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Latent iron deficiency
Last reviewed: 07.06.2024
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Latent iron deficiency (LID) is a condition in which iron levels in the body are reduced but have not yet reached the threshold at which clear clinical symptoms of iron deficiency (e.g., anemia) appear. That is, blood iron levels may be below normal, but the patient may not experience severe symptoms or have no visible manifestations.
Latent iron deficiency can be a precursor to a more serious condition, iron deficiency anemia. If iron deficiency is not detected and treated at this stage, it can progress over time to anemia, which means that there is not enough iron in the body for normal red blood cell formation and oxygen transport.
Symptoms of latent iron deficiency may be nonspecific and include fatigue, increased weakness, decreased performance, and pallor (pallor of the skin and mucous membranes). Laboratory tests such as measuring blood ferritin levels, which is an indicator of the body's iron stores, are used to diagnose latent iron deficiency.
Treatment for latent iron deficiency includes taking iron supplements or changing to a higher iron diet. It is important to see your doctor to diagnose and treat iron deficiency, as it can affect your overall health and well-being.
Causes of the latent iron deficiency
Latent iron deficiency can have several causes. This condition occurs when the body's iron stores are decreasing, but have not yet reached the level at which anemia develops. Here are some of the main causes of latent iron deficiency:
- Inadequate dietary iron intake: Inadequate intake of iron-rich foods (e.g., meat, fish, buckwheat) can lead to iron deficiency in the body.
- Iron Loss: Excessive iron loss can occur due to bleeding such as monthly bleeding in women or bleeding from the gastrointestinal tract, which can be caused by ulcers, polyps, hemorrhoids, or other problems.
- Iron absorption deficiency: Some conditions can reduce the body's ability to absorb iron from food. For example, celiac disease (a disease associated with gluten intolerance) or surgical removal of part of the intestine may affect iron absorption.
- Increased iron requirements: During periods of intense growth and development, such as pregnancy, lactation or adolescence, the body's need for iron may increase, which can lead to deficiency if iron intake is insufficient.
- Other factors: Various factors such as stress, loss of appetite, or illness can also contribute to latent iron deficiency.
Pathogenesis
The pathogenesis of latent iron deficiency is associated with insufficient iron stores in the body without obvious clinical symptoms or with mild but nonspecific symptoms. A gradual decrease in iron levels leads to the following processes:
- Declining iron stores: Iron in the body is stored as stores in tissues, especially in the liver and spleen. The gradual decline of these stores means that the body has less iron to maintain normal functions.
- Increased iron intake: Some conditions, such as pregnancy or periods of intense growth and development (e.g., adolescence), may increase the body's need for iron. This can make iron deficiency worse.
- Low serum ferritin: Serum ferritin is a protein that reflects the level of iron stores in the body. Serum ferritin levels decrease in latent iron deficiency, indicating a decrease in iron stores.
- Minor or no symptoms: In the initial stages of latent iron deficiency, symptoms may be either absent or minor and nonspecific, such as fatigue or decreased performance. This makes diagnosis difficult.
- Gradual progression of deficiency: If latent iron deficiency is not detected and treated, it can progress over time to a more serious stage, such as iron deficiency anemia, when iron levels become insufficient for the formation of red blood cells and sufficient hemoglobin.
- Potential Causes: Latent iron deficiency can have a variety of causes, including inadequate dietary iron intake, iron loss due to bleeding, or problems with iron absorption in the body.
Symptoms of the latent iron deficiency
Latent iron deficiency is a condition in which the body's iron levels are reduced, but does not yet cause overt symptoms of anemia, which is usually associated with iron deficiency. However, some people with LJD may still experience some non-specific symptoms that can vary in severity. Here are some of the possible symptoms of latent iron deficiency:
- Fatigue: General fatigue and weakness may be presented as one of the first signs of LJ.
