, but also for preparing an infusion.

Products

If you want to increase your iron levels, eat meat

Regardless of whether medications and traditional medicine recipes are used, the diet should always be adjusted. To increase iron, it is important to add the following foods to your diet:

• Meat of all varieties.
• Vegetables, mostly green, as well as herbs.
• Seafood.
• Cereals.
• Nuts of all kinds.
• Dried fruits.
• Eggs.

Naturally, dishes should be prepared correctly, avoiding long heat treatment and frying. It is advisable to eat vegetables raw.

How to lower iron in the blood

It may also be that your iron levels are elevated. In this case, treatment is also prescribed by all available methods.

Therapy should be started only after tests have been completed and the root cause of the condition has been determined.

Medicines

Trental should not be used if you have an increased tendency to bleed.

The drugs are prescribed individually, as they have certain contraindications and side effects. Using them alone can cause serious consequences. To reduce hemoglobin, the following drugs are used:

• Trental - helps reduce hemoglobin, but is not used if there is an increased tendency to bleeding.
• Aspirin - helps reduce hemoglobin and thin the blood. It is strictly forbidden to use for gastrointestinal lesions.
• Ticlopidine - used to thin the blood after serious pathologies such as and.
• Clopidogrel - indications are similar to those described above. Prohibited for use in pregnant women and with kidney pathologies.

The drugs are taken in courses with constant monitoring of the blood picture.

Folk remedies

Mumiyo is, in fact, the only effective folk remedy for lowering iron levels

The choice of folk recipes is a little poorer compared to methods aimed at increasing iron. To reduce the level of the element in the blood, you can use mumiyo. Take the tablets for 10 days followed by a 5-day break. Then the course is repeated.

Products

That case when smoked meats won’t hurt

Elevated iron levels are one of the few conditions when the diet is selected, on the contrary, from “harmful” foods. They will help reduce the level of sweetness, fatty and smoked elements. From fruits you can eat bananas, grapes, lemons.

It is especially useful to include soybeans, beans of all types, fermented milk products, vegetables with a high content of oxalic acid, river fish, as well as oats and barley.

Leeches have proven themselves to be excellent. Following the rules for their use will not only help thin the blood, but will also improve your overall well-being. A combination of proper nutrition and traditional recipes will help you achieve results faster.

Iron in the human body is a necessary element, without which many processes and normal life activities are impossible. Doctors have established the normal level of iron in the blood. The human body contains 4 to 5 grams of iron.

Blood contains 80% of this volume. The remaining 20% ​​is distributed between the liver, spleen and bone marrow. Only 75% of iron is constantly used by human tissues, and the remaining 25% is a reserve that allows recovery from blood loss and temporary deficiency of the substance.

In severe cases, when the reserve volume is used up, persistent iron deficiency is noted.

During a biochemical blood test, the serum iron level is determined, which shows the most accurate level of the substance in the body. There are many reasons to get your serum iron tested. It is very important not to miss both a decrease and an increase in the level of iron in the blood.

Why is iron required in the body?

The norm of iron in the body shows how much of this element a person needs to maintain many vital processes, which include:

• hematopoiesis,
• intracellular metabolism,
• oxygen transfer,
• formation of hemoglobin (with a lack of which iron deficiency anemia develops),
• myoglobin formation,
• maintaining proper functioning of the thyroid gland,
• ensuring complete absorption of vitamin B,
• production of a number of enzymes (including those involved in the construction of DNA),
• ensuring the normal growth process of the child,
• maintaining healthy immunity,
• detoxification of toxins in the liver,
• production of oxidative enzymes,
• maintaining good condition of hair, skin and nails.

Since this chemical element is involved in basic processes in the body, its deficiency is dangerous and can lead to serious consequences. Knowing that a condition such as impaired iron content in the blood can have an extremely negative impact on your health, you need to be attentive to your well-being so as not to miss the first symptoms of the pathology.

Routes of iron entry into the body

To maintain the normal level of iron in the blood, its sufficient intake into the body is required. The main source of iron in the body is food. Maximum absorption of the element occurs if its consumption is combined with a dose of vitamin C, which is rich in greens such as parsley and dill.

The following products presented in the table contain the greatest amount of iron available to humans:

Read more about nutrition for iron deficiency in our article Products containing iron.

However, you should not rely too much on foods that contain a high content of the necessary substance, since excess iron may form in the body, which will not be as beneficial as its deficiency, and measures will need to be taken to reduce it.

Iron absorption in humans occurs in the duodenum, which is why in case of deficiency of this element, the condition of the intestines is first checked.

Normal blood iron level

An international standard for serum iron in the blood has been adopted, which is used by all doctors to identify pathologies. Until the age of 14, serum iron in the blood has the same standards, but later its lower limit in an adult, depending on gender, turns out to be different. Each age category has its own level of iron in the human body that is normal; the values ​​are given in the table.

Read also our article on this topic Iron in the female body.

The standards for how much iron should be present are quite flexible due to the way tissues perceive it. Certain foods can also increase the rate to some extent.

Deviation from the norm, both larger and smaller, is a pathology and requires therapy. Excess iron, due to the fact that it carries risks of serious diseases, turns out to be even more dangerous than its deficiency.

Fluctuations in iron levels in women deserve special attention, since they require this element in greater quantities during pregnancy. Their norm increases by one and a half times.

Causes of low iron levels

Iron levels in a biochemical blood test may be low for a number of reasons. Doctors believe that the main factors by which the indicator can be reduced are:

• deficiency of iron intake from food,
• Irregular diet - iron deficiency means that the body does not have time to replenish reserves, without receiving additional nutrients.
• an increase in the need for an element occurs during the recovery period after serious illnesses, blood loss, as well as during pregnancy, when the body needs everything in additional volume for the normal formation of the fetus,
• pathologies of the gastrointestinal tract, leading to the inability to absorb iron,
• Crohn's disease
• systemic lupus erythematosus - SLE,
• tuberculosis,
• malignant neoplasms in the gastrointestinal tract,
• severe purulent-inflammatory diseases,
• osteomyelitis,
• heart attack,
• rheumatism,
• excess hemosiderin in tissues and internal organs,
• lack of erythropoietin production by the kidneys in renal failure,
• release of large amounts of iron by the kidneys in nephrotic syndrome,
• oncological diseases,
• cirrhosis,
• deficiency of ascorbic acid in food.

In order to accurately establish the reasons why the level of iron in the blood is low, a full examination is required. The only exceptions are when iron deficiency is obvious, such as during pregnancy, blood loss and poor nutrition.

Symptoms of iron deficiency

Read about the characteristics of iron deficiency in women in the article Iron deficiency in women: symptoms, causes, treatment.

A reduced level of a substance in the body has certain symptoms that should alert you. The following manifestations indicate that there is not enough iron in the human body:

• increased fatigue,
• excessive temper,
• migrating pains in the body,
• tearfulness,
• change in taste
• dry mucous membranes,
• belching,
• loss of appetite
• frequent constipation,
• some difficulty swallowing food,
• stomach ache,
• pallor,
• developmental delay in children - not only physical, but also mental,
• decreased immunity,
• increased brittleness of nails,
• a change from the normal shape of the nails to a spoon-shaped one - the appearance of “watch glasses”, or a symptom of chronic hypoxia. May also indicate chronic pulmonary failure,
• low body temperature,
• strong "frost"
• dysfunction of the thyroid gland.

All these manifestations are direct indications for checking the level of serum iron in the body. The doctor issues a referral for a biochemical blood test and, after receiving its results, determines the level of iron in the blood serum and whether there is a need for therapy. If the iron content is low, a diet must be prescribed and then the treatment that will be optimal for a particular patient is selected.

