How to replenish iron in the body with folk remedies. How to raise blood iron levels: medications and best recipes. What foods increase hemoglobin in adults

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

The human body is 60% water, 34% organic and 6% inorganic. 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 macronutrients. It depends on the mass fraction of the element. Microelements include iron, copper, zinc and others. Macronutrients - calcium, sodium, potassium and others.

Iron ( Fe) refers to trace elements. Despite the low content of iron in the body, it plays a special role in maintaining its vital functions. The lack of iron in the human body, like its excess, negatively affects many functions of the body and human health in general.

If the patient complains of increased fatigue, malaise, palpitations, the doctor prescribes an analysis of serum iron. This analysis helps to assess the exchange of iron in the body and identify many pathological processes associated with iron metabolism. In order to understand what serum iron is, what it is needed for and how it appears, it is necessary to consider the functions of iron and its metabolism in the human body.

Why does the body need iron?

Iron is a versatile chemical element that performs vital functions in the body. The body cannot make iron, so it gets it from food. Human nutrition should 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 poor health.

The iron contained in the body is subdivided into:

• Functional hardware.Functional iron is part of hemoglobin ( iron-containing protein of red blood cells, capturing and carrying oxygen to organs and tissues of the body), myoglobin ( oxygen-containing protein of skeletal muscles and heart muscles, which creates 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 transferred from the source of iron intake to the body to each of its cells. Transport iron is not involved in the functions of the body It is part of the 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 ( a carrier protein for iron ions in a cell).
• Deposited iron.Part of the iron that has entered 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 ( an iron-containing pigment formed during the breakdown of hemoglobin).
• Free iron.Free iron or free pool is iron that is not bound 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 a cell, attaching molecules of various chemicals and transmitting regulatory signals). Iron is very toxic in its free form. Therefore, free iron is transported inside the cell by mobilferrin or deposited with ferritin.

Localization in the body is distinguished:

• 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 deposited iron. The extracellular gland includes free plasma iron and iron-binding transport proteins - transferrin, lactoferrin, mobilferrin. The deposited iron is in the body in the form of two protein compounds - ferritin and hemosiderin.

The main functions of iron are:

• oxygen transport to tissues - the erythrocyte contains hemoglobin, the molecules of which contain 4 iron atoms; iron in hemoglobin binds and transfers oxygen from the lungs to all cells of the body;
• participation in the processes of hematopoiesis - the bone marrow uses iron to synthesize hemoglobin, which is part of erythrocytes;
• detoxification of the body - iron is necessary for the synthesis of liver enzymes involved in the destruction of toxins;
• regulation of immunity and increasing the tone of the body -iron affects the composition of the blood, the level of leukocytes required 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 needed for the synthesis of thyroid hormones, which regulates the body's metabolism;
• providing cells with energy - iron delivers oxygen to energy protein 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 ( especially in turkey meat), dried mushrooms, legumes, vegetables, fruits, cocoa. The daily requirement for 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 old	10 mg per day
	11 - 14 years old	12 mg per day
Female	14 - 18 years old	15 mg per day
	19 - 50 years old	18 mg per day
	over 50 years old	8 mg per day
Pregnant women	-	38 mg per day
Lactating women	-	33 mg per day
Male	14 - 18 years old	11 mg per day
	over 19 years old	8 mg per day

Iron is found in the body in varying 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) falls on hemoglobin iron ( hemoglobin - an iron-containing protein that transports oxygen to tissues).	28 mg Fe / kg	31 mg Fe / kg
Myoglobin. The composition of myoglobin ( oxygen - a binding protein of skeletal muscle and heart muscle) includes 5 - 10% of the total amount of iron.	4 mg Fe / kg	5 mg Fe / kg
Heme and non-heme enzymes ( chemicals that speed up chemical reactions 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 - a carrier of iron in blood plasma).	0.2) mg Fe / kg	0.2) mg Fe / kg
Iron depot ( iron stores 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 exchange in the human body

Metabolism ( exchange) iron is a very well-organized process. In the body, the processes of intake and reutilization of iron are clearly regulated, since it is a very valuable trace element.

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 stores, the third is the release of iron into the blood plasma.

Iron enters the body through food. When you receive 10-20 milligrams of iron with food per day, only 10% of iron is absorbed, which is 1 to 2 milligrams. The body receives 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 ( 80 – 90% ). The absorption of such iron occurs passively and in small amounts ( 1 – 7% ). This process is also influenced by many external factors.

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

• fitins - found in cereals, legumes, semolina and oatmeal;
• tannins - found in tea, cocoa, coffee, quince, dark grapes, currants;
• phosphoproteins - complex proteins found in milk, egg white;
• oxalates - found in corn, rice, grains, spinach, milk;
• some medicines -calcium preparations, oral contraceptives.

An increase in iron absorption occurs when eating:

• vitamin C ( ascorbic acid) – found in white cabbage, spinach, red and green peppers, black currants, dried rose hips;
• copper - found in liver, peanuts, hazelnuts, shrimps, peas, buckwheat, lentils;
• meat products -beef, veal, rabbit and others;
• seafood -fish, oysters, shrimps;
• 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 action of gastric juice, ferric iron ( Fe 3+) is released from food and converted into ferrous iron ( Fe 2+). This process is accelerated by ascorbic acid and copper ions. Basically, iron absorption occurs in the small intestine - up to 90% in the duodenum and the initial parts of the jejunum. With diseases of the stomach and intestines, the process of normal absorption of iron is disrupted.

After the intake of ferrous iron ( Fe 2+) into the sections of the small intestine, it enters the enterocytes ( epithelial cells of the small intestine). The absorption of iron into enterocytes occurs with the help of special proteins - mobilferrin, integrin and others. Transferrin and ferritin are found in the cells of the small intestine. 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), part is transported by the transferrin protein and used by the body for heme synthesis ( 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 - in the composition 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. Liver cell ferritin is the main iron depot in the body. Ferritin of small intestine cells is responsible for the transfer of iron entered into enterocytes to blood plasma transferrin. Hemosiderin is an iron-containing water-insoluble pigment that stores excess iron in tissues.

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

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

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

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

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 research is venous blood. The most commonly used colorimetric method to analyze serum iron concentration. The essence of the method is to determine the concentration of iron in the serum by the intensity of the color of the solution. The color intensity of the solution is directly proportional to the concentration of the colored chemical trace element. This method allows you to determine the concentration of a trace element with high accuracy.

The indications for the analysis of the concentration of serum iron are:

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

Serum iron analysis is performed for:

• assessing iron stores 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;
• monitoring the treatment of anemia;
• control of treatment with iron preparations;
• diagnosis of genetic diseases of iron metabolism disorders.

