The document provides an overview of iron as an essential trace element, its physiological role, recommended dietary allowances (RDA), metabolism, and disorders related to iron deficiency and excess. It highlights sources of dietary iron, mechanisms of iron absorption, storage, and excretion, as well as the significance of iron in oxygen transport and energy production. Additionally, it discusses iron deficiency anemia, its causes, symptoms, lab findings, and treatment options, including dietary changes and iron supplementation.

2. Content :
 Introduction
 source
 RDA ( Recommended Dietary Allowance)
 Metabolism
 Function
 Disorder

3. IRON
 Iron is one of the most essential trace element .
 Total body iron content is 3 to 5 gm
 75% present in blood , the rest is in liver , bone
marrow & muscles .
 Iron is present in almost all cells .
 Heme is the most predominant iron containing
substances .
 It is a constituent of protein / enzymes .

4. SOURCES OF IRON
HEME IRON
• Liver
• Meat
•Poultry
• Fish
NON HEME IRON
• Leafy Vegetables
• Legumes
• Beans
• Cereals
•Milk

5. IRON RDA
 Paediatrics
Infant (7-12 months) – 11mg / day
Toddlers (1-3years) – 7mg / day
Kids (4-8years) – 10mg / day
Child (9-13years) – 8mg / day
• Adult : 10-20mg / day
• Pregnancy : 40mg/day

6. IRON METABOLISM
Absorption
⬇
Transport
⬇
Storage
⬇
Excretion

7. IRON ABSORPTION
SITE (small intestine )
⬇
Forms
(Heme & Non heme )
⬇
Efficiency
(About 10% of total food iron is absorbed)

8. Iron in food
⬇ (if the body doesn’t need
iron)
Mucosal cells in the intestine , Iron is not absorbed
& is
store excess iron in mucosal ➡ excreted in shed
intestinal
Ferritin (a storage protein) instead . Thus , iron
⬇ if the body needs iron absorption is reduced
when
Mucosal Ferritin releases the body doesn’t
need
iron to mucosal Transferrin iron .
(a transport protein ) ,
which hands off iron to
another Transferrin that

9. FACTORS AFFECTING
ABSORPTION
Factors increasing iron absorption :
• Ferrous form
• Ascorbic form
• Erythropoisis
• Hemochromatosis
Factors decreasing iron absorption:
• Oxalate and phosphate
• Antacid
• Gastrointestinal disease

10. MECHANISM OF IRON ABSORPTION

11. STORAGE OF IRON
STORAGE FORM :
• Heme
• Ferritin
• Hemosederin
STORAGE SITE :
• Liver
• Intestine
• Spleen
• Bone Marrow

12. EXCRETION
 Iron excreted in the feces is mainly exogenous i.e.
dietary iron that has not been absorbed.
 In females there are additional sources of loss ,
due to menstruation and pregnancy .
 Urine contains negligible amount of iron .

13. IRON FUNCTION
 Oxygen carriers
- hemoglobin
 Oxygen storage
- myoglobin
 Energy production
- Cytochromes (oxydative phosphorylation)
- Krebs cycle enzyme
 Others
- Liver detoxification

14. FUNCTION OF IRON
Iron is requird for synthesis of heme and non heme
compound .
HEME : - Hemoglobin
- Myoglobin
- Cytochromes
- Catalase
NON HEME : - Succinate dehydrogenase
- Xanthine Oxdase
- Iron Sulfur proteins

15. DISORDER OF IRON
METABOLISM
Iron Excess
Iron Deficiency

16. IRON DEFICIENCY ANEMIA
An anemia with increased cell production and
an MCV <80fl characterized by
hypochromic cells and low levels of iron
stored in the body .
 Causes
 Features
 Lab Findings
 Treatment

17. IDA : Causes
 Deficient intake
- lower intake of iron rich food
- cow milk feeding
 Impaired absorption
- gastric surgery
- celiac disease
 Excessive loss
- hookworm infestation
- GI losses : peptic ulcer , carcinoma , polyp
 Increase Demand
- growth spurt (infancy , puberty)

18. IDA : Features
SYMPTOMS:
• Pallor
 Fatigue
 Palpiations
 Dizziness
 Irritability
SIGNS:
 Angular Stomatitis
 Pica
 brittle nail
 koilonychia

19. IDA : Lab Findings
• Hematological Findings :
CBC – decreased RBC , low MCV , low MCHC ,
elevated RDW
PBS - Hypochromic microcytic anemia
• Biochemical Findings :
- decreased transferrin saturation
- elevated serum total iron binding capacity
- decreased plasma ferritin and serum iron

20. IDA : Treatment
 Treatment of underlying causes
- deworming against hookworm infestation
- dietary counselling
• Oral Iron Therapy
- 3-6mg/kg/day of elemental iron ; ferrous sulfate
- Iron therapy increases reticulocyte count within 72-96hour .
After correction of anemia , oral iron should be continued for 4-
6month.
• Parenteral iron therapy
- indicated for intolerance to oral iron malabsorption & high rate
of ongoing blood loss .
- IV iron sucrose 1-3mg /kg diluted in 150ml NS slow infusion
over 30-90min.

21.  Blood transfusion
- In emergency situation such as urgent surgery ,
acute severe anemia with congestive cardiac
failure , prior to invasive procedure .

22. IRON OVERLOAD
 HEMOSIDEROSIS
- Increase in iron stores as hemosiderin
- Without associated with tissue injury
 HEMOCHROMATOSIS
- Excessive deposition of iron in tissue
-Associated with tissue injury