- Skin pallor: Pallor of the skin or mucous membranes may be observed, but it is usually less severe than in iron deficiency anemia.
- Insomnia: Some people with LJ may experience difficulty falling asleep or insomnia.
- Reduced physical endurance: Deterioration in athletic performance and decreased physical activity may be noticed.
- Tachycardia: A fast heartbeat (tachycardia) can sometimes occur due to iron deficiency.
- Dizziness and headache: Some people with LJW may experience dizziness or headache.
- Digestive disorders: Some patients may experience decreased appetite or other digestive disorders.
It is important to note that the symptoms of LIDD can be quite nonspecific and may be confused with other diseases or conditions. If you suspect latent iron deficiency, or if you detect similar symptoms, it is important to consult your doctor. A diagnosis of LJD is usually made based on blood tests to measure iron levels, ferritin (a protein that stores iron in the body), and other indicators.
Latent iron deficiency in children
Means that the iron level in the child's body is below normal, but there are no obvious symptoms of anemia yet. This condition can be caused by insufficient iron intake from food, poor absorption, intensive growth and increased blood volume in a growing body, and other factors.
Treatment for latent iron deficiency in children may include the following:
- Dietary correction: It is important to provide your child with a nutritious diet rich in iron. A variety of foods such as meat, fish, eggs, grains, beans, nuts, and green vegetables can be useful sources of iron. Make sure your child gets enough iron from food.
- Iron supplements: A doctor may recommend iron supplements for a child if iron deficiency is considered severe or if the diet cannot provide adequate iron intake. However, it is important to strictly follow the doctor's recommendations regarding dosage and duration of administration.
- Regular monitoring: A child's iron levels should be checked regularly with blood tests to monitor the effectiveness of treatment and adjust it if necessary.
- Avoiding factors that contribute to iron deficiency: It is important to consider that certain factors, such as excessive consumption of dairy products or caffeine, can impair iron absorption. Parents should pay attention to the child's diet and pay attention to its composition.
Treatment of latent iron deficiency in children should be supervised by a pediatrician or pediatric gastroenterologist. Parents should follow the doctor's recommendations and actively communicate with the doctor about the child's condition and treatment.
Latent iron deficiency in pregnancy
This is a condition in which a pregnant woman has reduced iron stores in the body, but has not yet developed iron deficiency anemia. During pregnancy, women have an increased need for iron because it is necessary to support normal fetal growth and development, as well as the increased blood volume that accompanies pregnancy.
Symptoms of latent iron deficiency in pregnancy may include:
- Fatigue and weakness.
- Pallor of the skin and mucous membranes.
- Dizziness and headache.
- Insomnia.
- Shortness of breath.
- Increased nail fragility and brittleness.
- Loss of appetite.
To combat latent iron deficiency and prevent the development of iron deficiency anemia in pregnant women, the following is usually recommended:
- Nutrition: Meals should include iron-rich foods such as meat (especially beef and liver), fish, eggs, legumes, nuts, whole grain products, green vegetables and dried fruits.
- Iron supplements: Your doctor may prescribe iron supplements, especially if your iron levels are too low. The dosage and duration of intake will be determined by your doctor.
- Vitamin C: Vitamin C helps increase the absorption of iron from food. Consumption of foods rich in vitamin C (e.g., citrus fruits, strawberries, kiwi) in combination with iron-containing foods may be beneficial.
- Regular monitoring: It is important to see your doctor regularly to monitor your iron levels and the general health of the pregnant woman.
Pregnancy is a period when women are at an increased risk of developing iron deficiency, so it is important to follow your doctor's recommendations and pay attention to proper nutrition and taking the necessary supplements to maintain optimal iron levels in the body.
Complications and consequences
Iron deficiency is a serious condition and if it goes untreated or does not progress long enough, it can lead to various complications and consequences. Below are some of the possible complications and consequences of iron deficiency anemia:
- Anemia: This is the main and most common complication of iron deficiency. Anemia develops when hemoglobin (oxygen-binding protein in red blood cells) levels become insufficient to provide enough oxygen to the body's tissues. This can lead to symptoms such as fatigue, weakness, pale skin, shortness of breath, and others.