Causes of high iron in the body

An increased level of iron in the body is no less dangerous than a decreased one. If the daily intake of a substance is too high, it can even lead to death. A lethal dose of iron is considered to be 7 g or more. An increase in serum iron levels in the blood is observed in people for the following reasons:

• excessive intake of the substance from food - can also appear with a high iron content in water,
• pancreatic diseases,
• pathologies of the spleen - the organ from the reserve concentrated in it begins to secrete more of the element than necessary, which is why excess iron appears,
• liver pathologies - with them there is an incorrect distribution of the substance: its excess in the blood and its deficiency in the organ,
• large volume blood transfusion
• improper use of iron-containing drugs - in this case, a person receives too much iron, which leads to it becoming higher than normal. You should take iron-containing medications only at the rate prescribed by your doctor, and do not prescribe them to yourself without permission.
• chronic alcoholism – when it disrupts the process of absorption and elimination of substances from the body, which is why iron in the blood increases,
• iron metabolism disorders,
• anemia associated with a deficiency in the formation of red blood cells,
• hemolytic anemia - in pathology, excessively rapid destruction of red blood cells is observed with the release of iron from them, which is why its significant increase occurs,
• deficiency of vitamin B12 in the body,
• liver necrosis,
• hepatitis,
• poor absorption of the substance by tissues,
• hereditary predisposition.

Elevated iron in the blood certainly requires treatment - reducing the level to an acceptable norm. In cases where there is an increase in the level of iron in the blood, we can talk about the development of serious diseases, and therefore the person must undergo an examination.

Manifestation of excess iron in the body

Elevated serum iron always manifests itself with special symptoms, which should not be ignored and the disturbances should not be attributed to simple fatigue. It is necessary to visit a doctor and check whether iron is present in the blood normally if the following phenomena occur:

• frequent headache,
• dizziness,
• general loss of strength
• frequent nausea, even vomiting,
• alternating diarrhea and constipation,
• stomach pain,
• weight loss,
• decline in immunity.

However, it must be emphasized that these symptoms do not always indicate that serum iron is elevated, but only in 90% of cases. The remaining 10%, when the cause of poor health is not excess iron, is associated with severe pathologies of internal organs, including oncology and systemic diseases.

Complications of high iron in the blood

Increased iron content in the body increases the likelihood of developing a number of diseases. According to medical data, such a pathology can provoke the following diseases:

• vascular atherosclerosis,
• diabetes mellitus,
• arthritis,
• heart disease,
• liver diseases,
• infectious diseases,
• neoplasms.

These complications of the condition are also a reason not to ignore the increase in iron levels in the blood. If the problem is identified in a timely manner, in most cases it is solved effectively and the normal iron content in the blood is restored.

How is the analysis done?

Your doctor can always tell you exactly what it is – a test for high or low iron levels. The study is carried out on the basis of material obtained from a vein. The test requires serum, so the blood is put through a centrifuge. Next, using special reagents, iron in the serum is detected. Today, the analysis has been implemented in all medical institutions, so you can almost always check your iron level near your home. Iron is detected precisely from blood serum.

How to prepare for analysis

In order for the value of the analysis to be accurate, you should properly prepare for it. Blood collection is carried out from 8 to 11 am. The last meal can be no later than 8 hours before submitting the material. Drinking is allowed without restrictions, but only clean, non-carbonated water. 3 days before donating blood, you need to give up alcohol and oral contraceptives, as they will distort normal values ​​because they can raise iron.

Due to the fact that many medications can interfere with the result of biochemistry, the doctor will precisely instruct the person about which of them can be used and which cannot.

It is not advisable to take tests during menstruation, as the indicators will be subject to large errors due to the presence of bleeding. In such a situation, if possible, you need to reschedule the day of collection of the material, and if it is not possible, then you need to inform the nurse so that she can mark this on the tube with the material. The importance of a blood test for iron levels cannot be underestimated.

Serum iron– a trace element that is present in the hemoglobin molecule and carries oxygen. Analysis to determine the concentration of iron ions in the blood is diagnostically significant in hematology, gastroenterology, surgery and other areas of medicine. It is performed in conjunction with tests for hemoglobin, transferrin, total serum iron-binding capacity (TIBC) and ferritin. The results are useful for identifying iron deficiency, diagnosing and monitoring the treatment of anemia, hereditary hemochromatosis, infections, systemic inflammatory diseases and intestinal malabsorption. Blood is drawn from a vein. The study is carried out using a colorimetric photometric method (with ferrozine). Normally, in men, the iron content in serum is 11.6-31.3 µmol/l, in women – 9.0-30.4 µmol/l. The analysis period does not exceed 1 working day.

Iron in serum is a trace element that is present in the hemoglobin molecule and carries oxygen. Analysis to determine the concentration of iron ions in the blood is diagnostically significant in hematology, gastroenterology, surgery and other areas of medicine. It is performed in conjunction with tests for hemoglobin, transferrin, total serum iron-binding capacity (TIBC) and ferritin. The results are useful for identifying iron deficiency, diagnosing and monitoring the treatment of anemia, hereditary hemochromatosis, infections, systemic inflammatory diseases and intestinal malabsorption. Blood is drawn from a vein. The study is carried out using a colorimetric photometric method (with ferrozine). Normally, in men, the iron content in serum is 11.6-31.3 µmol/l, in women – 9.0-30.4 µmol/l. The analysis period does not exceed 1 working day.

Serum iron in the blood is a marker of iron deficiency and anemia. The study has diagnostic and prognostic value in many areas of clinical medicine. Iron is an important microelement for the body. Its main functions are the transfer of oxygen to tissues, participation in hematopoiesis, redox reactions, formation of the immune response, production of DNA and hormones. A significant part of this trace element (about 70%) is found in red blood cells (in hemoglobin molecules), the rest of the iron is located in enzymes, muscle tissue and blood serum (0.1%).

Serum iron is iron ions bound to transferrin, a protein synthesized in the liver. Transferrin transports iron to that part of the body where it is lacking. Deficiency occurs due to poor nutrition or frequent bleeding; in severe cases, the deficiency results in anemia. When iron is supplied in too large quantities, for example, with the wrong dosage of iron-containing drugs, damage to internal organs develops. A blood test to determine the level of serum iron allows you to identify a deficiency or excess of this element, including in the early stages, when there are no clinical symptoms of diseases. The material for the study is serum obtained from venous blood. Determination of iron is carried out by a colorimetric method, often using ferrozine. The results find application in hematology, gastroenterology, rheumatology, nephrology and surgery.

Indications and contraindications

The main indication for a blood test for serum iron is anemia of various etiologies. The results are used for primary, including differential diagnosis. They allow you to determine what caused the disease: iron deficiency, chronic pathology or vitamin B12 deficiency. During treatment, this test is prescribed to monitor the effectiveness of therapy and prevent overdose of iron-containing drugs. The basis for the study are patient complaints of chronic fatigue, dizziness, headaches, shortness of breath, lethargy, muscle weakness, cracks in the corners of the mouth, burning on the tip of the tongue, the desire to eat unusual substances (for example, chalk or clay) - all these are symptoms of iron deficiency. anemia. In addition, the doctor may order a serum iron level test if the results of a general blood test, namely tests for hemoglobin, hematocrit and/or red blood cells, are abnormal.

Another important indication for prescribing this test is conditions accompanied by excess iron in the body: poisoning with iron-containing drugs or lead, as well as hereditary hemochromatosis (increased absorption of iron). In this case, patients complain of joint pain, weakness, discomfort or pain in the right hypochondrium, heart rhythm disturbances and decreased sexual desire. As part of a comprehensive diagnosis, a serum iron test is carried out for infectious and systemic inflammatory diseases, hypo- and avitaminosis, disorders of the gastrointestinal tract, malabsorption syndrome, unbalanced or insufficient nutrition. As part of screening, the analysis is indicated to assess iron reserves in the body.

