Anemia, what are the misunderstandings about iron supplementation

Iron is an important essential trace element for the human body.

65%-70% of the iron in a normal human body is stored in hemoglobin. Iron supplementation has always been a common topic.

However, do you know what common misunderstandings are about iron supplementation?

Myth 1: Only when hemoglobin is low should you supplement your blood

Hemoglobin levels lower than the normal reference value can be diagnosed as anemia, but within the normal reference value range, the possibility of iron deficiency cannot be ruled out. Hemoglobin is a late indicator of iron deficiency.

In fact, iron deficiency can be roughly divided into three stages:

●The first stage is the iron reduction period, during which the body's iron storage decreases, serum ferritin concentration decreases, and there are no clinical symptoms.

●The second stage is the iron-deficient period of erythropoiesis. At this time, in addition to the decrease in serum ferritin, serum iron decreases, iron binding capacity increases, and the concentration of free protoporphyrin increases.

●The third stage is the iron deficiency anemia stage, during which the hemoglobin and red blood cell volume ratio decrease.

Therefore, instead of supplementing iron only when hemoglobin is low, serum ferritin should be used as a laboratory indicator to take corresponding measures in the early stages of anemia.

Myth 2: For anemia, only iron supplementation

Hemoglobin is composed of one globin and four ferroporphyrins.

Nutritional anemia is often caused by dietary reasons. The dietary iron sources of the human body include heme iron and non-heme iron. Heme iron has high bioavailability, with an effective absorption rate of 15%-35%, while non-heme iron must first be reduced to divalent iron before it can be absorbed, and its absorption rate is only 2%-20%.

Heme iron mainly comes from animal food. The protein in animal food is digested and absorbed. On the one hand, it serves as the raw material for globin synthesis, and on the other hand, it can stimulate gastric acid secretion and promote iron absorption. Vitamin C is an effective factor in promoting iron absorption. Vitamin A, folic acid, vitamin B12, vitamin B2 and other vitamins have an important synergistic effect on iron absorption.

Therefore, when using iron supplements, you should ensure food diversity and increase the intake of other nutrients in appropriate amounts and at the right time.

Myth 3: Blindly using iron supplements can lead to iron overdose

Under normal circumstances, the absorption, transport, utilization, storage and loss of iron are regulated by the body to maintain iron balance.

However, high-dose iron therapy can lead to iron overload. The target organs of iron overload damage are mainly the liver, heart, and joints, which can lead to liver fibrosis, heart failure, and even other serious oxidative damage to the body.

Therefore, iron supplementation for anemia should adhere to the principle of "small amount, long-term". Take the medicine strictly according to the doctor's instructions, and do not increase the dosage on your own to avoid overdose.

Author: Gao Chunhai | Registered nutritionist and popularizer of Chinese nutrition knowledge

Reviewer Zhou Shiqiong | Chief Physician of Nutrition Department

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