- Cardiac complications: Iron deficiency can affect the heart, impairing its ability to pump blood. This can lead to heart failure and palpitations.
- Immune system problems: Iron deficiency can weaken the immune system, making the body more vulnerable to infections.
- Development of acceptable mental and physical abilities in children: Iron deficiency in children can affect their physical and mental development. It can lead to delayed psychomotor development and cognitive problems.
- Gastrointestinal disorders: Iron deficiency can cause gastrointestinal disorders such as constipation or diarrhea.
- Development of acceptable mental and physical abilities in children: Iron deficiency in children can affect their physical and mental development. It can lead to delayed psychomotor development and cognitive problems.
- Complications during pregnancy: In pregnant women, iron deficiency may increase the risk of low birth weight and other complications during pregnancy and labor.
Diagnostics of the latent iron deficiency
Diagnosing latent iron deficiency can be difficult, as this condition often occurs without obvious symptoms. However, there is a diagnostic algorithm that involves a series of steps and laboratory tests to determine the presence of iron deficiency. Below is the algorithm for diagnosis:
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Anamnesis and clinical assessment:
- The physician begins by taking a history and discussing the patient's symptoms and medical history. It is important to consider risk factors for iron deficiency, such as menstrual bleeding, pregnancy, surgery, or gastrointestinal disease.
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Physical Examination:
- The doctor may perform a physical examination of the patient, including checking for anemia, signs such as pale skin, weakness, and increased fatigue.
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Lab tests:
- Examination of hemoglobin levels (hemoglobin greater than 13.7 g/dL in men and greater than 12.0 g/dL in women is considered normal).
- Examination of ferritin levels (low ferritin levels are often associated with iron deficiency).
- Serum iron-binding parameters such as serum iron and total iron-binding capacity (TIBC).
- Examination of mean red blood cell volume (MCV) and other red blood cell parameters.
- Inflammatory markers such as C-reactive protein (CRP) to rule out the influence of inflammatory conditions on the results.
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Additional research:
- Depending on the results of basic laboratory tests and the clinical picture, the doctor may decide to perform additional tests, such as a bone marrow iron study, to confirm iron deficiency.
The algorithm for diagnosing latent iron deficiency may vary depending on clinical practice and specific patient circumstances.
The diagnosis of LJD can be made based on the results of laboratory blood tests and evaluation of iron and ferritin (a protein that stores iron in the body) levels. Criteria for the diagnosis of LJD may include the following:
- Serum ferritin level: Ferritin is a protein that stores iron in the body. Usually, to diagnose LJD, serum ferritin levels must be reduced, but not too low to cause anemia. Specific norms may vary from lab to lab, but generally ferritin below 30-40 µg/L is considered low for adults.
- Serum iron levels: Serum iron levels can also be reduced, but not necessarily. Low serum iron levels may be associated with LJ, but this parameter may fluctuate depending on time of day and diet.
- Normal hemoglobin: One of the main criteria for diagnosing iron deficiency anemia is a decreased hemoglobin level in the blood. In cases of LJD, the hemoglobin level usually remains within the normal range.
- Absence of overt symptoms of anemia: LWA is characterized by the absence of classic symptoms of anemia such as pallor, fatigue, dyspnea and weakness.
It is important to note that the diagnosis of LJD is usually made by a physician based on blood results and clinical evaluation of the patient.
Differential diagnosis
Latent iron deficiency and iron deficiency anemia are two different conditions related to iron deficiency in the body, but with different levels of severity and clinical manifestations. Here's how they differ:
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Latentiron deficiency (latent iron deficiency):
- In latent iron deficiency, iron levels in the body are reduced but have not yet reached the threshold at which iron deficiency anemia develops.
