By :Payal patel

Outline:IntroductionTypes of iron with examplesAbsorption, transport & storageFactors affecting iron absorptionFunctions Dietary sources & RDADeficiencyToxicity

MineralsMinerals are inorganic compound which are

essential for the normal growth and maintenance of the body.

Major elements/Macro minerals : • Requirement>100mg/day e.g : Ca, Mg, P, Na, K, Cl, STrace elements/ Micro minerals:• Requirement<100mg/daye.g: Fe, I, Cu, Co, Se, Mn, Zn, Se, Mo.

IronMacro mineralBody iron content : 3-4 g• Blood- 75%• Liver• Bone marrow• Muscles

Types of iron :• Functional iron(Heme): Heme proteins 7 enzymes: Hb, Mb, cytochromes catalases, peroxidases xanthine oxidase, typtophen pyrrolase.

Storge iron(non heme containing protin):TransferrinFerritinHemosiderin.

Absorption, transport & storage:Absorption: duodenum & jejunumOnly Fe+2 form is absorbed

Factors affect iron absorption:

Increased:AcidityAscorbic acidcysteine Iron deficiency anemia

Decreased:Phytate & oxalateTeaCopper deficiencyCalcium, lead,

phosphateAlkalinegastractomy

Iron metabolism is maintained by regulation at the level of absorption & not by excretion.

Iron store in the body depleted absorption increased.When adequate amount of iron present in the body

absorption is decreased this is called “mucosal block theory”

Regulation of absorption:1.Mucosal regulation: absorption required DMT-I,

ferroportin, both are synthesised by down regulation of HEPCIDIN. In anemia hepacidin synthesis decreased so ferroportin synthesis increased.

2.Store regulation3.Erythropoeric regulation

Transport form: Transferrin: Glycoprotein1 molecule bind with 2 iron moleculeIron deficiency transferrin level increased.Storage form: Ferritin:Present in intestine, mucosal cell, liver, spleen,

bone marrow Hemosiderin:Form by partial deproteinization of ferritinPresent in liver, spleen, bone marrow

Iron is one way element.It is very efficiently utilized and reutilized,not

excreted in urine. 1mg of iron is loss through bile, sweat, feces.Any type of bleeding will cause loss of iron.

Functions of iron:Fuctions are exerts through the compound in

which it is present.Hb & myoglobin: transport of o2 & co2Cytochrome : for ETC& oxidative

phosphorylationPeroxidase: phagocytosis

Dietary sources:

Plant Leafy vegetable Pulses Cerals jeggery

Animal Liver Meat Milk-poor

RDA:Male: 10mg/dayMenstruation:20mg/dayPregnancy: 40mg/dayLactation: 40 mg/day

Deficiency:Causes:Nutrition deficiencyHypochlorhydriaGastrectomyHookworm infection, 1-0.3 ml of blood lossPiles, peptic ulcer, menorrhagiaRepeated pregnancies- 1gm lossNephrosis-loss of heptoglobin, hemopexin,

transferrinLead poisoning

Clinical manifestation:Microcytic hypochromatic anemiaHb <10gm – apathyDerangment in cellular respirationIrritability

Laboratory diagnosis:• Serum iron leve:l- decreased in iron deficiency,

kwashikor, acute and chronic infection• TIBC: - increased in hypochromatic anemia,

pregnancy• TfR:- increased in iron deficiency anemia,

hemolytic anemia

Tretment:Oral iron supplementation:Pregnancy: 100mg of iron + 500microgram folic

acidChildren: 20mg of iron + 100microgram folic acidIron tablet gives along with vitaminC & E

Toxicty:Intake>50mgNauseaAbdominal pain

Hemosiderosis:Excess of ironHemosiderin(golden

brown granules) seen in spleen & liver

Causes: repeated blood transfusion

Primary hemosiderosis:

Hereditary due to abnormal gene on chrmosome no.6

Bantu siderosis:

Hemochromatosis:Total ironis is 25-30gmHemosiderin is

deposited in liver cell n leads to cell death & cirrhosis

Deposited in skin leads to brown yellow discolorition called hemochromatosis

Deposited in pancreas leads to diabetes

Bronze diabetes