Perspectives for Better Neurological Care

Dr. Adams
Dr. C. Robert Adams
Board Certified Neurologist
109 N. 15th St., Ste 14, Norfolk Ne. 68701 Phone: 402-371-0226
3900 Dakota Ave, South Sioux City, Ne. 68776 Toll Free: 888-516-2398
Brodstone Memorial Hospital, 520 E. 10th, Superior, Ne. 68978

EPIDEMIC IRON DEFICIENCY

Iron deficiency is an extremely common problem affecting all age groups including very young children, teenagers and the elderly.

Iron deficiency and its ill effects seem to spare no age group.

Symptoms of iron deficiency can include weakness, fatigue, dizziness, malaise, depression, sleepiness and even recurrent headaches.

A person with iron deficiency may have pale skin and their eyes may look pale without the normal red injection of the blood vessel usually seen.

Problems of iron deficiency can include chronic dizziness, unexplained fainting or loss of consciousness, and even severe headaches. It appears that iron deficiency predisposes to headaches and even sometimes to pseudotumor cerebri or marked brain swelling.

Again, it should be emphasized that iron deficiency is extremely common. This often relates to dietary inadequacy in young children.

In teenagers on a "fast-food diet", lack of red meat intake can cause iron deficiency.

Further compounding this problem can be menstrual bleeding in even young teenage girls.

Other causes or iron deficiency can include bleeding from the GI tract including irritation from ulcers and gastritis, as well as diverticulitis, polyps, and even cancer in the colon.

Identification of iron deficiency can sometimes a little bit tricky from a laboratory standpoint. You can be severely iron deficient and have essentially normal hemoglobin and hematocrit (without striking anemia).

Even the routine serum or blood iron studies can sometimes be misleading.

The only way to absolutely ascertain and identify iron deficiency is to get a serum ferritin. The serum ferritin and laboratory blood analysis is an absolute indicator of iron deficiency if low. The serum ferritin should be above 40 or 50 for ideal or optimal health.

Further misleading is the range of values given for serum ferritin levels.

The observable ranges on laboratory analysis sheets sometimes go as low at 10 or 20. However, this only represents the high number of people on the low end of the range that are iron deficient.

However, pathologist and hematologist will verify that a serum ferritin of 20 or less suggests drastically reduced iron stores and essentially no iron reserve or store in the body.

A serum ferritin blood level should be obtained in cases of suspicion including pale teenagers, elderly patients with unexplained weakness.

Severely low serum ferritin or the lack of tolerance for oral iron replacement can prompt consideration for IV iron or Venofer. This is very safely given and well tolerated as compared to some of the older preparations of IV iron which had a high instance of allergic hypersensitivity. Intravenous Venofer seems to be well tolerated even in very young or sick and debilitated patients.

Again, there is an absolute epidemic of iron deficiency in our society affecting multiple age groups.

A high index of clinical suspicion for iron deficiency is clearly in order.

A serum ferritin blood level should be drawn as the "goal standard" to check for iron deficiency in individuals who have presentations of pallor, weakness, fatigue, unexplained syncope, anemia or even unexplained headaches.

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