- Patients with latent iron deficiency may have no significant symptoms or only minor symptoms such as fatigue or insomnia.
- Usually, hemoglobin and red blood cell levels in the blood remain within normal limits and there is no anemia.
- Treatment may include dietary adjustments, taking iron-containing foods or iron supplements.
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Iron-deficiency anemia (iron-deficiency anemia):
- Iron deficiency anemia is a more serious condition in which iron levels in the body are so low that there is not enough iron to make enough red blood cells and hemoglobin.
- This condition is accompanied by a decrease in hemoglobin levels in the blood, resulting in pallor, fatigue, weakness, shortness of breath, and other symptoms of anemia.
- Iron deficiency anemia may require more intensive and prolonged treatment, including taking iron-containing medications under a doctor's supervision.
It is important to note that latent iron deficiency may be a precursor to the development of iron deficiency anemia, and timely diagnosis and treatment of latent deficiency may help prevent the development of anemia.
Treatment of the latent iron deficiency
Treatment for latent iron deficiency (LID) is usually aimed at increasing iron levels in the body and managing symptoms, if any. Treatment may include the following measures:
- Diet: One way to increase iron intake is to improve your diet. Iron-rich foods include meats (especially liver and red meat), fish, eggs, nuts, seeds, enriched grain products, beans, spinach, and other green vegetables.
- Taking iron supplements: A doctor may recommend taking iron supplements to increase iron levels in the body. However, it is important to consult a doctor before starting iron supplements as improper use of iron can be harmful.
- Treatment of the underlying condition: If latent iron deficiency is associated with some other disease or condition (e.g., bleeding from the gastrointestinal tract), treatment of that underlying condition may help correct the iron deficiency.
- Regular monitoring: Once treatment has started, it is important to regularly monitor iron levels in the body through blood tests. This will help your doctor monitor the effectiveness of treatment and adjust it if necessary.
- Avoiding factors that contribute to iron deficiency: It is important to avoid factors that may contribute to iron loss, such as excessive use of caffeine, alcohol, and calcium-rich foods while taking iron preparations, as they may impair iron absorption.
Medicines
Latent iron deficiency (LID) may require treatment to normalize iron levels in the body and prevent more serious problems from developing. Treatment usually involves taking iron-containing medications and dietary recommendations. Here are some medications and recommendations that may be used for LIDD:
- Iron-containing preparations: Iron can be taken in the form of specialized preparations such as ferrous sulfate, ferrous gluconate or ferrous fumarate. These are available in various forms including tablets, capsules and liquids. A doctor can prescribe a specific preparation and determine the dosage depending on the degree of deficiency.
Below are some common names of iron-containing preparations and typical dosages that can be used for latent iron deficiency. However, it is recommended to consult a physician before starting treatment and obtain individualized recommendations on dosage and duration of intake:
- Ferrofumarate: It is usually taken in doses ranging from 50 mg to 300 mg of iron per day.
- Ferro-sulfate: Dosage can range from 60 mg to 325 mg of iron per day.
- Ferro-gluconate: It is usually taken in doses of 300 mg to 600 mg of iron per day.
- Iron polymaltosate: Dosage may vary, but is usually 100 mg of iron per day.
- Iron complex preparations: Some preparations include iron in combination with other vitamins and minerals. The dosage depends on the iron content of the complex.
- Iron-containing vitamins and minerals for pregnant women: In case of latent iron deficiency in pregnant women, a special preparation containing iron, folic acid and other vitamins and minerals may be prescribed.
Dosage and regimen may vary significantly depending on the degree of iron deficiency and individual characteristics of the patient.
- Vitamin C (ascorbic acid): Vitamin C helps improve the absorption of iron from food and medications. Therefore, it can be taken along with iron-containing medications. Support yourself with fresh fruits and vegetables to get enough vitamin C.