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

Age	Floor	Iron rate
	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 old	female	5.0 - 16.8 μmol / l
	male	4.6 - 20.5 μmol / l
from 7 to 10 years old	female	5.5 - 18.7 μmol / l
	male	4.9 - 17.3 μmol / l
from 10 to 13 years old	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
\u003e 18 years old	female	8.9 - 30.4 μmol / l
	male	11.6 - 30.4 μmol / l

When receiving tests, the doctor focuses on the gender and age of the patient. The results obtained can be within the normal range, below or above the norm. If the iron level is below normal, the patient has an iron deficiency. If the level of iron is higher than normal, there is an excess of iron in the patient's body. When interpreting the results obtained, many factors should be taken into account - nutrition, medication, a woman's menstrual cycle, and others. Do not forget about the 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 hours. In women, in the period before and during menstruation, the concentration of iron in the blood is higher than after the end of menstruation. Therefore, a serum iron test should be taken after the cessation of menstruation. There may be occasional fluctuations in the level of iron in the blood, for example, with a sharp increase in the consumption of meat in the patient's diet.

Medicines that increase the level of iron in the blood are:

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

Medicines that lower blood iron levels are:

• acetylsalicylic acid in high doses - non-steroidal anti-inflammatory agent;
• allopurinol - a drug that lowers the level of uric acid in the blood;
• cortisol - glucocorticoid hormone;
• metformin - tableted hypoglycemic agent ( lowering blood sugar);
• corticotropin - an adrenocorticotropic hormone preparation;
• cholestyramine - hypolipidemic agent ( lowering blood fat);
• asparaginase - antineoplastic agent;
• preparations containing testosterone - male sex hormone.

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

How to properly prepare for a serum iron test?

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

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

• stop taking medications and complexes of iron-containing vitamins a week before taking an analysis for serum iron;
• postpone the analysis of serum iron for a few days after blood transfusion ( blood transfusion);
• explain to the patient that for the analysis of serum iron it will be necessary to take a blood sample, explain the essence of the procedure, 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 a test blood on an empty stomach;
• exclusion of smoking, alcohol and fatty foods, physical activity 12 hours before the analysis;
• taking the test material before carrying out any diagnostic procedures ( radiography, computed tomography);
• the patient has no viral and inflammatory diseases.

What should be the serum iron level during pregnancy?

Pregnancy is a very important and difficult period in the life of any woman. At this time, serious physiological changes take place in the body. The fetus uses the mother's micronutrients and macronutrients as building blocks. Therefore, it is very important for a woman to monitor her diet. It must be balanced and provide adequate supply of vitamins, minerals, proteins and other substances. Usually the need for these substances exceeds the daily norm of a non-pregnant woman, since 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, therefore, the need for iron for the production of hemoglobin increases 2 times ( iron-containing protein that transports blood);
• significant consumption of iron from the mother's iron depot for the formation of placenta, erythrocytes ( oxygen-carrying red blood cells) the fetus;
• 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 in pregnant women, daily iron consumption increases. In the first trimester, the additional costs of iron are 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 is needed, for the uterus that has increased in size - 50 - 75 milligrams of iron; for the construction of the placenta, through which the vital activity of the fetus is maintained, 100 milligrams of iron is 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) consumes about 650 milligrams of iron.

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

For a pregnant woman and her unborn baby, both iron deficiency and its excess are equally dangerous. If the required daily rate of iron does not enter the body of a pregnant woman, then its reserves are quickly depleted. This leads to a lack of iron ( serum iron levels) 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 the mother suffer from a lack of oxygen. Iron deficiency anemia leads to a weakening of the immune system, 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 death of a newborn.

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 can lose a lot of blood. If there was already an iron deficiency before, then bleeding can lead to the development of severe anemia and the need for blood transfusion. It has been scientifically proven that iron deficiency is one of the causes of postpartum depression.

Excess iron ( serum iron level\u003e 30 μmol / L) also negatively affects the course of pregnancy and fetal health. An excess of iron can be observed in hereditary diseases with impaired iron metabolism and excessive intake of iron into the body ( uncontrolled intake of iron medications). Excessive iron in the blood of a pregnant woman can cause gestational diabetes ( pathology in which there is a high blood sugar in 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 physician.

Iron deficiency during pregnancy is much more common than excess iron. Iron deficiency can be compensated for with an iron-rich diet or with iron supplements. A pregnant woman's diet should contain red meat ( richest source of iron), rabbit, chicken, turkey, as well as cereals, legumes, spinach, cabbage, cereals and others.

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

Iron supplements prescribed during pregnancy are:

• Sorbifer durules.This tablet contains 100 milligrams of iron and vitamin C to improve intestinal absorption of iron. During pregnancy, in order to prevent iron deficiency, 1 tablet is prescribed per day, for treatment - 1 tablet in the morning and in the evening.
• Ferroplex.Dragee contains 50 milligrams of iron and vitamin C. Take 2 dragees 3 times a day.
• Totem.Totem is a solution containing 50 milligrams of iron. For prophylaxis, 1 ampoule is prescribed orally per day from 4 months of pregnancy. In large doses, totem is prescribed only for laboratory-confirmed iron deficiency anemia. Prescribed for 2 - 4 ampoules per day.
• Fenuls.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 appear, you should consult a doctor. The doctor will reduce the dose of the iron preparation or stop it altogether ( if the patient's condition and laboratory tests allow).

What diseases lead to a decrease in blood iron levels?

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

Symptoms of iron deficiency in the body

Iron deficiency leads to a deterioration in the functioning of organs and systems, a lack of oxygen, a violation 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 the depletion of iron stores, symptoms begin to appear, which become more pronounced over time.

Distinguish between latent ( hidden) and clear signs of a lack of iron in the blood. Latent signs appear with a slight iron deficiency. Serum iron levels are often normal or close to the cutoff ( women - 8.9 μmol / l, men - 11.6 μmol / l). In this case, the body uses up its iron stores.

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

• decreased performance;
• increased fatigue;
• severe malaise, weakness;
• heart palpitations ( tachycardia);
• increased irritability;
• depression;
• headaches and dizziness;
• difficulty swallowing;
• glossitis ( inflammatory process of the tongue);
• hair loss;
• brittle nails;
• pallor of the skin;
• impairment of memory, attention, thought processes, learning ability;
• frequent respiratory tract infections;

When iron is consumed from the reserves and its insufficient intake into the body, many processes in the body are disrupted. The 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 ° С, a person feels uncomfortable at low temperatures, he has constantly cold limbs;
• impairment of memory, attention, learning rates - with iron deficiency, it is difficult for the patient to concentrate, remember information, there is frequent forgetfulness;
• decreased performance -the patient constantly feels tired, "overwhelmed", even after a full sleep;
• disruption of the gastrointestinal tract - loss of appetite, difficulty swallowing, pain in the stomach, constipation, flatulence ( excessive accumulation of gas in the intestinal lumen), the appearance of belching and heartburn;
• increased fatigue, muscle weakness -the patient observes in himself increased fatigue even after a short activity, also notes weakness in the muscles during physical exertion and at rest;
• neurological disorders -increased irritability, irascibility, depressive states, tearfulness, migratory pain ( head, in the region of the heart);
• retardation of mental and physical development in children - lack of iron leads to oxygen starvation, which negatively affects the central nervous system of the child, the development of the cardiovascular system and others;
• geophagy ( food perversion) – with a deficiency of iron, 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 off, cracks and pronounced wrinkles appear, wounds form in the corners of the mouth ( cheilitis), stomatitis ( inflammation of the mucous epithelium of the oral cavity);
• dry, brittle nails and hair -with a lack of iron, the hair becomes dull, brittle, loses shine and volume, nails exfoliate 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, and darkening in the eyes;
• shortness of breath, heart palpitations - iron deficiency leads to a lack of oxygen, which the body tries to compensate by increasing breathing and heart rate.

