Iron is essential for multiple biological functions of the body. It is necessary for the synthesis of hemoglobin, myoglobin, cell regulation/proliferation, DNA synthesis, and electron transport in the mitochondria.
Nearly two-thirds of the body iron is found in the circulating RBCs as part of hemoglobin, with remaining iron present in the storage form(bone marrow, liver, etc.) myoglobin and many enzymes involved in various physiological functions.
Iron deficiency or sideropenia is a state where total body iron stores are inadequate to support normal metabolic functions. Iron is the most common nutritional worldwide deficiency and is the most common cause of anemia among an estimated 2 billion people worldwide.
Iron deficiency can be absolute or functional. Women of reproductive age and children between ages 0 to 5 are particularly at risk.
As there are no well established diagnostic criteria for iron deficiency without anemia and symptoms are vague, it can easily be missed. Clinicians should suspect a chronic iron deficiency in patients with normal complete blood counts who present with symptoms similar to anemia symptoms and have low ferritin. These patients need to be investigated for evidence of iron deficiency and inquired about blood loss in medical history.
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