Drawing blood for analysis of serum iron is contraindicated in cases of mental and motor agitation. The question of the need for the procedure is decided individually with the doctor in case of severe anemia, hypotension and blood clotting disorders. The advantage of this test is that it allows you to detect iron deficiency in the body at a preclinical stage. To obtain reliable information about the reserves of a microelement in the body, a serum iron test is performed in conjunction with a study of total iron-binding capacity, determining the level of ferritin and transferrin in the blood.

Preparation for analysis and collection of material

Venous blood is used to study serum iron. In most laboratories, collection is carried out from 8 to 11 a.m. on an empty stomach. The break between the procedure and the last meal should be at least 8 and no more than 14 hours. For 30 minutes before the collection, you need to refrain from smoking and physical activity, and avoid worries and emotional stress. To obtain correct results, you must stop taking dietary supplements and medications containing iron 7-10 days before donating blood. The study should be postponed for several days if the patient has recently received a blood transfusion.

The procedure for collecting biomaterial is standard: a tourniquet is applied to the shoulder, the required amount of blood is taken using a syringe, and the blood is placed in a test tube. In the laboratory, serum is isolated from whole blood. The essence of the colorimetric method is as follows: guanidine is added to the serum, transferrin-bound iron ions are released and reduced with hydroxylamine, then ferrozine is introduced, which forms a colored complex with iron. It is measured and the amount of iron is calculated using the formula. The research is carried out using automatic analyzers. Preparation of results takes no more than 1 business day.

Normal values

Reference values ​​for the serum iron test for women over 14 years of age are 9.0-30.4 µmol/l, for men over 14 years of age - 11.6-31.3 µmol/l. In elderly and senile people, the amount of this microelement in the blood decreases, but remains within the normal range. The highest test values ​​are determined immediately after birth; for children in the first month of life, the norm ranges from 17.9 to 44.8 µmol/l. At the age of up to 1 year, the indicators decrease and range from 7.2 to 17.9 µmol/l, from 1 year to 14 years - from 9.0 to 21.5 µmol/l. It is worth remembering that the range of reference values ​​may vary slightly depending on what reagents and equipment are used in the laboratory.

Physiological deviations of the results from the norm may be associated with the phase of the menstrual cycle: high values ​​are determined in the luteal phase, low values ​​are determined immediately after menstruation. During pregnancy, the level of iron in the blood decreases, especially in the 2nd trimester, when the fetus develops a depot of this microelement. The result of the analysis can be affected by lack of sleep, stress, intense physical activity, alcohol, smoking - all these factors reduce the studied indicator.

Boosting Iron Levels

The most common cause of increased serum iron levels is anemia, which develops against the background of vitamin B12 deficiency. Excess iron is associated with a decrease in its use for the synthesis of new red blood cells. The concentration of this trace element increases in hereditary diseases - thalassemia and hemochromatosis. In the first case, the structure of hemoglobin changes, in the second, the absorption of iron from food increases, as a result of which it accumulates in the organs. Another common reason for increased serum iron levels is its intake in large quantities due to inadequate dosage of iron-containing drugs in the form of tablets or injections, acute poisoning with lead or iron drugs (single large dose), and frequent blood transfusions. The amount of serum iron increases with acute hepatitis, glomerulonephritis, leukemia, the use of chloramphenicol, estrogens, oral contraceptives, methotrexate and cisplatin.

Decreased iron levels

A common cause of low serum iron levels is iron deficiency anemia, caused by blood loss or poor nutrition with insufficient consumption of meat products. The concentration of this microelement in the serum also decreases when its absorption is impaired in patients with intestinal diseases and in patients after removal of the stomach. The cause of some decrease in serum iron levels may be chronic collagenosis, infections, sepsis, malignant tumors, chronic liver pathologies, myocardial infarction, hypothyroidism and hemolytic anemia. Iron deficiency may be associated with increased consumption during pregnancy, lactation and puberty, or with increased losses, for example, with chronic bleeding. Among the drugs that can affect the test result are androgens, glucocorticoids, aspirin, cholestyramine and allopurinol.

Treatment of abnormalities

A blood test for serum iron allows you to evaluate the metabolism of this microelement and its reserves in the body. Most often, this study is used to diagnose iron deficiency anemia, but the results are in demand not only in hematology, but also in surgery, gastroenterology, nephrology, rheumatology and toxicology. If the values ​​obtained do not correspond to the norm, you must seek advice and treatment from a hematologist or the doctor who issued the referral for the test. Some decrease in indicators can be corrected with the help of nutrition; the diet should contain a sufficient amount of foods with iron: red meat, chicken and beef liver, cod, tuna, salmon. Iron is less absorbed from plant foods. You should normalize your sleep schedule (sleep at least 8 hours at night), stop smoking and drinking alcohol, and practice stress prevention.

The human body consists of various chemical elements that perform specific functions in the body. Chemical elements are in balance, which allows maintaining normal functions of organs and systems. Violation of this balance leads to pathological processes and various diseases.

The human body consists of 60% water, 34% organic matter and 6% inorganic matter. Organic substances include carbon, oxygen, hydrogen and others. Inorganic substances contain 22 chemical elements - Fe, Ca, Mg, F, Cu, Zn, Cl, I, Se, B, K and others.
All inorganic substances are divided into microelements and macroelements. It depends on the mass fraction of the element. Microelements include iron, copper, zinc and others. Macroelements include calcium, sodium, potassium and others.

Iron ( Fe) refers to microelements. Despite the small iron content in the body, it plays a special role in maintaining its vital functions. A lack of iron in the human body, as well as its excess, negatively affects many functions of the body and human health in general.

If the patient complains of increased fatigue, malaise, or rapid heartbeat, the doctor prescribes a serum iron test. This analysis helps evaluate iron metabolism in the body and identify many pathological processes associated with iron metabolism. In order to understand what serum iron is, why it is needed and how it appears, it is necessary to consider the functions of iron and its metabolism in the human body.

Why is iron needed in the body?

Iron is a universal chemical element that performs vital functions in the body. The body cannot produce iron, so it gets it from food. Human nutrition must be balanced, containing the daily intake of vitamins and chemical elements. Lack or excess of vitamins and minerals leads to the development of diseases and deterioration of health.

Iron, which is contained in the body, is divided into:

• Functional iron. Functional iron is part of hemoglobin ( iron-containing protein of red blood cells, which captures and carries oxygen to the organs and tissues of the body), myoglobin ( oxygen-containing protein of skeletal muscles and cardiac muscles, creating oxygen reserves), enzymes ( specific proteins that change the rate of chemical reactions in the body). Functional iron is involved in many processes in the body and is constantly used.
• Transport iron. Transport iron is the amount of an element that is transported from the source of iron entering the body to each of its cells. Transport iron is not involved in body functions. It is part of carrier proteins – transferrin ( the main carrier protein of iron ions in blood plasma), lactoferrin ( a carrier protein found in breast milk, tears, saliva and other secretory fluids) and mobilferrin ( iron ion transport protein in the cell).
• Deposited iron. Part of the iron that enters the body is stored “in reserve.” Iron is deposited in various organs and tissues, mainly in the liver and spleen. Iron is deposited in the form of ferritin ( water-soluble complex protein complex, which is the main intracellular iron depot) or hemosiderin ( iron-containing pigment formed during the breakdown of hemoglobin).
• Free iron. Free iron or free pool is iron unbound to proteins inside cells, formed as a result of the release of iron from the ternary complex - iron, apotransferrin ( transferrin precursor protein) and receptor ( molecules on the surface of the cell that attach molecules of various chemical substances and transmit regulatory signals). In its free form, iron is very toxic. Therefore, free iron is transported inside the cell by mobilferrin or deposited with ferritin.