How to increase the level of iron in the blood?

Before starting therapy 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 have a temporary effect. This will lead to the need for repeated courses of treatment.

Before using iron-containing drugs or changing the diet, it is necessary to undergo an examination, be tested for serum iron. If an iron deficiency is confirmed in a laboratory study, the doctor will individually select the treatment tactics for the patient. The principle of treatment will depend on the indicators of the level of iron, the patient's condition ( e.g. pregnancy), concomitant diseases ( in some diseases, increased iron losses may be observed).

With a slight iron deficiency, 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 ( with chronic bleeding, pregnancy, breastfeeding, intensive growth) The amount of iron from food may not be enough. Then the therapy is supplemented by taking iron preparations.

In severe iron deficiency, treatment begins immediately with taking medications in the form of capsules, tablets and pills. In severe cases, iron preparations are administered intravenously under the strict supervision of the attending physician.

Diet for iron deficiency

With food, heme and non-heme iron enters the human body. Heme iron ( the source is hemoglobin) is several times more efficiently absorbed by the body, in contrast to non-heme. The body receives 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 meat	3,7 – 4,0
chicken	1,6 – 3,0
veal	2,8
pork liver	19,0
calf liver	5,5 – 11,0
beef kidney	7,0
sea \u200b\u200bfish	1,2
a 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 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 intestine by 6 times. Therefore, for better absorption of this microelement, it is necessary to increase the intake of foods rich in vitamin C. Such foods include spinach, cauliflower, citrus fruits, broccoli and others. Sources of folate include peanuts, almonds, walnuts, flax seeds, and others. B vitamins are found in fermented milk products, nuts, yeast, and egg yolk.
• Reduce consumption of tea and coffee.The tannin found in tea and coffee significantly reduces the absorption of iron. Therefore, you should not consume these drinks immediately after a meal, as they reduce iron absorption by 62%. Do not forget that the body normally assimilates only 10% of the iron ingested with food.
• Limit the intake 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 states, you should limit the consumption of hard cheese, milk, sesame seeds, herbs and others. Also, if the patient is taking calcium supplements, then it should be canceled or limited to its intake. If this is not possible, calcium should be taken in between meals.

Iron preparations

If diet cannot increase serum iron levels, then the patient is prescribed iron medications. The doctor selects the dosage and duration of the course of treatment individually. Iron therapy should be monitored for serum iron levels as determined in laboratory conditions.

Iron supplements for iron deficiency

A drug	Dose, duration of treatment
Maltofer	Oral solution. For the treatment of iron deficiency, take 1 bottle ( 100 mg iron) from 1 to 3 times a day. The duration of treatment is from 3 to 5 months. After that, continue to take 1 bottle per day for 1 to 3 months to restore iron stores. For the prevention of iron deficiency, take 1 bottle for 1 to 2 months.
Biofer	For the treatment of 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 stores. To prevent iron deficiency, take 1 tablet for 1 - 2 months. Contains folic acid to improve iron absorption.
Ferro-foil	For the treatment of iron deficiency anemia, take 1 capsule ( 37 mg iron) 3 times a day. The duration of treatment is 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	For treatment, use from 1 to 3 capsules ( 50 mg iron) per day. Treatment continues until the level of iron in the blood normalizes. Then maintenance therapy is continued for 4 weeks. Contains folic acid.
Hemofer	It is taken orally between meals, 46 drops ( a 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	Inside 1 tablet ( 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 to 4 months. Contains ascorbic acid.
Tardiferon	Inside 1 tablet ( 80 mg iron) 2 times a day before meals or during meals. The duration of treatment is from 3 to 6 months.
Ferrum	The injectable form of this drug is used only intramuscularly. First, a test dose is administered. In the absence of a reaction, the entire dose is administered. Assign 1 - 2 ampoules ( 100 mg iron) per day.
Venofer	Intravenous. Intramuscular administration is unacceptable. Injected slowly after the test dose. The dose is selected individually depending on the severity of iron deficiency. One ampoule contains 40 mg of iron.
Cosmofer	The drug is for intramuscular and intravenous administration. One ampoule contains 100 mg of iron. The dose and duration of treatment are selected individually.
Totem	Oral solution. 1 ampoule contains 50 mg of iron. Assign 1 ampoule inside 2 - 3 times a day for up to six months of treatment.
Hematogen	In the form of gummies or tablets. Iron content varies. Take 1 - 2 lozenges 2 - 3 times a day.

Iron preparations 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 is administered - a dose to exclude adverse reactions. The introduction of the drug is carried out only in the presence of a doctor.

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

What does an elevated blood iron level mean?

Serum iron levels are considered elevated if they are greater than the upper limit of 30.4 μmol / L. An increase in the level can be observed with various pathologies, as well as with an overdose of iron preparations. An increase in iron levels occurs when the intake of iron in the body exceeds its consumption and excretion.

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

An increased level of iron in the blood can be observed with:

• Hemochromatosis.Hemochromatosis is a hereditary disease in which the normal exchange 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 - cirrhosis of the liver ( replacement of healthy liver tissue with scar tissue), arthritis, diabetes and others.
• Various types of anemias ( hemolytic, hypoplastic, aplastic, sideroblastic and others). The 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, an increased destruction of red blood cells occurs. In this case, iron from erythrocytes 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) the structure of hemoglobin. As a result, less iron is consumed for the synthesis of hemoglobin.
• Acute iron poisoning.Acute iron poisoning occurs with a significant overdose of iron preparations - taking up to 200 milligrams of iron. This can lead to uncontrolled intake of iron supplements, self-medication, intake of iron supplements by children in large quantities ( whole package).
• Liver disease ( viral hepatitis, liver necrosis), spleen, pancreas.Diseases of various organs lead to metabolic disorders, to impaired absorption of vitamins and microelements, to hormonal disruptions. 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 be manifested as a decrease in its level, and an increase.
• Excessive intake of iron in the body.Excessive intake of iron into the body is possible with self-treatment with iron preparations. Also, with a normal intake of iron in the body and a violation of its metabolism, an increase in serum iron may be observed.
• Premenstrual period.Increased iron levels in the premenstrual period are normal. 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 elevated blood iron levels 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 the joints), atherosclerosis ( deposits of atherosclerotic plaques on the walls of the vessel), diabetes ( high blood sugar);
• decreased immunity;
• hyperpigmentation of the skin, gray-brown tint of the skin and mucous membranes;
• hair loss;
• muscle pain;
• delay in the physical and mental development of the child;
• decreased libido ( sex drive).

How to lower iron levels in the blood?

