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Diet diary: Haemoglobin not always indicator of iron levels

One may have normal haemoglobin levels and still have non-anaemic deficiency.

Written by Ishi Khosla | Updated: May 1, 2016 1:47:33 pm
Iron absorption though is dependent on whether it is heme iron (from animal food) or non- heme iron (present in plant foods). (Photo: Thinkstock) Iron absorption though is dependent on whether it is heme iron (from animal food) or non- heme iron (present in plant foods). (Photo: Thinkstock)

If you thought haemoglobin levels indicate iron status, think again! While haemoglobin reflects whether an individual is anaemic or not, it may or may not necessarily be an indicator of your body’s iron stores. You may have normal haemoglobin levels and still have iron deficiency, a condition also referred to as non-anaemic iron deficiency.

Non-anaemic iron deficiency was picked as a causative factor for diffuse hair loss in women in 1963. Numerous studies have also linked low ferritin levels to hair fall, thinning of hair, hair loss (alopecia), dull lifeless hair and lightening of dark hair.

Iron is stored in the body as ferritin. Ferritin accounts for 20 per cent of total iron in adults and plays an important role both in absorption and recycling of iron. It is formed by intestinal mucosa, liver, spleen and bone marrow. Ferritin levels are a good indication of iron storage levels.

Low ferritin levels indicate depleted iron reserves, while high ferritin levels indicate inflammation and can be a risk factor for cardiovascular disease and diabetes. A higher-than-normal ferritin level may be due to any inflammatory condition, alcoholic liver disease, frequent blood transfusion or too much stored iron in the body (hemochromatosis).

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Low iron stores or ferritin have been considered a possible contributing factor in several other conditions: muscle weakness, aching joints, breathlessness or heart palpitations, difficulty in swallowing (dysphagia), dry skin, sensitivity to cold temperature; pale pallor, thin, soft or brittle nails that don’t grow or may ’spoon’, ‘curl’-up or split, meaty tongue and a pale conjunctiva under the eye lids.

Iron deficiency is also known to depress the immune system, making the body more vulnerable to infection — particularly thrush, chronic herpes, mouth ulcers or chronic ear infections. Thyroid, para-thyroid and adrenal gland function are also influenced by an imbalance of iron. Ammehorea (loss of menstrual cycles) is also seen with low iron stores. A poorly understood behaviour seen among iron deficient people is pica — the craving and consumption of ice, chalk, starch, clay, soil and other non-edible substances.

Most common causes of low ferritin levels and hair loss include heavy menstrual bleeding, crash-dieting, poor diets, parasitic infections, surgeries, severe illnesses, digestive tract bleeding, emotional stress, medications, certain health conditions like malabsorption and thyroid abnormalities or hormonal changes.

Iron rich foods include animal foods- meat, especially organ meat (liver), poultry and fish and green leafy vegetables including cauliflower greens, mustard greens, radish leaves, amaranth (chaulai), lotus stem, black gram, black sesame, seaweed, black beans, soybean, water melon, grains like quinoa and some dry fruits like dates and sultanas. Iron absorption though is dependent on whether it is heme iron (from animal food) or non- heme iron (present in plant foods). Heme iron is easily absorbed by the body compared to non-heme.

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