Based on location in the body, they are classified into:

• Heme iron ( cellular). Heme iron makes up the bulk of the total iron content in the human body - up to 70 - 75%. Participates in the internal exchange of iron ions and is part of hemoglobin, myoglobin and many enzymes ( substances that accelerate chemical reactions in the body).
• Non-heme iron. Non-heme iron is divided into extracellular and stored iron. Extracellular iron includes free plasma iron and iron-binding transport proteins - transferrin, lactoferrin, mobilferrin. Deposited iron is found in the body in the form of two protein compounds - ferritin and hemosiderin.

The main functions of iron are:

• transport of oxygen to tissues – the erythrocyte contains hemoglobin, the molecules of which contain 4 iron atoms; iron in hemoglobin binds and transports oxygen coming from the lungs to all cells of the body;
• participation in hematopoietic processes – bone marrow uses iron to synthesize hemoglobin, which is part of red blood cells;
• detoxification of the body - iron is necessary for the synthesis of liver enzymes involved in the destruction of toxins;
• regulation of immunity and increasing body tone – iron affects the composition of the blood, the level of leukocytes necessary to maintain immunity;
• participation in the process of cell division – iron is part of proteins and enzymes involved in DNA synthesis;
• synthesis of hormones - iron is necessary for the synthesis of thyroid hormones, which regulates metabolism in the body;
• providing cells with energy – iron delivers oxygen to protein energy molecules.

Iron enters the human body from the external environment along with food. It is found in red meat ( especially in rabbit meat), dark poultry meat ( especially in turkey meat), dried mushrooms, in legumes, vegetables, fruits, cocoa. The daily requirement of iron is on average 6 – 40 milligrams. The toxic dose of iron is 150–200 mg, the lethal dose is 7–35 g.

Daily iron requirement

Floor	Age	Daily iron requirement
Children (regardless of gender)	1 – 3 years	6.8 mg per day
	3 – 11 years	10 mg per day
	11 – 14 years old	12 mg per day
Female gender	14 – 18 years old	15 mg per day
	19 – 50 years	18 mg per day
	over 50 years old	8 mg per day
Pregnant women	-	38 mg per day
Breastfeeding women	-	33 mg per day
Male gender	14 – 18 years old	11 mg per day
	over 19 years old	8 mg per day

Iron is found in the body in different concentrations depending on the type of iron, as well as gender.

Distribution of iron in the human body

Iron type	Iron concentration ( mg Fe/kg)
	women	men
Total iron
The total iron content in the human body is 4.5 – 5 grams.	40 mg Fe/kg	50 mg Fe/kg
Functional iron
Hemoglobin ( Hb). Of the total amount of iron in the body, 75–80% ( 2.4 g) accounts for hemoglobin iron ( hemoglobin is an iron-containing protein that transports oxygen to tissues).	28 mg Fe/kg	31 mg Fe/kg
Myoglobin. The composition of myoglobin ( oxygen - binding protein of skeletal muscles and heart muscles) includes 5–10% of the total amount of iron.	4 mg Fe/kg	5 mg Fe/kg
Heme and non-heme enzymes ( chemicals that accelerate chemical reactions occurring in the human body). Respiratory enzymes account for about 1% of the total amount of iron in the body.	1 mg Fe/kg	1 mg Fe/kg
Transport iron
Transferrin ( specific protein – carrier of iron in blood plasma).	0.2) mg Fe/kg	0.2) mg Fe/kg
Iron depot ( iron reserves in the body). Reserve iron makes up 20–25% of the total amount of iron in the body.
Ferritin.	4 mg Fe/kg	8 mg Fe/kg
Hemosiderin.	2 mg Fe/kg	4 mg Fe/kg

Iron metabolism in the human body

Metabolism ( exchange) gland is a very well organized process. The body clearly regulates the processes of intake and recycling of iron, since it is a very valuable microelement.

Iron absorption occurs in three stages. The first stage is the initial stage ( absorption in the small intestine), the second is intracellular transport with the formation of iron reserves, the third is the release of iron into the blood plasma.

Iron enters the body with food. When you receive 10–20 milligrams of iron from food per day, only 10% of the iron is absorbed, which is 1–2 milligrams. The body obtains heme iron from food ( meat, liver) and non-heme iron ( milk, vegetables, fruits). Heme iron enters the body as part of hemoglobin and myoglobin from meat products and is absorbed by the body 20–30% more efficiently ( regardless of the secretion of gastric juice and other factors). Non-heme iron comes mainly from food ( 80 – 90% ). Absorption of such iron occurs passively and in small quantities ( 1 – 7% ). This process is also influenced by many external factors.

Substances that inhibit the absorption of non-heme iron are:

• phytins - found in cereals, legumes, semolina and oatmeal;
• tannins – found in tea, cocoa, coffee, quince, dark grapes, currants;
• phosphoproteins - complex proteins found in milk and egg whites;
• oxalates – found in corn, rice, grains, spinach, milk;
• some medications - calcium supplements, oral contraceptives.

Increased absorption of iron occurs when eaten:

• vitamin C ( ascorbic acid) – found in white cabbage, spinach, red and green peppers, black currants, dried rose hips;
• copper – found in liver, peanuts, hazelnuts, shrimp, peas, buckwheat, lentils;
• meat products - beef, veal, rabbit and others;
• seafood – fish, oysters, shrimp;
• amino acids – found in legumes, nuts, fish, meat, milk, peanuts, eggs.

In food, iron is mainly in an oxidized state ( Fe 3+) and is part of proteins and organic acids. But the absorption of ferrous iron is better ( Fe 2+), therefore in the stomach, under the influence of gastric juice, ferric iron ( Fe 3+) is released from food and converted to ferrous iron ( Fe 2+). This process is accelerated by ascorbic acid and copper ions. Iron absorption mainly occurs in the small intestine - up to 90% in the duodenum and the initial parts of the jejunum. In diseases of the stomach and intestines, the process of normal absorption of iron is disrupted.

After the intake of ferrous iron ( Fe 2+) into parts of the small intestine, it enters enterocytes ( epithelial cells of the small intestine). Iron absorption into enterocytes occurs with the help of special proteins - mobilferrin, integrin and others. The cells of the small intestine contain transferrin and ferritin. These two proteins regulate the absorption and distribution of iron throughout the body.

When iron enters the body through enterocytes, part of it is deposited ( put aside in reserve), part is transported using the transferrin protein and is used by the body to synthesize heme ( part of hemoglobin containing iron), erythropoiesis ( formation of red blood cells in the bone marrow) and other processes.

Deposit ( reservation) iron occurs in two forms - as part of ferritin and hemosiderin. Ferritin is a water-soluble protein complex that is synthesized ( produced) cells of the liver, bone marrow, small intestine and spleen. The main function of this protein is to bind and temporarily store iron in a form that is non-toxic to the body. Ferritin in liver cells is the main iron store in the body. Ferritin in small intestinal cells is responsible for the transfer of iron entering enterocytes to transferrin in the blood plasma. Hemosiderin is an iron-containing water-insoluble pigment that deposits excess iron in tissues.

Transport of iron in blood plasma is carried out by a special carrier protein – transferrin. Transferrin is synthesized by liver cells. Its main function is the transport of iron absorbed in intestinal cells and iron from destroyed red blood cells ( red blood cells responsible for transporting oxygen to tissues and organs) for reuse. Normally, transferrin is saturated with iron by only 33%.

The body loses iron daily - up to 1 - 2 milligrams per day. Physiological losses of iron normally occur during the excretion of iron in bile through the intestines, during desquamation of the epithelium of the gastrointestinal tract ( Gastrointestinal tract), with desquamation ( exfoliation) skin, in women with menstrual blood ( from 14 mg to 140 mg per month), hair loss and nail cutting.