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

Reducing the level of iron in the blood will help:

• The use of special drugs.Medicines that accelerate the excretion of iron include hepatoprotectors, zinc preparations, iron-binding drugs - deferoxamine ( desferal), calcium tetacin.
• Compliance with a special diet. With an excess of iron, foods rich in this trace element are excluded from the diet. These are meat, beans, dried mushrooms, dried apples and pears, seafood and others. Also, do not take vitamins that help improve the absorption of iron - B vitamins, vitamin C, folic acid. It is recommended to consume more foods that impair the absorption of iron - coffee, tea, foods rich in calcium, calcium and zinc preparations.
• Periodic bloodletting. The procedure involves taking about 350 milliliters of blood from the patient every week. If desired, the patient can become a blood donor.
• Hirudotherapy ( leech therapy). Leech therapy can also help lower blood iron levels. This happens as a result of the feeding of leeches with 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 consists in the simultaneous collection of blood from the patient's bloodstream and blood transfusion from the donor.

Why is hemoglobin low when serum iron levels are normal?

In some pathological conditions, the hemoglobin level can be lowered with a normal or elevated serum iron level. In these cases, anemia ( a condition characterized by low levels of hemoglobin in the blood) develops with a sufficient intake of iron in the body. When does this happen, and is it dangerous for 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, with a normal level of iron in the body, not enough hemoglobin is produced?

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

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

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

The reason for an insufficient number of red blood cells or an inferiority of the hemoglobin protein are:

• Sickle cell anemia. Sickle cell anemia is a congenital disease associated with a violation of the structure of hemoglobin, in which it acquires a characteristic sickle shape. Clinical manifestations of sickle cell anemia are vascular thrombosis of various organs with sickle erythrocytes, hemolytic anemia, pallor and yellowness of the skin, repeated thrombosis of various organs, splenomegaly ( pathological enlargement of the spleen in size), hepatomegaly ( enlargement of the liver in size), shortness of breath, general weakness and malaise. Sickle cell anemia is an incurable disease. Symptomatic treatment for a crisis is adequate hydration ( saturation of the body with fluid), transfusion of erythrocyte mass ( a blood product composed of red blood cells), as well as intravenous antibiotics.
• Destruction of red blood cells by certain chemicals. The destruction of red blood cells occurs when exposed to compounds of arsenic, lead, nitrites, amines, some organic acids, foreign serums, insect and snake venoms. The mechanism of the damaging action is due to the destruction of erythrocyte membranes and the ingress of a large amount of hemoglobin into the plasma. This leads to intense protein breakdown with subsequent damage to the excretory organs - kidneys and liver. First aid consists in the introduction of specific antidotes, for example, for snake bites - anti-snake 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 erythrocytes 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. What is this trace element important for the human body? Iron is a part of a very important protein for the body - hemoglobin, which plays the role of carrying oxygen from the lungs to all organs and tissues. Iron deficiency 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 a part of many enzyme systems; it is found in the cells of the liver, spleen, muscles, and bone marrow. That is why its deficiency affects the general well-being of a person - general weakness, malaise, dizziness, decreased performance ( as a result of metabolic disorders). Functional and regenerative ( restorative) the ability 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 their 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), cheilitam ( cracks in the corners of the mouth).

With iron deficiency, the patient often suffers from bronchitis ( inflammation of the bronchi), tracheitis ( inflammatory processes in the trachea), rhinitis ( inflammation of the nasal mucosa). At the level of the cardiovascular system, stabbing pains in the heart, low blood pressure, shortness of breath during physical exertion 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 sensation 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 with a lack of iron leads to false urge to urinate, urinary incontinence when coughing, laughing, physical exertion.
In children, chronic iron deficiency anemia leads to growth retardation, impaired memory, attention, learning disabilities, nocturnal diuresis ( spontaneous urination during sleep).

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

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

Iron preparations with low hemoglobin in adults and children are a common medical prescription. Coming to the pharmacy, a person is lost from the abundance of drugs. They differ in the valence of iron (bivalent or trivalent), in the type of iron compound (organic - hyconates, malates, succinylates, chelate forms and inorganic - sulfates, chlorides, hydroxides), in the method of administration (oral administration - tablets, drops, syrups and parenteral - intramuscular and intravenous forms).

If a doctor recommends the best iron supplement for the treatment of anemia, then in order to prevent an increase in iron stores in the blood, you often have to figure out all this ugliness of diversity on your own. We will deal with the analysis of drugs that are effective for iron deficiency.

Reasons for the development of iron deficiency

The body contains 3 to 5 grams of iron. Most of it (75-80%) is in erythrocytes, part in muscle tissue (5-10%), about 1% is part of many enzymes in the body. The bone marrow, spleen and liver are the storage sites for reserve iron.

Iron is involved in the vital processes of our body, which is why it is so important to maintain a balance between its intake and losses. When the rate of iron excretion is higher than the rate of intake, various iron deficiency states develop.

If a person is healthy, then the removal of iron from our body is insignificant. Iron content is largely controlled by altering the level of iron absorption in the intestine. In food, iron is presented in two forms: Fe III (trivalent) and Fe II (bivalent). When it enters the digestive tract, inorganic iron dissolves, and ions and iron chelates are formed.

Chelated forms of iron are best absorbed. Ascorbic acid contributes to the formation of iron chelates. In addition, fructose, succinic and citric acids, amino acids (for example, cysteine, lysine, histidine) help chelate iron.

Reasons for the appearance of a lack of iron:

• Decrease in the efficiency of absorption of iron in the digestive tract (an increase in the rate of passage of food through the digestive tract, the presence of inflammation in the intestines, surgical interventions on the intestines and stomach, digestive disorders, etc.);
• Increase in the body's need for iron (during intensive growth, pregnancy, lactation, etc.);
• Decreased iron intake due to dietary habits (anorexia, vegetarianism, etc.);
• Acute and chronic blood loss (gastric bleeding with ulcers, bleeding in the intestines, kidneys, nasal, uterine and other localizations);
• As a consequence of tumor diseases, prolonged inflammatory processes;
• Decreased synthesis of iron transport proteins (eg transferrin);
• Destruction of blood cells with subsequent loss of iron (hemolytic anemias);
• Increased intake of calcium into the body - more than 2 g / day;
• Lack of trace elements (cobalt, copper).

The body constantly loses iron in feces, urine, sweat, hair, nails, and during menstruation.

The male body loses 0.8-1 mg of iron per day. Women lose more iron during menstruation. For a month, women lose an additional 0.5 mg of iron. With blood loss of 30 ml, the body loses 15 mg of iron. Iron consumption increases significantly in pregnant and lactating mothers.

Iron losses exceeding 2 mg / day lead to the development of iron deficiency. Since the body is not able to replenish more than 2 mg of iron per day.

Lack of iron more often occurs in women also because they store iron 3 times less than men. And the incoming iron does not always cover the costs.

In Russia, the latent iron deficiency in some areas reaches 50%. Almost 12% of girls of childbearing age have iron deficiency states. 75-95% of all anemias of pregnant women are iron deficiency. Iron deficiency in pregnant women can threaten with weakness of labor, miscarriages, excess blood loss during childbirth, decreased lactation, and a decrease in the weight of newborns.

The use of iron supplements in pregnant women to reduce the risk of developing anemia is justified in the third trimester, and the intake is continued for 2-3 months after childbirth. Additional sources of iron are not given to term infants in the first 3 months. For premature babies, iron supplements are given earlier.

