Iron is an essential trace mineral required for human health. Iron deficiency is the most common nutritional deficiency Worldwide. The most well known role for iron in humans is that of a component of the haemoglobin molecule found in red blood cells and in this role it is required for the correct transport of oxygen in the blood. However, iron is also found in myoglobin is skeletal muscle cells, and is a cofactor for a number of enzymes including hydroxylase enzymes that are required for neurotransmitter synthesis in the brain. Iron deficient anaemia is a common result of an iron deficiency and can result in lethargy and an inability to concentrate. This relates largely to a reduced capacity of red blood cells to transport oxygen. Iron deficiency in children has been shown to lead to developmental changes and delayed development. Supplemental iron such as the ferrous sulphate form are provided medicinally to treat iron deficiency, and a diet rich in iron is recommended. However it can take a long time to restore iron stores in those affected.
Current evidence suggests that it can take between 6 months a 1 year for iron stores to be repleted. The turnover rate of red blood cells is around 120 days, and so it is not surprising that although iron deficient anaemia can respond relatively quickly to iron supplementation, in general it may take several months for the symptoms to completely abate. The integrity of the brush border of the enterocytes must be good in order for iron absorption to take place, and as a result those with gastrointestinal disorders such as celiac disease may develop iron deficiencies. Studies show that even a low gluten diet is commenced, the restoration of iron stores can take from 6 months to 1 year to return to normal ranges, and in some individuals, even at 2 years iron stores have not fully recovered. Although in this study the subjects were not administered supplements, they were under medical supervision, and this demonstrates the possible time frames for restoration of iron stores under such conditions.
Iron deficiency can be difficult to treat. One of the biggest and often overlooked problems with treating an iron deficiency is poor patient compliance. A high iron diet containing red meat, in combination with iron supplements can be effective at restoring iron levels. However, poor patient compliance with regard not taking the supplements daily or straying from the high iron diet can mean that it takes many year for some individuals to restore iron levels. Many individuals fall in and out of iron deficiency without noticeable improvements in health for this reason. For vegetarians, spinach and legumes are a good source of iron, although it may not be as bioavailable as that found in meat.
The choice of iron supplements can also make a significant difference to the rate at which iron stores are repleted. In this regard, amino acid chelated iron may be far superior that inorganic forms of iron in terms of absorption. For example in one study, ferrous sulphate or ferrous bis-glycinate chelate was administered to children with iron deficiency. The apparent iron bioavailabilities for 5 mg of iron were calculated by the authors to be 26.7 % for ferrous sulphate and 90.9 % for ferrous bis-glycinate chelate, respectively. Only the ferrous bis-glycinate was able to elevate the ferritin levels of the children within the 28 day study time frame, although both compounds increased haemoglobin levels. Therefore is supplements are used to aid restoration of iron stores amino acid chelated forms such as ferrous bis-glycinate are the prefered choice. However, ferrous sulphate can be effective, but the latency period between commencing supplementation and the elimination of symptoms may be longer.
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