Describe the development of iron deficiency, including measurements used to assess iron status, and the development of iron-deficiency anemia.

Question

What will be an ideal response?

Answer 1

Iron deficiency develops in stages. In the first stage, iron stores are diminished. Measures of serum ferritin (in the blood) reflect iron stores and are most valuable in assessing iron status at this stage.
The second stage of iron deficiency is characterized by a decrease in transport iron: the iron-carrying protein transferrin increases (an adaptation that enhances iron absorption). Together, measurements of serum ferritin and transferrin can determine the severity of the deficiency—the more transferrin and the less serum ferritin, the more advanced the deficiency is. Transferrin saturation—the percentage of transferrin that is saturated with iron—decreases as iron stores decline.
The third stage occurs when the lack of iron limits hemoglobin production. Now the hemoglobin precursor, erythrocyte protoporphyrin, begins to accumulate as hemoglobin and hematocrit values decline. Hemoglobin and hematocrit tests are easy, quick, and inexpensive, so they are the tests most commonly used in evaluating iron status.
Iron-deficiency anemia refers to the severe depletion of iron stores that results in a low hemoglobin concentration. In iron-deficiency anemia, hemoglobin synthesis decreases, resulting in red blood cells that are pale (hypochromic) and small (microcytic). Without adequate iron, these cells can’t carry enough oxygen from the lungs to the tissues. Energy metabolism in the calls falters. The result is fatigue, weakness, headaches, apathy, pallor, and poor resistance to cold temperatures.