The required daily intake of iron in boys is 0.35-0.7 mg / day. In girls, before the onset of menstruation, 0.3-0.45 mg.

What can decrease the intake of iron from food:

• Excess phosphates in food;
• Oxalic acid found in some plants;
• Tannin, which gives a tart taste, reduces the absorption of iron;
• Tea reduces iron intake by 60%, coffee by 40%;
• Phytate found in wheat bran, rice, nuts and corn;
• Excessive fiber content in food;
• Substances that neutralize the hydrochloric acid of the stomach - antacids;
• Egg white, soy and milk protein;
• Some preservatives such as EDTA.

Rules for taking iron supplements

Iron preparations are used to reduce the risk of iron deficiency, as well as in the complex therapy of anemia.

Traditionally, treatment begins with oral tablets. Preference is given to drugs that can produce a rapid rise in hemoglobin in the blood with a low risk of side effects.

Usually they start with the appointment of high doses of iron: 100-200 mg / day. A similar amount of iron is able to compensate the body's costs for the formation of the required amount of hemoglobin. If the dosage is exceeded in 200 mg / day, side effects are much more common.

If the drug is selected correctly, hemoglobin returns to normal within 15-30 days. When the blood counts reach the desired values, the iron supplement is continued for at least 2 months to replenish iron stores (in the bone marrow, liver, spleen).

How to take iron supplements correctly:

• Before meals or during meals. Bioavailability does not depend on the time of day, but there are recommendations to take in the evening;
• It is recommended to drink it with clean water;
• You can not drink milk, coffee, tea due to a decrease in absorption;
• Do not combine the intake of oral iron preparations with drugs that block the production or neutralize the effect of hydrochloric acid: antacids (baking soda, phosphalugel, almagel, gastal, rennie, etc.), proton pump inhibitors (omeprazole, lansoprazole, esomeprazole, etc.);
• Iron preparations affect the action of some antibiotics, therefore, the intake of these drugs should be separated in time by 2 hours;
• Iron supplementation is not compatible with alcohol consumption. Alcohol enhances iron absorption and increases the risk of iron intoxication;
• Iron absorption will not be affected by magnesium (magne B6, magnelis, cardiomagnyl, magnesium chelate), but extreme dosages of 2 grams or more of calcium can reduce it.

Features of iron preparations

In the case of iron deficiency anemia, preparations of two (Fe II) and trivalent (Fe III) iron are taken. Preparations with Fe II have a higher bioavailability than trivalent. Molecular iron in these preparations is enclosed in organic and inorganic compounds, which also differ in their bioavailability and tolerability (frequency of side effects).

I. Inorganic salts of ferrous iron

The most common representative of an inorganic iron compound in preparations with Fe II is iron sulfate. It is characterized by a relatively low bioavailability (up to 10%) and frequent side effects associated with irritation of the mucous membrane of the digestive tract.

Such iron preparations are usually cheaper than analogues in cost. The most popular representatives that can be found in pharmacies: Sorbifer Durules, Aktiferrin, Aktiferrin compositum, Ferro-Folgamma, Fenuls, Tardiferon, Feroplekt... To increase the bioavailability of iron, ascorbic and folic acid are often included in the composition.

Pharmacies will give you a fairly modest choice if you want to buy an iron supplement with ferric chloride. Ferrous iron, which is part of the inorganic salt, will not please with 4% bioavailability, and does not guarantee the absence of side effects. Representative: Hemofer.

II. Organic ferrous salts

They combine a higher bidavailability of Fe II and organic salts, bioavailability can reach 30-40%. Less common side effects associated with the use of iron supplementation. Medication is well tolerated during pregnancy and lactation. The disadvantages are the higher cost of these drugs.

• The combination of organic salts of iron, copper and manganese gluconates is presented in the French preparation Totem, which is available as a solution.
• The combination of ferrous fumarate and folic acid is hidden in a capsule of Austrian origin - Ferretab.
• A complex composition of chelated forms of iron gluconate, ascorbic acid, herbal synergists can be found in Iron Chelate - bad of American production. It is not a drug, but it is an excellent source of easily digestible iron with virtually no side effects.

III. Inorganic ferric compounds

They are characterized by low bioavailability of these forms of iron (up to 10%). The most common forms of release are injection.

This form of drugs solves the problem of side effects associated with irritation of the gastrointestinal mucosa. But it adds a number of conditions necessary for the fulfillment of the drug administration and the associated side effects and complications. They are the drugs of choice for severe forms of anemia, for pathologies of the digestive tract, leading to a decrease in iron absorption.

The route of administration (parenteral - intravenous or intramuscular injections, oral - tablets, drops, syrup or solution) does not affect the availability of iron itself. Safer - oral, parenteral is prescribed according to indications.

The active ingredient is complexes with iron hydroxide. Folic acid is used as an excipient. Popular representatives: Ferrum Lek, Maltofer, Maltofer Fall, Biofer, Ferinject, Ferroxide, Ferropol, Venofer, CosmoFer, Likferr, Monofer.

IV. Organic ferric compounds

They are presented by the Spanish drug Ferlatum in two modifications: with and without folic acid. Available in the form of a solution for oral administration.

