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IRON IN HEALTH AND DISEASE

IRON IN HEALTH AND DISEASE. Surah 57. Al-Hadid (The Iron) Aya: 25. Surah 57. Al-Hadid (The Iron) Aya: 25.

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IRON IN HEALTH AND DISEASE

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  1. IRON IN HEALTH AND DISEASE

  2. Surah 57. Al-Hadid (The Iron) Aya: 25

  3. Surah 57. Al-Hadid (The Iron) Aya: 25

  4. We have indeed sent Our messengers with clear evidences and sent down with them the Scripture and the balance that the people may maintain (their affairs) in justice. And we sent down iron, where in is great military might and benefits for the people,and so that Allah may make evident those who support Him and His messengers unseen. Indeed, Allah is powerful and Exalted in Might.

  5. Distribution Daily Requirements Dietary sources Important functions Absorption & Metabolism Deficiency diseases Learning Objectives

  6. Introduction It is an established fact now that : • Deficiency or over exposure to various elements constitute a threat to human health. • Iron can form free radicals, its concentration in body tissues must be tightly regulated . • In excessive amounts, it can lead to tissue damage.

  7. Disorders of iron metabolism are among the most common diseases of humans and encompass a broad spectrum of diseases with diverse clinical manifestations. • Ranging from anemia to iron overload, and possibly to neurodegenerative diseases.

  8. Factors and actors • Element’s effect is determined by many factors, including availability in diet, absorption, metabolism, and its interaction with other processes.

  9. Iron is an essential trace element for almost all living organisms. • It participates in a wide variety of metabolic processes, including O2 and CO2 transport, DNA synthesis, and electron transport.

  10. IRON • Called by Egyptians as “Heavenly metal”. • Used as medicine around 1500 B.C. for the treatment of parasitic infection and a variety of other ailments. • Quran describes it as a means of power. • One of the most plentiful elements on earth. • 5% of earth crust, still its deficiency a common health problem

  11. IRON • 18th Century: presence was demonstrated in animal tissues and blood. • 20th Century: Much learnt about iron & its interaction with other elements.

  12. At. No. 26IRON At. Mass 56

  13. IRON ( Al-Hadeed) At. No. 26 & At.W. 56Aya No. 25 & Sura No. 57

  14. DISTRIBUTION • 4 grams of Fe ,on an average in human body • 3 grams in active or functional form and • 1 gram in storage or transport form.

  15. Distribution of Iron in human body • Hemoglobin 66% • Myoglobin 03% • Other body cells 05% • Enzymes 01% • Ferritin (store) 25%

  16. Recommended Dietary Allowance (RDA) Infants 0 – 0.5 = 10 mg 0.5 – 1.0 = 15 mg Children 1 – 3 = 15 mg 4 – 6 = 10 mg 7 – 10 = 10 mg

  17. Iron RDA

  18. Major Dietary sources • Red meat, Liver and Eggs • Green Vegetables and , Cereals • Apple, Nuts, Peaches and Dry fruits • Iron from cooking utensils, made of iron

  19. FUNCTIONS • Essential elements in the daily diet. • Vital role in O2 transport and energy production. • Exclusively involved in the uptake and release of O2at cellular level.

  20. FUNCTIONS • Shuttles O2 from lungs to all other tissues and • CO2 back from tissues to lungs. • Ability of Hb molecule to take up O2 and release CO2, is dependent on presence of Fe in Hb. • Without Fe, the Hb. molecule cannot perform this function. • The cytochrome enzyme system functions in energy production.

  21. FUNCTIONS • Active part is mostly in Porphyrin and forms an integral part of Hb and Myoglobin, • In RBCs enzymes cytochrome, oxidase, catalase and peroxidases .

  22. FUNCTIONS • Myoglobin works on similar principle but performs in muscles only.

  23. Absorption and Metabolism

  24. METABOLISM • Fe++ is absorbed from intestinal lumen into the cells of intestinal mucosa. • Here Fe++ is oxidized to Fe+++ • Combines with proteins Apoferritin. • Iron – protein complex, Ferritin and stored.

  25. EXCRETION • Iron is unique among mineral elements. • There is no physiologic mechanism for regulating its increase or decrease excretion. • Balance is mainly controlled at the site of intestinal absorption.

  26. Iron Absorption Absorption is influenced by the amount present in the diet / food that increase or decrease the availability of iron for absorption. • Primary regulator of iron homeostasis • 1-50% of iron is absorbed. • If body needs more iron, it increases amount of “transferrin” an iron carrying protein. • Iron can also be stored in another protein called “ferritin”

  27. Iron Absorption

  28. ABSORPTION OF IRON Enterocyte Gut Fe+++ Ferritin Fe++ Tf-Fe+++ Fe++ Fe++ Haem Tf

  29. BODY IRON CYCLING

  30. METABOLISM • When iron is needed by the body, Ferritin gives up its iron to the blood stream. • Fe+++ iron is reduced within the mucosal cell to Fe++ form and released. • The apoferritin in the mucosal cell can then combine with dietary iron absorbed in the intestine. • If all the mucosal cells are saturated, no further absorption.

  31. METABOLISM • Most of iron in blood stream is utilized by bone marrow to synthesize Hb. • Some is used by other tissue in the formation of enzyme

  32. FACTORS AFFECTING IRON ABSORPTION

  33. Factors affecting Iron Absorption Absorbed through intestinal mucosa, only when needed No excessive storage. Ferrous (Fe++) is better absorbed than Fe+++ (Ferric) Better absorbed in Acidic medium, by virtue of conversion of ferric to ferrous state.

  34. Factors • Absorption is more efficient in presence of Vit C, sulfhydral and other reducing substances • Vitamin C and fructose forms soluble complexes with iron and therefore better absorbed.

  35. High fiber in diet – decrease iron absorption • Tea can also inhibit the absorption of non heme iron • Phosphate, Oxalates, Phytates forms insoluble complexes with iron, preventing absorption.

  36. Absorption • Absorption increase with need: • Period of rapid growth (in infancy) • Childhood and adolescence • During pregnancy, • As a result of blood loss and • At high attitude.

  37. IRON DEFICIENCY Hypochromic Microcytic anemia: • No of RBCs are either normal or reduced • Amount of circulating Hb is reduced • In each RBC the Hb. content fall • Hb low, oxygen carrying capacity is reduced

  38. IRON REQUIREMENTS • Due to efficient conservation and reutilization in the body daily physiologic requirement is small. • Healthy man loses about 1 mg/day iron, while women lose about 1.5 mg/day • 10% of average available dietary iron is absorbed which comes to 10 mg/day required for men and 18 mg/day required for women

  39. IRON REQUIREMENTS • Pregnancy increase iron daily need by 3.5 mg/day • To be taken as iron supplement and not diet 30 – 60 mg/day • Lactation iron losses are 0.5 – 1.0 mg/day • Continuous Supplementation needed for 2 – 3 month after delivery

  40. IRON DEFICIENCY Commonest cause of anaemia worldwide Cause of chronic ill health May indicate the presence of important underlying disease eg. blood loss from tumour

  41. CLINICAL FEATURES (Symptoms) • Dizziness • Headache • Weakness • Fatigue

  42. CLINICAL FEATURES (signs) Pallor Glossitis Angular cheilosis and koilonychia. Koilonychia Glossitis

  43. CLINICAL FEATURES OF IRON DEFICIENCY Angular Cheilosis or Stomatitis

  44. Hypochromic microcytic red cells

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