What is serum iron and what is the normal level of iron in the blood? Why is serum iron tested?

Serum or plasma iron is the concentration of iron in serum or plasma, not including iron in hemoglobin and ferritin iron. Blood plasma is the liquid part of blood ( 60% ) light yellow in color, not containing formed elements ( erythrocytes, platelets, leukocytes, lymphocytes and others). Blood plasma consists of water and proteins, gases, minerals, fats and others dissolved in it. Blood serum is blood plasma that does not contain fibrinogen, a blood protein involved in the formation of a blood clot.

Iron in the blood cannot be in a free state, as it is very toxic. Therefore, the level of iron in the carrier proteins – transferrin – is determined. To do this, using special chemical reactions, iron is isolated from the complex with transferrin. The material for the study is venous blood. More often, the colorimetric method is used to analyze serum iron concentration. The essence of the method is to determine the concentration of iron in serum by the color intensity of the solution. The color intensity of the solution is directly proportional to the concentration of the colored chemical microelement. This method allows you to determine the concentration of a trace element with high accuracy.

Indications for analysis of serum iron concentration are:

• diagnostics, differential diagnostics ( the difference between one pathology and another with similar symptoms) and control of anemia treatment ( pathological condition characterized by low hemoglobin content in red blood cells);
• diagnosis of hemochromatosis ( hereditary disease characterized by impaired iron metabolism);
• diagnosis of intoxication ( poisoning) iron;
• malnutrition, hypovitaminosis ( lack of vitamins);
• various diseases of the gastrointestinal tract in which normal absorption of iron is disrupted;
• detected deviations in the results of a general blood test ( red blood cells, hematocrit);
• bleeding of various etiologies ( heavy prolonged menstruation, bleeding gums, bleeding from hemorrhoids, stomach or duodenal ulcers and others).

Serum iron testing is performed for:

• assessment of iron reserves in the body;
• calculating the percentage of transferrin saturation with iron ( that is, determining the concentration of iron carried by the blood);
• differential diagnosis of anemia;
• control of anemia treatment;
• control of treatment with iron preparations;
• diagnosis of genetic diseases of iron metabolism disorders.

The normal level of iron in the blood, depending on age and gender

Age	Floor	Iron norm
	female	5.1 – 22.6 µmol/l
	male	5.6 – 19.9 µmol/l
from 1 to 12 months	female	4.6 – 22.5 µmol/l
	male	4.9 – 19.6 µmol/l
from 1 to 4 years	female	4.6 – 18.2 µmol/l
	male	5.1 – 16.2 µmol/l
from 4 to 7 years	female	5.0 – 16.8 µmol/l
	male	4.6 – 20.5 µmol/l
from 7 to 10 years	female	5.5 – 18.7 µmol/l
	male	4.9 – 17.3 µmol/l
from 10 to 13 years	female	5.8 – 18.7 µmol/l
	male	5.0 – 20.0 µmol/l
from 13 to 16 years old	female	5.5 – 19.5 µmol/l
	male	4.8 – 19.8 µmol/l
from 16 to 18 years old	female	5.8 – 18.3 µmol/l
	male	4.9 – 24.8 µmol/l
> 18 years old	female	8.9 – 30.4 µmol/l
	male	11.6 – 30.4 µmol/l

When receiving tests, the doctor is guided by the gender and age of the patient. The results obtained may be within normal limits, below or above normal. If the iron level is below normal, the patient has iron deficiency. If the iron level is higher than normal, the patient has excess iron in the body. When interpreting the results obtained, many factors should be taken into account - nutrition, medications, the woman’s menstrual cycle and others. Do not forget about daily fluctuations in the concentration of iron in the blood. Thus, the maximum daily concentration of iron in the blood is observed in the morning. In women, the concentration of iron in the blood is higher before and during menstruation than after the end of menstruation. Therefore, you should take a serum iron test after the cessation of menstruation. Random fluctuations in iron levels in the blood may also occur, for example, with a sharp increase in meat consumption in the patient’s diet.

Medicines that increase iron levels in the blood are:

• acetylsalicylic acid ( aspirin) – non-steroidal anti-inflammatory drug;
• methotrexate – antitumor agent;
• multivitamins containing iron;
• oral contraceptives – birth control pills;
• antibiotics – methicillin, chloramphenicol, cefotaxime;
• drugs containing estrogens ( female sex hormones) .

Medicines that lower iron levels in the blood are:

• acetylsalicylic acid in large doses - non-steroidal anti-inflammatory drug;
• allopurinol – a drug that lowers the level of uric acid in the blood;
• cortisol – glucocorticoid hormone;
• metformin – tablet hypoglycemic agent ( lowers blood sugar levels);
• corticotropin – adrenocorticotropic hormone drug;
• cholestyramine – lipid-lowering agent ( reduces blood fat levels);
• asparaginase – antitumor agent;
• drugs containing testosterone - male sex hormone.

In order to obtain reliable results of iron levels in the blood, it is necessary to properly prepare the patient for diagnosis.

How to properly prepare for a serum iron test?

To avoid distortion of the obtained results of serum iron concentration, it is necessary to properly prepare the patient.

To properly prepare for diagnosing iron levels in the blood, you must:

• a week before taking a serum iron test, stop taking medications and iron-containing vitamin complexes;
• reschedule the serum iron test for several days after the blood transfusion ( blood transfusion);
• explain to the patient that to analyze serum iron it will be necessary to take a blood sample, explain the essence of the procedure, and warn about unpleasant sensations when applying a tourniquet and puncture ( piercing) veins;
• describe the daily and nutritional regimen that the patient should follow.

The general requirements for a blood test for serum iron are:

• taking test blood on an empty stomach;
• exclusion of smoking, drinking alcohol and fatty foods, physical activity 12 hours before the test;
• taking test material before performing any diagnostic procedures ( radiography, computed tomography);
• the patient has no viral or inflammatory diseases.

What should your serum iron level be during pregnancy?

Pregnancy is a very important and difficult period in the life of any woman. At this time, serious physiological changes occur in the body. The fetus uses microelements and macroelements from the mother as “building particles”. Therefore, it is very important for a woman to monitor her diet. It must be balanced and ensure the supply of vitamins, minerals, proteins and other substances in sufficient quantities. Typically, the need for these substances exceeds the daily requirement of a non-pregnant woman, as they are used for the functional needs of the mother and fetus.

The reasons for the increased need for iron during pregnancy are:

• an increase in blood volume by 50%, and, consequently, a 2-fold increase in the need for iron for the production of hemoglobin ( iron-containing protein that transports blood);
• significant consumption of iron from the mother's iron depot for the formation of the placenta and red blood cells ( red blood cells that transport oxygen) fruit;
• iron deficiency anemia ( anemia – a condition characterized by low levels of hemoglobin in the blood) before pregnancy, which aggravates iron deficiency during pregnancy.

In addition to normal physiological iron loss, pregnant women have an increased daily iron requirement. In the first trimester, additional iron consumption is 0.8 milligrams per day, in the second trimester - 4 - 5 milligrams per day, in the third trimester - up to 6.5 milligrams per day. For the development of the fetus, 400 milligrams of iron are needed, for an enlarged uterus - 50 - 75 milligrams of iron, for the construction of the placenta, through which the vital activity of the fetus is supported, 100 milligrams of iron are needed. In general, for the normal course of pregnancy and childbirth, the expectant mother needs about 800 milligrams of additional iron. During pregnancy and childbirth ( without complications) about 650 milligrams of iron are consumed.

The normal level of serum iron in pregnant women is from 13 µmol/l to 30 µmol/l. The daily iron requirement for pregnant women is up to 30 – 38 milligrams.