List of iron supplements for low hemoglobin for adults and children

Title / Manufacturer	The form release	Prices ($)	Compound gland	amount gland	Subsidiary substances
Inorganic Fe II salts
Sorbifer Durules / (Hungary)	tab. 320 mg / №30/50	4.5- 15.5	Sulfate	100 mg / tab.	Vitamin C
Aktiferrin / (Germany)	caps. 300 mg / №20/50	2.33- 8.5	Sulfate	34.5 mg / caps.	L-serine
	drops / 30 ml	3.33- 8.42		9.48 mg / ml
	syrup / 100 ml	2.33- 5.82		6.87 mg / ml
Aktiferrin compositum / (Germany)	caps / №30	5.9		34.5 mg / caps.	L-serine, folic acid, cyanocobalamin
Ferro-Foilgamma / (Germany)	caps. / №20/50	4.17- 14.82	Sulfate	37 mg / caps.	Ascorbic, folic acid, cyanocobalamin,
Fenuls / (India)	caps. / №10/30	1.67- 7.32	Sulfate	45 mg / caps.	Ascorbic, pantothenic acid, riboflavin, thiamine, pyridoxine
Ferroplex / (Germany)	dragee / №100	—	Sulfate	50 mg / dragee	Ascorbic acid
Tardiferon / (France)	tab. / №30	3.17- 7.13	Sulfate	80 mg / tab.	—
Gyno-Tardiferon / (France)		16.33			Folic acid
Ferrogradumet / (Serbia)	tab. / №30	—	Sulfate	105 mg / tab.	—
Feroplect / (Ukraine)	tab / №50	1.46- 1.65	Sulfate	10 mg / tab.	Ascorbic acid
Hemofer / (Poland)	drops / №30	1.19- 1.63	Chloride	44 mg / ml	—
Organic salts of Fe II
Totem / (France)	solution / №10	6.67- 12.81	Gluconate	50 mg / 10 ml	Copper gluconates and manganese
Ferretab / (Austria)	caps. / №30/100	4.17- 16.46	Fumarate	50 mg / caps.	Folic acid
Iron Chelate / (USA)	tab. / №180	14.52	Chelate, gluconate	25 mg / tab.	Ascorbic acid, calcium chelate, collection of synergistic herbs
Inorganic Fe III compounds
Ferrum Lek / (Slovenia)	solution for injection / №5/50	10.5- 67	Hydroxide	100 mg / 2 ml	—
	syrup / 100 ml	2.12- 9.07		50 mg / 5 ml	—
	tab. chew / №30/50/90	4.33- 14.48		100 mg / tab	—
Maltofer / (Switzerland)	tab. / №10/30	4.33- 9.3	Hydroxide	100 mg / tab.	—
	syrup / 150 ml	4.03- 9.17		10 mg / ml
	solution for injection / №5	13.33- 23.3		100 mg / 2 ml
	drops / 30 ml	3.67- 5.08		50 mg / ml
Maltofer Foul / (Switzerland)	tab. / №10/30	6.67- 14.72		100 mg / tab.	Folic acid
Biofer / (India)	tab. / №30	4.63- 7.22	Hydroxide	100 mg / tab.	Folic acid
Ferinject / (Germany)	solution for injection / 2/10 ml	20.45- 66.67	Hydroxide	50 mg / ml	—
Ferroxide / (Belarus)	solution for injection / №5/10	8.23- 16	Hydroxide	100 mg / 2 ml	—
Ferropol / (Poland)	drops / 30 ml	6.30- 7	Hydroxide	50 mg / ml	—
Venofer / (Germany)	solution for intravenous injection / №5	43.46- 58.95	Hydroxide	100 mg / 5 ml	—
CosmoFer / (Germany)	solution for injection / №5	31.67- 78.45	Hydroxide	100 mg / 2 ml	—
Likferr / (India)	solution for intravenous injection / №5	25- 58.33	Hydroxide	100 mg / 5 ml	—
Monofer / (Germany)	solution for intravenous injection / №5	180.21- 223	Hydroxide	200 mg / 2 ml	—
Organic salts of Fe III
Ferlatum / (Spain)	solution / №10	9.71- 23.37	Succinylate	40 mg / 15 ml	—
Ferlatum Foul / (Spain)	solution / №10	8.72- 17.62	Succinylate	40 mg / 15 ml	Calcium folinate

Complications and side effects of iron supplementation

The most common complications are related to the digestive tract:

• feeling of bloating;
• feeling of heaviness in the stomach;
• vomiting, feeling of nausea;
• stool disorder (diarrhea or constipation).

The severity of these symptoms depends on the amount of iron that has not been absorbed in the intestines. Accordingly, the higher the bioavailability of iron in preparations, the better the tolerability of treatment and prevention of anemia.

Iron supplements often stain stool dark or black. Black stool, which is usually a sign of bleeding, in this case simply indicates that some part of the iron has not been absorbed and does not portend any threat.

In some cases, iron supplements affect the color of the teeth, leading to temporary dark plaque. This property spoils the appearance of the teeth. To prevent plaque build-up, it is recommended that you do not dilute liquid iron and thoroughly brush your teeth after ingestion.

There are also allergic reactions and intolerance to certain components of the drug: the appearance of itching, rash, urticaria, asthma. You should immediately stop taking the drug and seek help from a doctor.

In case of violation of the technique of introducing injectable forms of drugs, the following often occurs:

• the appearance of abscesses;
• staining of the skin at the injection site;
• atrophic changes;
• the appearance of painful lumps in the injection area.

With injection, iron overdose in the body is more common.

Excessive intake of iron can lead to an overload of the body with it - hemosiderosis. Often this condition occurs in men. They do not lose as much iron as women and often get it with some alcoholic beverages (ports, cognacs, red wines, ciders). Certain types of cider in some European countries can contain 16 mg or more of iron per liter.

Iron is a vital trace element, without which the full existence of the human body is impossible. It is present in a large number of foods that are in the diet of everyone, however, despite this, sometimes situations arise when it is not enough. How can you compensate for it, what are the pros and cons of each of the methods for correcting iron deficiency? Details in a new article on MedAboutMe.

If a person has a reliably confirmed iron deficiency, then there are various ways to compensate for it. There are five of them.

1. Eating foods rich in iron.
2. Taking multivitamins that contain iron.
3. Iron preparations in tablets.
4. Medicines containing iron for parenteral administration.
5. Transfusion of donor erythrocyte mass.

For each of the named methods, there are certain indications, that is, those situations or diseases that determine this particular choice. All of them have their pros, cons, side effects and, of course, the treatment should take place under medical supervision. During treatment, laboratory monitoring of hemoglobin, erythrocytes, serum iron and, ideally, ferritin should be periodically carried out, because an overdose of iron is much worse than its moderate deficiency.

For a full-fledged existence, any person needs to receive 10-18 mg of iron with food during the day, and women need it in larger quantities (given their regular blood loss with menstruation). The need for this trace element increases during pregnancy, lactation, during active growth in children and adolescents. However, the main problem is that only 10% of all iron that enters the digestive tract is absorbed in the intestine, and most of it leaves it unchanged naturally.

The richest in iron are meat products, liver, fish, chicken yolk. Among the products of non-animal origin, halva, apples, apricots, buckwheat, cocoa powder, pears, dried fruits are the leaders, however, with the exception of apples and pears, it will not be possible to eat a large amount of these products, since they are very satisfying. We can assume that the iron rate is obtained if a person ate 150 grams of beef, or 50 grams of liver or 200 grams of oatmeal per day. But this amount of food meets only the daily requirement for this microelement, it is not enough to eliminate the existing iron deficiency.

This means that foods rich in iron can and should be included in the diet for absolutely everyone without fear of overdose (it has been proven that it is impossible to exceed the dose by eating alone). However, if a person has a laboratory diagnosis of iron deficiency, there are clinical signs of sideropenia (this is the name of this condition), then more serious measures are needed to correct it.

Today, many people who adhere to a healthy lifestyle resort to a course of various multivitamins. There is a lot of controversy around these drugs, some doctors believe that to compensate for the daily need for essential vitamins and microelements, you only need good nutrition, while others are of the opinion that it is not enough.

In the windows of pharmacies, you can find many multivitamin complexes, most of which include iron. Manufacturers know that in order for this microelement to be better absorbed, it should be taken together with vitamin C and the latter must be added to the composition. However, the content of each individual component in them is usually very small. For example, Complivit Iron contains 15 mg of the substance, and AlfaVit Classic - 14 mg. This dose is commensurate with the daily requirement, but in fact only 10% is absorbed, that is, 1.5 and 1.4 mg, respectively. The situation is similar with other multivitamin complexes, which include iron.

Thus, multivitamins containing iron in combination with vitamin C can be taken to meet the daily requirement along with food rich in these elements. They can be useful for vegetarians who are often iron deficient. However, they are not suitable for the treatment of laboratory-confirmed anemia, since the dose of this element in them is too small.

