Iron Metabolism PDF

# Iron Metabolism ## "O My Lord, Increase Me in My Knowledge" - The image contains an Arabic quote, *"O my lord increase me in my knowledge!"* - It then gives the translation of the same quote, *"O Allah, I ask You for knowledge that is of benefit."* - This is followed by the Arabic version o...

# Iron Metabolism ## "O My Lord, Increase Me in My Knowledge" - The image contains an Arabic quote, *"O my lord increase me in my knowledge!"* - It then gives the translation of the same quote, *"O Allah, I ask You for knowledge that is of benefit."* - This is followed by the Arabic version of another quote, *"O Allah, I ask You for knowledge that is of benefit." * ## What is Iron? - Iron is a mineral found mostly in: - **Red blood cells** - where it is vital for the transport of oxygen throughout the body. - **Muscle** - where it is essential for the function of myoglobin enabling oxygen storage. - **Other tissues** - where it is part of enzymes involved in essential metabolic processes ## Iron Deficiency Anemia - Iron deficiency anemia occurs when there is not enough iron in the body to produce healthy red blood cells. - **Symptoms include:** - Fatigue - Weakness - Shortness of breath - Pale skin - Headache - Dizziness - Cold hands and feet - Brittle nails - Pica (desire to eat non-food items) - **Causes:** - Lack of iron in diet - Blood loss - Inability to absorb iron - **Diagnosis:** - Blood tests - Physical exam - **Treatment:** - Iron supplements - Dietary changes - Blood transfusions ## Iron Overload - Iron overload occurs when the body accumulates too much iron. - **Symptoms:** - Fatigue - Weakness - Abdominal pain - Joint pain - Liver damage - Heart problems - Diabetes - Bronze skin pigmentation - **Causes:** - Hereditary hemochromatosis (HH) - Blood transfusions - Iron injections - High intake of iron supplements - **Diagnosis:** - Blood tests - Liver biopsy - **Treatment:** - Bloodletting - Medications ## Iron Metabolism in the Human Body The document contains a detailed description and images of the following regarding iron metabolism: - **Total iron weight in body** - 4 grams - 2.5 grams in hemoglobin - 1 gram in stores - 0.7 grams in ferritin - 0.3 grams in hemosiderin - 0.5 grams in tissues - 0.32 grams in myoglobin - 0.08 grams in heme enzymes - 0.1 grams in non-heme enzymes  - **Daily Iron Metabolism** - Intake is 1 mg/day - Absorption is 1 mg/day, excretion 1 mg/day - The amount of iron in the red blood cells is 3500 mg/day, bone marrow is 150 mg/day, blood plasma is 4 mg/day, and the tissues is 500 mg/day. The reticulo-endothelial system which includes the spleen and liver plays a crucial role in daily iron metabolism.  - **Iron Absorption** - Duodenal cytochrome b is the enzyme that plays the key role in iron absorption. - **Factors affecting iron absorption:** - **Factors increasing iron absorption:** - Ascorbic acid & cysteine favors the reduction of ferric form of iron to ferrous form - Vitamin C, HCl also favors the reduction of ferric form of iron to ferrous form - In iron deficiency, the absorption increases 2-10 times that of normal - **Factors decreasing iron absorption:** - Phytates and phosphates in food - Achlorhydria - Iron absorption is deceased in the presence of gastrointestinal disease.  - **Iron Transport** - The primary protein responsible for iron transport in the blood is transferrin, which is a glycoprotein with two iron-binding sites. - The normal range of transferrin in blood is 3 - 4 g/l. - Plasma iron is normally in the range of 0.8-1.6 mg/l. - **Iron Stores** - Iron stores are primarily located in the liver, spleen, and bone marrow. - Iron stores are maintained by the proteins ferritin and hemosiderin. - Ferritin is the primary intracellular iron storage protein. - **Iron Elimination** - The majority of iron is eliminated via feces (90% dietary iron, 11 mg/day). - Desquamated epithelial cells, WBC and RBC are lost through urine (0.1 mg/day). - Desquamated skin cells are lost through sweat (-0.1 mg/day). - Other routes of elimination include menstrual blood (20-30 mg/month) and pregnancy (400 mg/pregnancy). ## Iron Redox Reactions - Iron participates in redox reactions, playing an essential role in electron transfer processes. - The primary form of iron in the body is Fe2+ (ferrous iron), but the form can be changed to Fe++ (ferric iron) and vice versa. - Iron is vital in redox reactions because it can gain or lose one electron, allowing it to act as either an oxidizing or reducing agent. ## Iron Transport in the Body - **Transport Iron:** Iron is transported through the body bound to transferrin, a protein in the blood.  ## Functions of Iron - **Hemoglobin:** The major function of iron is to be a component of hemoglobin in red blood cells. - **Oxygen Binding:** Iron is in the heme molecule which allows the oxygen to bind to it, allowing the oxygen to be transported throughout the body. The binding of oxygen to heme is reversible, ensuring oxygen release to the tissues.  - **Myoglobin:** Iron is a component of myoglobin, which is a protein in muscle. - **Oxygen Storage:** Myoglobin binds to oxygen and stores it in muscles. - **Electron Transport Chain:** Iron is present in several proteins involved in the electron transport chain. These proteins, known as cytochromes, are vital for producing energy in the mitochondria. - **Enzyme Activity:** Iron is a cofactor for various enzymes, including: - **Tryptophan pyrrolases** - an enzyme that converts the amino acid tryptophan into formyl kynurenine. - **Peroxidase** - an enzyme that catalyzes the reduction of hydrogen peroxide. - **Catalase** - an enzyme that breaks down hydrogen peroxide. - **NADH dehydrogenase** - an enzyme that plays a crucial role in electron transport. ## Investigations of Iron Deficiency Anemia - **Iron Deficiency Anemia Investigations:** Diagnostic tests frequently used for iron deficiency anemia include: - Complete blood count (CBC) - Serum iron - Total iron-binding capacity (TIBC) - Ferritin - Erythrocyte protoporphyrin - Biopsy ## Recommended Daily Intake of Iron - **Children up to puberty & men:** 10 mg/day - **Postmenopausal women:** 10 mg/day - **Adolescents:** 10-20 mg/day - **Women during reproductive life:** 20 mg/day - **Pregnancy:** 30 mg/day ## Iron Deficiency and Iron Overload - **Iron Deficiency:** Caused by insufficient iron absorption in the body. - **Iron Overload:** Caused by excessive iron buildup in the body. ## Causes of Iron Deficiency in Pakistan - **Causes of iron deficiency in Pakistan:** - Heavy menses - Repeated pregnancies - Hookworm infestation - Late weaning of babies - Inadequate intake - Excess of phytates, carbonates, oxalates, phosphates, or polyphenols in diet - Malabsorption - Increased requirement - Achlorhydria/Partial gastrectomy - Chronic infections - Hemorrhage ## Stages of Iron Deficiency - **Stages of Iron Deficiency:** - The first stage involves low iron stores and decreased ferritin levels. - In the subsequent stage, low serum iron with increased total iron-binding capacity (TIBC) occurs. - The final stage is characterized by the presence of microcytic hypochromic anemia, which includes decreased hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). ## Iron Deficiency Anemia Diagnostic Tests - **Iron Deficiency Anemia Laboratory Tests:** - **MCV:** Reduced - **MCH:** Reduced - **MCHC:** Normal to Reduced - **Iron:** Reduced - **TIBC:** Increased - **Transferrin saturation:** Reduced - **Ferritin:** Reduced - **RDW:** High - **Reticulocytes:** Normal/Low - **Platelets:** Normal/Low/High - **WBC:** Normal/Low - **Smear:** Hypochromia, anisocytosis, microcytosis, and poikilocytosis. ## Signs and Symptoms of Iron Deficiency - **Iron Deficiency Signs and Symptoms:** - **Cognitive and behavioral:** Reversible alterations of cognitive behavior, decreased attention span and alertness, impaired motor development - **Physical:** Decreased physical activity, fatigue, irritability, anorexia - **Other:** Abnormalities in thermo-regulation, low scholastic achievements, and low immunological and defensive responses. ## Signs and Symptoms of Iron Deficiency Anemia - **Iron Deficiency Anemia Signs and Symptoms:** - Easy fatigue - Headache - Tachycardia - Ankle edema - Exertional dyspnea. - Inelastic, dry, wrinkled skin - Sore, atrophic tongue - Angular stomatitis. - Pallor - Pica ## Iron Overload - **Iron Overload:** Occurs when the body accumulates too much iron. - **Causes:** - **Primary Haemochromatosis:** Hereditary haemochromatosis (HH), an autosomal recessive condition. - **Secondary Haemochromatosis:** Acquired causes of iron overload, such as: - Iron-loading anemia's with transfusions (Thalassemia major, sideroblastic anemia) - Excessive dietary ingestion - Chronic Liver disease (alcoholic liver disease, hepatitis B, and C viruses). ## Signs and Symptoms of Iron Overload - **Signs and Symptoms of Iron Overload:** - Fatigue - Weakness - Weight loss - Abdominal pain - Arthralgia - Arthritis - Amenorrhea - Early menopause - Loss of libido - Impotence - Dyspnea - Hypopituitarism - Hypogonadism - Cardiomyopathy - Arrhythmias - Cirrhosis - Liver cancer - Heart failure - Bronze skin pigmentation ## Bronze Diabetes - **Bronze Diabetes:** A rare condition occurring in severe hemochromatosis, where the body is overloaded with iron deposits. - **Signs and Symptoms:** - Bronze skin pigmentation - Diabetes - Liver damage - Heart problems - The document ends with a discussion of factors affecting iron absorption and how iron overload affects the body. 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