For a pregnant woman and her unborn baby, both iron deficiency and excess are equally dangerous. If a pregnant woman’s body does not receive the required daily intake of iron, its reserves are quickly depleted. This leads to iron deficiency ( serum iron level) and the development of iron deficiency anemia ( pathology in which the level of hemoglobin in the blood decreases). As a result of anemia, both the fetus and mother suffer from a lack of oxygen. Iron deficiency anemia leads to weakened immunity, increased fatigue, dizziness, and weakness. The development of iron deficiency anemia in the first or second trimester of pregnancy significantly increases the risk of premature birth, low birth weight, stillbirth, or neonatal death.

Also, iron deficiency in the mother contributes to the development of iron deficiency anemia in the newborn, which can negatively affect his mental and physical development. During childbirth, a woman may lose a large amount of blood. If there has already been an iron deficiency, bleeding can lead to the development of severe anemia and the need for a blood transfusion. It has been scientifically proven that iron deficiency is one of the causes of postpartum depression.

Excess iron ( Serum iron level > 30 µmol/l) also negatively affects the course of pregnancy and the health of the fetus. Excess iron can be observed in hereditary diseases with impaired iron metabolism and excessive intake of iron into the body ( uncontrolled intake of iron-containing medications). Excessive iron levels in the blood of a pregnant woman can cause gestational diabetes ( pathology in which there is a high level of sugar in the blood of a pregnant woman), preeclampsia ( complications of pregnancy after 20 weeks, characterized by high blood pressure and high protein in the urine), miscarriage. Therefore, iron supplements must be taken under the strict supervision of a doctor.

Iron deficiency in pregnant women is much more common than iron excess. Iron deficiency can be compensated for by eating an iron-rich diet or taking iron-containing medications. A pregnant woman's diet should include red meat ( richest source of iron), rabbit, chicken, turkey meat, as well as grains, legumes, spinach, cabbage, porridge and others.

If the intake of iron from food does not satisfy the body's needs, the doctor may additionally prescribe iron supplements. Taking iron supplements is carried out under the strict control of serum iron. The dosage of drugs is selected by the attending physician depending on the patient’s laboratory parameters ( serum iron levels, hemoglobin). Pregnant women are often prescribed calcium supplements, which impair iron absorption. Therefore, during treatment with iron supplements, it is worth stopping or limiting the use of calcium supplements. If this is not possible, then calcium should be taken in between meals and iron supplements.

Iron supplements prescribed during pregnancy are:

• Sorbifer durules. A tablet of this drug contains 100 milligrams of iron and vitamin C to improve the absorption of iron in the intestines. During pregnancy, in order to prevent iron deficiency, 1 tablet per day is prescribed, for treatment - 1 tablet in the morning and in the evening.
• Ferroplex. The pills contain 50 milligrams of iron and vitamin C. Take 2 pills 3 times a day.
• Totema. Totema is a solution containing 50 milligrams of iron. For prevention, 1 ampoule per day is prescribed orally from 4 months of pregnancy. In large doses, totem is prescribed only for laboratory-confirmed iron deficiency anemia. Prescribed 2 – 4 ampoules per day.
• Fenyuls. The capsules contain 45 milligrams of iron. For prevention, take 1 capsule per day from the 14th week of pregnancy. After taking the drug daily for 2 weeks, take a week break and then continue taking the drug again.

Side effects of iron supplements include nausea, abdominal pain, constipation, or diarrhea. The stool will also turn black, which is normal. If side effects occur, you should consult a doctor. The doctor will reduce the dose of the iron supplement or stop it altogether ( if the patient’s condition and laboratory test results allow).

What diseases lead to low blood iron levels?

Many diseases, habits and dietary patterns affect the concentration of iron in the blood, namely, they reduce its level in the blood.

Symptoms of iron deficiency in the body

Iron deficiency leads to deterioration in the functioning of organs and systems, lack of oxygen, and disruption of the synthesis of enzymes and hormones. But iron deficiency does not immediately lead to symptoms. At first, the body uses iron from its reserves. Gradually, after iron stores are depleted, symptoms begin to appear, which become more pronounced over time.

There are latent ( hidden) and clear signs of iron deficiency in the blood. Latent signs appear with minor iron deficiency. Serum iron levels are often normal or close to the borderline low value ( women – 8.9 µmol/l, men – 11.6 µmol/l). In this case, the body uses iron reserves.

Symptoms of the latent stage of iron deficiency in the blood are:

• decreased performance;
• increased fatigue;
• severe malaise, weakness;
• rapid heartbeat ( tachycardia);
• increased irritability;
• depression;
• headaches and dizziness;
• difficulty swallowing;
• glossitis ( inflammation of the tongue);
• hair loss;
• brittle nails;
• pale skin;
• deterioration of memory, attention, thought processes, learning ability;
• frequent respiratory tract infections;

When iron is consumed from reserves and is insufficiently supplied to the body, many processes in the body are disrupted. Symptoms become more pronounced. Severe iron deficiency leads to illness and serious complications.

Symptoms of severe iron deficiency are:

• decreased immunity – the patient often suffers from viral and respiratory diseases;
• low body temperature, chilliness - body temperature is below 36.6°C, the person feels uncomfortable at low temperatures, his extremities are constantly cold;
• deterioration of memory, attention, pace of learning – with iron deficiency, it is difficult for the patient to concentrate and remember information, and frequent forgetfulness is observed;
• decreased performance – the patient constantly feels tired, “broken,” even after a full night’s sleep;
• disruption of the gastrointestinal tract - loss of appetite, difficulty swallowing, pain in the stomach, constipation, flatulence ( excessive accumulation of gases in the intestinal lumen), the appearance of belching and heartburn;
• increased fatigue, muscle weakness - the patient observes increased fatigue even after short-term activity, and also notes weakness in the muscles during physical activity and at rest;
• neurological disorders – increased irritability, short temper, depression, tearfulness, migrating pain ( head, in the region of the heart);
• delayed mental and physical development in children – lack of iron leads to oxygen starvation, which negatively affects the child’s central nervous system, the development of the cardiovascular system and others;
• geophagy ( food perversion) – with iron deficiency, a person may begin to eat inedible objects - chalk, earth, sand;
• dryness, pallor of the skin and mucous membranes – the skin becomes dry, begins to peel, cracks and pronounced wrinkles appear, wounds form in the corners of the mouth ( cheilitis), stomatitis ( inflammation of the oral mucosa);
• dry, brittle nails and hair – with a lack of iron, hair becomes dull, brittle, loses shine and volume, nails flake and break easily;
• dizziness, loss of consciousness ( fainting) – as a result of a decrease in the level of hemoglobin in the blood, the body suffers from oxygen starvation, this especially affects the brain, which is manifested by dizziness, short-term loss of consciousness, darkening of the eyes;
• shortness of breath, rapid heartbeat - Iron deficiency leads to a lack of oxygen, which the body tries to compensate by increasing breathing and heart rate.

How to increase iron levels in the blood?

Before starting treatment for iron deficiency in the body, it is necessary to determine the cause of its occurrence and eliminate it. If the cause of iron loss is not eliminated, treatment will only bring a temporary effect. This will lead to the need for repeated courses of treatment.

Before using iron-containing medications or changing your diet, you must undergo an examination and take a serum iron test. If a laboratory test confirms iron deficiency, the doctor will individually select treatment tactics for the patient. The principle of treatment will depend on iron levels, the patient’s condition ( for example, pregnancy), concomitant diseases ( Some diseases may cause increased iron loss).

If there is a slight deficiency of iron, it will be enough to adjust the patient’s diet by increasing the amount of iron-rich foods in the diet. In this case, it is necessary to take into account the consumption of iron in the patient’s body. In some cases ( for chronic bleeding, pregnancy, breastfeeding, intensive growth) The amount of iron you get from food may not be enough. Then the therapy is supplemented with iron supplements.