If the patient has iron deficiency anemia, then the treatment option is to take medications that contain iron, in tablets, syrups or drops. This is convenient, because the course of therapy is usually several months, during which a person must take control blood tests so that the doctor can see if there is any dynamics during therapy. The therapeutic dose of iron preparations is 100-200 mg per day, in rare cases - 300 mg. This applies to drugs that contain both ferrous and ferric iron. After reaching normal levels of erythrocytes and hemoglobin (usually this occurs after 1-2 months from the start of admission), the patient is transferred to a maintenance dose, which is 50-100 mg. The duration of therapy is determined individually and takes into account the cause that caused the anemia.

• Medicines containing ferrous iron.

These include Fenyuls, Sorbifer, Hemofer, Tardiferon, etc. They are better absorbed, but often during therapy various side effects develop, such as abdominal pain, constipation, heartburn, staining of the teeth in a dark color, nausea. The drugs are available in the form of tablets, capsules, syrups and drops, which facilitates therapy in young children and patients who have difficulty swallowing solid food.

• Preparations containing ferric iron.

In its pure form, this substance is not absorbed, therefore it needs to be restored to bivalent. For this reason, these drugs are absorbed much worse than the previous ones, but they have fewer side effects. These include Maltofer, Ferrum Lek, Cosmofer and others. They are used mainly for intolerance to drugs containing ferrous iron.

In some situations, taking iron preparations by mouth is undesirable, or even impossible. In this case, they resort to parenteral administration of drugs (intravenously or intramuscularly). The indications for this type of therapy are as follows:

• the patient is unconscious, or his mental state makes it impossible to take drugs inside;
• exacerbation of gastric ulcer, gastrointestinal bleeding;
• ulcerative colitis or other severe bowel disease in which absorption is impaired;
• condition after removal of part of the stomach;
• there is a need to quickly saturate the body with iron after massive blood loss.

In the latter situation, the administration of drugs into a vein or muscle is carried out until the anemia is considered "mild", and then the patient is transferred to oral forms.

Considering that with this route of administration, the entire drug enters the bloodstream, its dose is reduced and is no more than 100 mg per day, however, it is calculated individually, taking into account body weight and the rate of renal glomerular filtration. The doctor should regularly monitor the level of hemoglobin, red blood cells and serum iron in order to prevent an overdose, which is no less dangerous than a deficiency. For parenteral administration, the drugs Venofer, Ferbitol, Ferruk Lek, Zhektofer, etc. are produced.

This type of replenishment of iron deficiency is a reserve type of therapy, because it is used in cases where the patient's condition is regarded as severe. It can arise as a result of massive blood loss after trauma, surgery, difficult childbirth, etc. Usually, donor erythrocyte transfusions are used when the hemoglobin level is below 50-60 g / l, that is, the patient has severe anemia. However, in this case we are talking about acute blood loss, because with chronic blood loss, the human body gradually adapts to oxygen deficiency, and transfusion of erythrocyte mass is not always indicated for such patients.

The advantages of this procedure include the speed of the effect - one blood transfusion can increase the hemoglobin level immediately by 20-40 g / l. If necessary, it is repeated several times until the moment when the patient comes out of a critical condition. However, the real minus of the transfusion of donor erythrocyte mass is the risk of an allergic reaction up to anaphylactic shock. It is extremely rare that severe complications occur if the patient's blood group or Rh factor was incorrectly determined (which can happen in an emergency, with a strong rush).

The option for correcting iron deficiency should be determined by the doctor after examination, determining the level of hemoglobin, erythrocytes, serum iron and, if possible, ferritin. At the same time, he is obliged to send the patient for a comprehensive examination to find out the cause of iron deficiency anemia, which never develops in an absolutely healthy person.

Reduced hemoglobin complex worsens the condition of the body, since in this case all organs and tissues experience oxygen starvation.

And this is complemented by an increased load on the cardiovascular system - the body simply accelerates blood flow to increase the flow of oxygen.

Especially dangerous is hemoglobin deficiency and anemia in preschool children - this often provokes the development of pathologies of the nervous system, which ultimately leads to mental retardation.

Factors influencing hemoglobin

The main hemoglobin is iron. It is through the process of its oxidation and reduction that oxygen is transported and absorbed in the tissues of a living organism.

Iron deficiency Is one of the most common causes of a sharp drop in hemoglobin levels.

It is not enough simply to include in the diet of foods rich in the iron. This microelement cannot be fully absorbed without certain factors. For example, for its splitting into derivative atoms (which then react with certain groups of proteins), vitamin C, B-group vitamins (), omega-3 and omega-6 unsaturated fatty acids are required.

Along with this, there are a number of factors that reduce the bioavailability of iron. For example, a high calcium content in the body inhibits the production of new hemoglobin molecules. If there is a deficiency of the above trace elements, iron simply will not be absorbed.

It should also be borne in mind that a decrease in the level of hemoglobin can be provoked by a whole range of diseases and the gastrointestinal tract. That is why you should not postpone the visit to the doctor - it is better to immediately establish the cause of the hemoglobin deficiency and eliminate this particular factor.

If a low hemoglobin level is triggered by a micronutrient deficiency, then it is recommended to include the following foods in the diet:

1. rich in iron;
2. rich in vitamins C, E, B-groups;
3. rich in amino acids (preferably of animal origin);
4. exclude those foods that reduce the bioavailability of iron.

In most cases, the above list of recommendations will be sufficient to normalize the composition of the formed elements in the blood.

List of 20 products to increase it

The body must receive sufficient amounts of all micronutrients, including minerals, vitamins, metals. All these elements directly or indirectly affect the hematopoietic function, which must be stimulated (hemoglobin is produced in, like erythrocytes, platelets, leukocytes). So, here is a list of the 20 most effective products.

1. Liver

... Suitable beef, chicken, pork. Moreover, it is low roast (Rare), since in this case most of the micronutrients are preserved.

The liver contains vitamins of the B-group, and iron (6.9 mg per 100 grams), and iodine - all this just contributes to an increase in hemoglobin levels.

2. Meat

The basis of any meat is a wide range of proteins and essential amino acids, which react with iron, thereby forming hemoglobin molecules.

In this plan are rabbit, pork, beef. But, again, the meat should be cooked to a minimum, ideally steamed.

3. Buckwheat

Virtually all grains reduce the bioavailability of iron. The only exception is buckwheat, which acts exactly the opposite.

In addition, (almost 7 mg per 100 grams of kernel). That is why it is recommended to use it primarily as a complementary food for infants, and not semolina (which contains calcium and, thereby, slows down the production of hemoglobin).

4. Halva

- almost 30 mg per 100 grams of the product (and even more in tahini, up to 50 mg per 100 grams). That is, 50 grams of such a dessert provide a daily rate iron in the body.

But it is worth considering that there are practically no B-group vitamins and ascorbic acid in halva. Therefore, if it is included in the diet, then taking care of a sufficient rate of other micronutrients that contribute to the absorption of iron.

5. Beets

Contains both iron and amino acids, vitamins that. The peculiarity of table beets is that all the micronutrients in it are preserved even during heat treatment.

You can also include beet juice in your diet, but you should drink it diluted (1 part juice to 2 parts water).

6. Pomegranate

Of all fruits, it is considered the most useful due to the high content of vitamin B 6.