- Dietary recommendations: Eat iron-rich foods such as meat (especially liver), fish, legumes, nuts, seeds and green vegetables. Limit tea and coffee as they can make it difficult to absorb iron.
- Monitor deficiency: Have regular blood tests to monitor iron and ferritin levels to see if the deficiency decreases or disappears.
- Doctor's supervision: It is important to consult your doctor before starting treatment with iron supplements. Your doctor will determine the need and treatment regimen based on your individual needs and health status.
The use of iron-containing medications may be accompanied by some side effects such as constipation or stomach upset, so it is important to follow your doctor's recommendations and notify him or her of any adverse reactions.
Nutrition and diet for latent iron deficiency
To treat latent iron deficiency and improve iron levels in the body, it is important to eat a healthy diet by including iron-rich foods in the diet and paying attention to factors that can improve iron absorption. Here are some dietary recommendations for latent iron deficiency:
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Iron-rich foods:
- Beef, pork, chicken and other meat products.
- Fish, especially iron-rich fish such as tuna and sardines.
- Liver (but it is not recommended to consume it in large quantities due to its high vitamin A content).
- Eggs.
- Grain products such as oatmeal, buckwheat, and quinoa.
- Legumes, including beans, chickpeas and lentils.
- Nuts and seeds such as almonds, cashews and pumpkin seeds.
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Vegetables and fruits:
- Vegetables and fruits rich in vitamin C (e.g., citrus fruits, strawberries, kiwi) can help improve iron absorption from plant sources.
- It is important to include a variety of fruits and vegetables in your diet to ensure adequate intake of vitamins and minerals.
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Avoid conflicting foods:
- Some foods such as coffee, tea, calcium-containing foods (milk, yogurt) and foods rich in phytic acid (e.g. Whole-grain bread) can reduce iron absorption. Therefore, it is better to consume them in reasonable amounts and separate them from the intake of iron-containing foods.
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Multivitamin complexes:
- In some cases, the doctor may recommend taking multivitamin complexes containing iron to meet the body's needs for this mineral.
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Watch your iron intake:
- It is best to spread the intake of iron-containing foods evenly throughout the day to improve absorption.
It is important to remember that taking iron supplements or changing your diet should be discussed with your doctor, especially if you have medical contraindications or other health conditions. The diet should be balanced and adapted to your individual needs.
Clinical Guidelines
Treatment of latent iron deficiency and clinical recommendations may include the following steps:
- Consult your doctor: If you suspect latent iron deficiency or have symptoms such as fatigue, pallor (pale skin), weakness, and other signs associated with iron deficiency, see your doctor. Your doctor will perform the necessary tests and determine your iron status.
- Laboratory tests: To diagnose latent iron deficiency, your doctor will usually order laboratory tests, including measuring serum ferritin levels in the blood. Elevated ferritin levels may indicate iron deficiency.
- Clarifying the cause: It is important to determine the cause of latent iron deficiency, as this will help develop the most effective treatment plan. For example, if you are found to have bleeding from the gastrointestinal tract, this may require further evaluation.
- Maintaining your diet: It is recommended to increase the intake of iron-containing foods in your diet. These may include meat, fish, poultry, legumes, nuts, whole grain products and green vegetables. Intake of foods rich in vitamin C can help increase the absorption of iron from food.
- Iron supplements: Your doctor may prescribe iron supplements in the form of tablets or capsules if your iron levels are too low or if you are unable to achieve the required levels through diet.
- Monitor your health: After starting treatment, it is important to follow your doctor's recommendations and regularly check your iron levels. Watch for symptoms and report them to your doctor.
- Treatment of the underlying disease: If latent iron deficiency is associated with other diseases (e.g., bleeding from the gastrointestinal tract), treatment should be directed toward eliminating this underlying cause.
It is important to remember that self-medication and taking iron supplements without consulting a doctor can be harmful, as excess iron can also cause health problems.