In case of severe iron deficiency, treatment begins immediately with taking medications in the form of capsules, tablets and dragees. In particularly severe cases, iron supplements are prescribed intravenously under the strict supervision of the attending physician.

Diet for iron deficiency

Heme and non-heme iron enters the human body with food. Heme iron ( the source is hemoglobin) is several times more efficiently absorbed by the body in contrast to non-heme. The body obtains heme iron from meat products, and non-heme iron from plant products.

Sources of heme iron

Product (100 grams)	(mg)
beef	2,7
pork	1,7
turkey	3,7 – 4,0
chicken	1,6 – 3,0
veal	2,8
pork liver	19,0
veal liver	5,5 – 11,0
beef kidneys	7,0
sea ​​fish	1,2
heart	6,3
mackerel	2,4
cod	0,7
shellfish	4,2
mussels	4,5
oysters	4,1

From plant products, the body receives non-heme trivalent ( Fe 3+) and ferrous iron ( Fe 2+). Non-heme iron is much less easily absorbed by the body.

Sources of non-heme iron

Product (100 grams)	Iron content in milligrams (mg)
apricots	2,2 – 4,8
peas	8,0 – 9,5
beans	5,6
buckwheat	8,0
nuts ( almonds, hazelnuts)	6,1
dried mushrooms	35
dried pear	13
beans	11,0 – 12,5
apples	0,6 – 2,3
dried apples	15,0
rose hip	11,0

For better absorption of iron you need:

• Eat foods rich in vitamin C, B vitamins and folic acid. Vitamin C improves the absorption of iron in the intestines by 6 times. Therefore, for better absorption of this microelement, it is necessary to increase the intake of foods rich in vitamin C. These foods include spinach, cauliflower, citrus fruits, broccoli and others. Sources of folic acid include peanuts, almonds, walnuts, flax seeds and others. B vitamins are found in fermented milk products, nuts, yeast, and egg yolk.
• Reduce tea and coffee consumption. Tannin, which is found in tea and coffee, significantly reduces the absorption of iron. Therefore, you should not drink these drinks immediately after meals, as they reduce iron absorption by 62%. Do not forget that the body normally absorbs only 10% of the iron received from food.
• Limit consumption of foods rich in calcium and calcium supplements. Calcium also slows down the absorption of iron by the human body. Therefore, when treating iron deficiency conditions, you should limit your consumption of hard cheese, milk, sesame seeds, herbs and others. Also, if the patient is taking calcium supplements, then their intake should be discontinued or limited. If this is not possible, calcium should be taken between meals.

Iron supplements

If it is not possible to increase serum iron levels through diet, the patient is prescribed iron supplements. The doctor selects the dosage and duration of treatment individually. Therapy with iron supplements should be carried out under the control of serum iron levels determined in the laboratory.

Iron supplements prescribed for iron deficiency

Preparation	Dose, duration of treatment
Maltofer	Oral solution. To treat iron deficiency, take 1 bottle ( 100 mg iron) from 1 to 3 times a day. Duration of treatment is from 3 to 5 months. After this, continue to take 1 bottle per day for 1 to 3 months to restore iron reserves. To prevent iron deficiency, take 1 bottle for 1 to 2 months.
Biofer	To treat iron deficiency, take 1 tablet ( 100 mg iron) from 1 to 3 times a day for 3 to 5 months. Then, for several months, take 1 tablet per day to restore iron reserves. To prevent iron deficiency, take 1 tablet for 1 to 2 months. Contains folic acid, which improves iron absorption.
Ferro foil	To treat iron deficiency anemia, take 1 capsule ( 37 mg iron) 3 times a day. The duration of treatment ranges from 3 to 16 or more weeks ( depending on the severity of iron deficiency). For prevention – 1 capsule 3 times a day for a month. Contains vitamin B 12 and folic acid.
Ferretab	When treating, use from 1 to 3 capsules ( 50 mg iron) per day. Treatment is continued until the level of iron in the blood normalizes. Then maintenance therapy is continued for 4 weeks. Contains folic acid.
Hemofer	Take 46 drops orally between meals ( per drop contains 2 mg of iron) 2 times a day with juice or water. The duration of treatment is at least 2 months.
Sorbifer Durules	1 tablet orally ( 40 mg iron) 1 – 2 times a day. If necessary, the dose is increased to 3–4 tablets per day in 2 divided doses. The course of treatment is 3–4 months. Contains ascorbic acid.
Tardiferon	1 tablet orally ( 80 mg iron) 2 times a day before meals or during meals. Duration of treatment is from 3 to 6 months.
Ferrum	The injection form of this drug is used only intramuscularly. First, a test dose is administered. If there is no reaction, the entire dose is administered. Prescribe 1 – 2 ampoules ( 100 mg iron) per day.
Venofer	Will be used intravenously. Intramuscular administration is unacceptable. Administer slowly after test dose. The dose is selected individually depending on the severity of iron deficiency. One ampoule contains 40 mg of iron.
Cosmopher	The drug is for intramuscular and intravenous administration. One ampoule contains 100 mg of iron. The dose and duration of treatment are selected individually.
Totema	Oral solution. 1 ampoule contains 50 mg of iron. Prescribe 1 ampoule orally 2-3 times a day for a course of treatment of up to six months.
Hematogen	In the form of chewable lozenges or bars. Iron content varies. Take 1 - 2 lozenges 2 - 3 times a day.

Iron supplements are prescribed intravenously for extremely severe iron deficiency conditions. Also indications for intravenous administration are diseases of the gastrointestinal tract, in which the absorption of iron is significantly reduced. First, a test dose is administered to exclude adverse reactions. The drug is administered only in the presence of a doctor.

For the treatment and prevention of iron deficiency in children, syrups, tablets and chewing strips are used.

What does an elevated blood iron level indicate?

The serum iron level is considered elevated if it is above the upper acceptable limit - 30.4 µmol/l. An increase in level can be observed in various pathologies, as well as in case of an overdose of iron preparations. Elevated iron levels occur when the body's intake of iron exceeds its consumption and excretion.

Depending on the cause of its appearance, excess iron is divided into primary and secondary. Primary excess iron is caused by a hereditary pathology - hemochromatosis. Diseases of internal organs and many external factors lead to secondary excess iron.

Elevated levels of iron in the blood can occur with:

• Hemochromatosis. Hemochromatosis is a hereditary disease in which the normal metabolism of iron is disrupted with its accumulation in organs and tissues. The accumulation of iron in organs leads to disruption of their structure and function. Subsequently, various diseases develop - liver cirrhosis ( replacement of healthy liver tissue with scar tissue), arthritis, diabetes and others.
• Various types of anemia ( hemolytic, hypoplastic, aplastic, sideroblastic and others). An increase in iron content in various types of anemia occurs for many reasons. It depends on the type of anemia. For example, with hemolytic anemia, increased destruction of red blood cells occurs. In this case, iron from red blood cells enters the blood. In sideroblastic anemia, the utilization of iron by the bone marrow for the synthesis of hemoglobin is impaired.
• Thalassemias. Thalassemia is a hereditary pathology characterized by impaired synthesis of components ( chains) structure of hemoglobin. As a result, less iron is consumed for hemoglobin synthesis.
• Acute iron poisoning. Acute iron poisoning occurs with a significant overdose of iron preparations - taking up to 200 milligrams of iron. This can be caused by uncontrolled intake of iron supplements, self-medication, and children taking iron-containing medications in large quantities ( whole package).
• Liver diseases ( viral hepatitis, liver necrosis), spleen, pancreas. Diseases of various organs lead to metabolic disorders, impaired absorption of vitamins and microelements, and hormonal imbalances. One of the consequences is excessive accumulation of iron in the blood.
• Iron metabolism disorders. Various diseases and pathological processes can lead to impaired iron metabolism. This can manifest itself either as a decrease in its level or as an increase.
• Excessive intake of iron into the body. Excessive intake of iron into the body is possible with self-treatment with iron supplements. Also, with a normal intake of iron into the body and a disturbance in its metabolism, an increase in serum iron may be observed.
• Premenstrual period. An increase in iron levels in the premenstrual period is a variant of the norm. Therefore, it is better to take a serum iron test after the end of menstruation.
• Frequent blood transfusions. With frequent blood transfusions and a short interval between them, an increase in serum iron levels is possible.