There is also iron in pomegranate seeds, but in small quantities - only 1 - 1.5 milligrams per 100 grams.

7. Carrots

- it contains beta-carotene and vitamin A the most.

And these trace elements accelerate biochemical reactions with the use of calcium - a decrease in its "free" level in the blood increases the bioavailability of iron (in carrots it contains only 0.5 - 0.7 mg per 100 grams).

8. Dried fruits

It is best to eat prunes, raisins, apricots, cherries, cherries, bananas - they contain B-group vitamins, E, C.

The fact that dried fruits contain a large amount of vegetable fiber also helps to speed up the absorption of iron - this comprehensively normalizes the work of the gastrointestinal tract.

9. Nuts

Walnuts, as well as pistachios, contain a considerable amount of omega-3 and omega-6 unsaturated fatty acids, which accelerate a whole range of intercellular metabolic processes, including with iron.

The most useful nuts are considered for young children - they almost halve the likelihood of pathologies of the nervous system.

But peanuts should be discarded. It is extremely high in fat, which creates a high load on the gastrointestinal tract, and also slows down the absorption of iron.

See in a separate article.

10. Fish roe

, as they contain iron (6 to 12 mg per 100 grams), as well as omega-3 unsaturated fatty acids. Literally 100 grams of such a product per day fully provides the body with all the necessary micronutrients to normalize the hemoglobin level.

And most importantly, this product is easily digestible, so it can be included in the diet in the presence of chronic diseases of the gastrointestinal tract (when meat or liver is contraindicated).

11. Honey

- it contains a huge range of minerals (including rare ones that cannot be obtained from other food), which has a positive effect on the water-salt balance... And this is also an important point in the normalization of hemoglobin levels.

This will also help to get rid of edema, which often occurs when the load on the cardiovascular system increases (which will necessarily be in case of hemoglobin deficiency).

Nutritionists point out that it is necessary to eat buckwheat or honeydew honey in order to achieve the desired effect - they have the highest concentration of minerals.

12. Nettle

Contains a small amount of iron and vitamin B 12, which increases its bioavailability for the body.

But it is worth remembering that it also stimulates the secretion of gastric juice, which in case of gastritis or gastric ulcer and / or duodenal ulcer can aggravate the patient's condition.

13. Eggs

- they contain up to 8 mg per 100 grams of iron. And it's better to eat them fresh or boiled soft-boiled.

Fresh chicken eggs can be a source of salmonellosis. But quail also contain iron, but their shells have smaller pores through which the infection does not penetrate. Therefore, they are considered safer - they are recommended for children to include in the diet.

14. Fish

rich in omega-3 unsaturated fatty acids. And the more fatty it is, the more fatty acids it contains. River carp is also useful in this regard; carp (mirror), pike and perch are better suited. And from marine fish species - tuna, salmon.

By the way, it is no less useful to use seaweed. It contains iodine, which normalizes the endocrine system (which indirectly regulates the production of hemoglobin).

15. Chocolate

In cocoa powder, iron up to 12 mg per 100 grams (depending on the variety and variety). Nutritionists say that you should eat exactly. Less useful are milky, white, pink.

And it is advisable to cook chocolate yourself at home without adding butter (since it reduces the bioavailability of iron).

Chocolate also stimulates metabolic processes between cells by stimulating the production of endorphins. But you should not abuse this property, since the body tends to increase the need for the same serotonin. That is, over time, addiction and a kind of addiction develops.

16. Rosehip

Among - it is the largest source of ascorbic acid used in biochemical processes involving iron.

It is better to use rose hips in the form of a decoction (50 grams of fresh or dried berries per 300 milliliters of boiling water) or jelly.

Although rose hips contain a large amount of vitamin C, it does not irritate the lining of the stomach and esophagus, so these berries can be included in the diet for chronic diseases of the gastrointestinal tract.

17. Currant

Contains slightly less ascorbic acid than rose hips. It is better to use it - there is less tannin in it than in red (tannin is a tannin and slows down the production of hemoglobin).

No less useful are currant leaves, from which you can make aromatic and tasty tea. Its use is also an excellent prevention of immunodeficiency.

18. Strawberries

rich in vitamin C, it also contains a small amount of iron (from 0.2 to 1 mg per 100 grams, depending on the variety, as well as the growing method).

Only you should eat whole strawberries either with sugar or honey, but not with sour cream, yogurt or cream.

19. Turmeric

Of the spices, it contains the most iron - about 35-50 mg per 100 grams. And most importantly, it is perfect for preparing almost any dish, even for some desserts.

During pregnancy, turmeric should not be abused, as it can provoke smooth muscle spasms. In critical cases, this will lead to premature birth. Doctors in most cases warn about this.

20. Parsley

From iron-containing greens -. But it should be consumed fresh, so it is better to add it to salads, not soups. Contains about 2 mg of iron per 100 grams.

Parsley root is no less useful. It is also used as a spice.

Also check out the product table:

General food rules

For a faster and more effective increase in hemoglobin, nutritionists recommend adhering to the following tips:

1. Observe fractional meals. You need to eat in small portions, but as often as possible. Optimally - at least 6 times a day.
2. Refuse cereals (except for buckwheat) and fermented milk products - all of them prevent the production of corpuscles and hemoglobin.
3. Walking outdoors as often as possible - A sufficient balance of oxygen in the blood also indirectly stimulates the renewal of hemoglobin molecules, prevents oxidation and destruction of red blood cells. Ideally, take walks in the fresh air after each meal (this will also help to significantly speed up your metabolism).
4. Refuse tea and. Better, as well as homemade compotes, fruit and vegetable juices.
5. Do not eat 2-3 hours before scheduled sleep. Metabolic processes during sleep slow down significantly, so iron and vitamins are practically not absorbed during this period (but the load on the gastric mucosa increases, since the utilization of gastric juice slows down).

Features of the diet for certain groups of patients

Nutritional rules with low hemoglobin for different groups of patients are somewhat different. Nutritionists indicate:

1. Adults. The iron norm for adults is about 12 mg per day. It is much easier for adults to assimilate meat products, animal by-products (liver, lungs, kidneys, heart). It is recommended to include them in the diet every day at least in a minimal amount.
2. Children. The norm of iron in children is from 8 to 11 milligrams per day. Preference should be given to herbal products. But milk should not be abused, especially fatty, since it drastically reduces the level of hemoglobin, slows down the absorption of iron. It is also recommended to include in the diet buckwheat, fish, a small amount of chocolate and halva.
3. Pregnant women. The need for iron in pregnant women is the highest and reaches 20 mg per day. As a rule, specialized vitamin complexes are prescribed to them to normalize hemoglobin. It is also recommended to eat fish, red caviar, carrots. But turmeric, parsley and most other spices that stimulate smooth muscle spasm are best avoided. The doctor, with whom the woman registers, necessarily tells about all this in detail.
4. Elderly. They have the smallest need for iron - only 6 - 8 mg per day, which is explained by a natural slowdown in the functionality of the cardiovascular system and bone marrow. For elderly people, doctors also recommend eating fish, chicken fillet (breast, since there is practically no fat in it), as well as pomegranate and beetroot juice.

Folk remedies and vitamin complexes

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