Symptoms of high iron levels in the blood include:

• nausea, vomiting, heartburn, constipation, or diarrhea;
• damage to the intestinal mucosa;
• loss of appetite, weight loss;
• apathy, decreased performance;
• the appearance of pain, swelling in the joints;
• the appearance of arthritis inflammatory process in joints), atherosclerosis ( deposits of atherosclerotic plaques on the walls of the vessel), diabetes ( elevated blood sugar);
• decreased immunity;
• hyperpigmentation of the skin, gray-brown tint of the skin and mucous membranes;
• hair loss;
• muscle pain;
• delayed physical and mental development of the child;
• decreased libido ( sexual desire).

How to lower iron levels in the blood?

Excess iron in the blood can lead to many diseases - myocardial infarction, liver failure, diabetes, arthritis, cancer. In severe cases, even to the death of a person. Therefore, with laboratory confirmed excess iron in the blood, it is necessary to take measures to reduce its level.

Helps reduce iron levels in the blood:

• Use of special medications. Medicines that accelerate the excretion of iron include hepatoprotectors, zinc preparations, drugs that bind iron - deferoxamine ( desferal), thetacin calcium.
• Following a special diet. If there is an excess of iron, foods rich in this microelement are excluded from the diet. These are meat, beans, dried mushrooms, dried apples and pears, seafood and others. Also, you should not take vitamins that help improve iron absorption - B vitamins, vitamin C, folic acid. It is recommended to consume more foods that impair iron absorption - coffee, tea, foods rich in calcium, calcium and zinc supplements.
• Periodic bleeding. The procedure involves taking about 350 milliliters of blood from the patient weekly. If desired, the patient can become a blood donor.
• Hirudotherapy ( treatment with leeches). Leech treatment can also help lower blood iron levels. This happens as a result of leeches feeding on human blood. In this case, hemoglobin and iron in its composition are lost.
• Exchange blood transfusion. Exchange transfusion is used for severe iron poisoning. The procedure involves simultaneous collection of blood from the patient's bloodstream and transfusion of donor blood.

Why is hemoglobin low when serum iron levels are normal?

In some pathological conditions, hemoglobin levels may be reduced with normal or elevated serum iron levels. In these cases, anemia ( a condition characterized by low levels of hemoglobin in the blood) develops with sufficient iron intake in the body. When does this happen, and is it dangerous to human health? A low level of hemoglobin affects all human systems and organs in the form of oxygen starvation of cells. And in the future, this can lead to metabolic disorders in the tissues of the body. But why does the body produce insufficient hemoglobin when the iron level is normal?

One of the reasons for low hemoglobin with normal serum iron levels is a lack of vitamin B 12 and folic acid in the body, which are involved in the formation of red blood cells.

The treatment method is intramuscular injection of a solution of vitamin B 12 at a dose of 500-1000 mcg daily for 10 days, and then use of the drug 2-3 times a month for prophylactic purposes. Folic acid is used in a dose of 50 - 60 mg per day.

Another reason for the development of anemia with normal iron content is the problem of an insufficient number of red blood cells or inferior hemoglobin protein.

The causes of an insufficient number of red blood cells or inferior hemoglobin protein are:

• Sickle cell anemia. Sickle cell anemia is a congenital disease associated with a disorder in the structure of hemoglobin, in which it takes on a characteristic sickle shape. Clinical manifestations of sickle cell anemia are thrombosis of blood vessels of various organs with sickle-shaped erythrocytes, hemolytic anemia, pallor and jaundice of the skin, repeated thrombosis of various organs, splenomegaly ( pathological enlargement of the spleen in size), hepatomegaly ( liver enlargement), shortness of breath, general weakness and malaise. Sickle cell anemia is an incurable disease. Symptomatic treatment during a crisis is adequate hydration ( saturating the body with fluid), red blood cell transfusion ( blood product consisting of red blood cells), as well as intravenous antibiotics.
• Destruction of red blood cells under the influence of certain chemicals. Destruction of red blood cells occurs when exposed to compounds of arsenic, lead, nitrites, amines, some organic acids, foreign serums, insect and snake poisons. The mechanism of the damaging effect is due to the destruction of red blood cell membranes and the release of large amounts of hemoglobin into the plasma. This leads to intense protein breakdown with subsequent damage to the excretory organs - the kidneys and liver. First aid consists of administering specific antidotes, for example, for snake bites - antisnake serums.
• Diseases of the hematopoietic organs. An insufficient number of red blood cells can be observed in some diseases of the hematopoietic organs, in particular in blood cancer - lymphosarcoma, lymphogranulomatosis and others. In such cases, pathological cells develop faster and replace the precursor cells of red blood cells and other blood cells.

What are the consequences of iron deficiency?

About 30% of the world's population suffers from a lack of iron in the body. And at the same time, about 20% do not even know about it, having a latent ( hidden) iron deficiency. Why is this microelement important for the human body? Iron is part of a very important protein for the body - hemoglobin, which plays the role of a carrier of oxygen from the lungs to all organs and tissues. Lack of iron leads to iron deficiency anemia. Iron deficiency anemia is a condition characterized by impaired hemoglobin synthesis due to insufficient iron content.

With a lack of oxygen, chronic oxygen starvation of tissues and organs occurs at the cellular level. This leads to functional and structural changes in these organs. Iron is also part of many enzyme systems and is found in the cells of the liver, spleen, muscles, and bone marrow. That is why its deficiency affects a person’s general well-being - general weakness, malaise, dizziness, and decreased performance appear ( as a result of metabolic disorders). Functional and regenerative functions also deteriorate ( restorative) abilities of organs and tissues, the production of enzymes and hormones decreases. Immunity is noticeably reduced, which is manifested by frequent colds.

At the level of the skin and its appendages, iron deficiency manifests itself in pallor and dryness of the skin and mucous membranes, which leads to dermatitis and eczema ( inflammatory and allergic skin diseases), stomatitis ( ulcerative lesions of the oral mucosa), cheilitis ( cracks in the corners of the mouth).

With iron deficiency, the patient often suffers from bronchitis ( inflammation of the bronchi), tracheites ( inflammatory processes in the trachea), rhinitis ( inflammation of the nasal mucosa). At the level of the cardiovascular system, stabbing pain in the heart, low blood pressure, and shortness of breath during exercise appear.

With a lack of iron, thinning and atrophy of the mucous membrane of the gastrointestinal tract occurs, which is manifested by pain or burning in the tongue, perversion of taste ( patients eat chalk, clay, earth, lime), the acidity of gastric juice decreases with the formation of erosions and ulcers.

Muscle weakness due to iron deficiency leads to a false urge to urinate, urinary incontinence when coughing, laughing, or physical stress.
In children, chronic iron deficiency anemia leads to growth retardation, impaired memory, attention, learning disabilities, and nocturnal diuresis ( spontaneous urination during sleep).

In pregnant women, iron deficiency leads to premature birth, miscarriage, and stillbirth.

Iron is a vital microelement. Its deficiency or excess leads to damage to absolutely all organs and tissues. This negatively affects a person's quality of life. In some cases, iron deficiency can lead to irreversible consequences. And severe cases of excess or deficiency of iron can lead to death.