Analysis of blood for iron - indications for prescription, indicators of the norm and causes of abnormalities in children or adults

What is a blood test for iron

Most of the iron( Ferrum or ferrum) in the body contains red blood cells - erythrocytes, specifically, their constituent is hemoglobin. A small amount also includes tissues and plasma - in the form of complex compounds with protein transferrin and in the composition of hemosiderin and ferritin. During the day, the level of iron in the blood changes significantly. In general, it performs the following functions:

• activates the work of breathing pigments that transport oxygen;
• is involved in the synthesis of hemoglobin and oxidative cellular responses;
• ensures the normal functioning of hematopoietic processes;
• participates in the binding and transfer of oxygen, retains it in the red blood cells.

With a lack of iron, the process of synthesis of hemoglobin and transportation of oxygen through the body is disrupted. A consequence of this is oxygen deficiency - hypoxia. Excess of this microelement is less common, but also poses a threat to human health. To determine the level of iron and abnormalities and prescribe a biochemical analysis for iron.

Indications

A common indication for the analysis of blood for iron is the suspicion of an increase or decrease in its level. This happens with certain diseases, which the doctor also needs to confirm. Venous blood is taken for the study. The concentration of ferrum is determined by the intensity of the color of the solution, which directly depends on the amount of this trace element. Such a blood test for iron is considered one of the most accurate. Indications for its conduct are:

• suspected iron deficiency anemia;
• differential diagnosis of anemia;
• vitamin deficiency or hypovitaminosis;
• control of the effectiveness of treatment of anemia;
• poisoning with iron-containing tablets;
• disorders of the gastrointestinal tract, which prevent the normal absorption of iron;
• bleeding of various etiologies;
• revealing in the general anale of blood for iron abnormalities relative to erythrocytes and hematocrit;
• inflammatory processes, acute infectious diseases;
• diagnosis of hemochromatosis( hereditary pathology, in which the iron exchange is impaired).

How to prepare

In order for the result of the study to be more accurate, the analysis must be properly prepared. Blood is delivered to an empty stomach in the morning - approximately from 8 to 10 hours, because for this time the maximum concentration of ferrum is necessary. Iron-containing preparations should be canceled 6 days before the procedure. For the same period, you need to exclude from the diet of fatty and fried foods. Preparation involves several more rules:

• a day before the procedure to exclude smoking and alcoholic beverages;
• last time to take food 8-9 hours before the test( before the analysis only clean water is allowed);
• for a couple of days before the procedure to stop using oral contraceptives;
• before the analysis does not undergo fluorography and radiography;
• a couple of days before the analysis to limit physical activity;
• get a good night's sleep before the procedure, do not allow emotional stress.

How to take the

test Procedure is performed in a laboratory. In the morning around 8-10 o'clock the patient needs to come to the polyclinic. The specialist will take venous blood from the ulnar vein using a disposable syringe. Before the start, the puncture site is disinfected with medical alcohol, then blood is taken from the vein. The entire procedure takes about 1.5 minutes, and the process is almost painless. The biological material for analysis is serum. This means that the specialist takes the blood taken into a test tube that has never been used and has not been in contact with detergents.

Explanation of

A qualified person is responsible for decoding, which performs the procedure in the laboratory. The whole process takes about 3 hours. Since the level of iron varies throughout the day, the norm is not specific numbers, but intervals of values. For men, the average concentration of ferrum is 14.3-25.1 μmol / l, for women - 10.7-21.5 μmol / l. Differences are associated with the physiological monthly bleeding in menstruation, which is inherent only to the fairer sex. There are three versions of the analysis results:

• If the level of iron is within these intervals, this indicates a normal electrolyte balance.
• When the amount of ferrum is below normal values, doctors diagnose iron deficiency( anemia).
• If the norm of iron in the biochemical blood test is exceeded - experts state an overabundance of this element in the body.

When interpreting the results, the doctor takes into account not only the values ​​obtained, but also a number of other factors, such as nutrition, the menstrual cycle, the intake of certain medications. Before and during menstruation, women have elevated levels of iron. For this reason, they are advised to take the test after the end of menstruation. Sometimes the patient has fluctuations in the level of the ferrum: they are associated with a sharp increase in the patient's consumption of meat. The level of this trace element is also affected by drugs, such as:

• acetylsalicylic acid;
• Methotrexate;
• oral contraceptives;
• antibiotics;
• preparations with estrogens;
• Metformin;
• Asparaginase;
• Cortisol;
• Cholestyramine;
• preparations with testosterone.

The norm of iron in the blood

The level indicators of this element depend not only on sex, but also on age. For each age category, doctors have their own serum iron level in the blood. In neonates, there is a decrease in the volume of the ferrum for several hours after birth. As he grows up, his level gradually increases. Specific norms of iron in the blood of women and men, taking into account age, reflect the table:

Age	Normal for women, μmol / l	Normal for men, μmol / l
Less than 1 month	5,1-22,6	5,6-19.9
From 1 month to 1 year	4.6-22.5	4.9-19.6
1 to 4 years	4.6-18.2	5.1-16.2
From4 to 7 years	5.0-16.8	4.6-20.5
7 to 10 years	5.5-18.7	4.9-17.3
10 to 13 years	5, 8-18.7	5.0-20.0
13 to 16 years	5.5-19.5	4.8-19.8
16 to 18 years	5.8-18.3	4,9-24,8
Older than 18 years	8,9-30,4	11,6-30,4

Low level of iron in the blood

The main signs of iron deficiency are symptoms of anemia. These include headaches, flies flies before your eyes, dry and pale skin. Of the external signs, fragility of the nails and hair loss are also noted. At an early stage, the symptoms are not too pronounced. Over time, when the reserves of the ferrum are completely depleted, a person begins to feel weakness, migraine and dizziness. In the next stage of anemia, other symptoms are attached:

• chest pain;
• unusual taste preferences( desire to eat chalk or clay);
• weakness in the legs;
• shortness of breath;
• lack of appetite;
• muscle hypotension.

Reasons for

The main cause of iron deficiency is the inadequate supply of ferum with food, i.e.alimentary deficiency of iron. This happens when you follow a strict diet, malnutrition. Iron deficiency is characteristic for vegetarians, since iron from meat is more easily absorbed by the body than in the plant. The same is observed in children under 2 years and adolescents during puberty. Iron deficiency in them is caused by rapid growth, which requires a large consumption of trace elements. In addition to nutrition and age, the reasons for this micronutrient deficiency include:

• iron deficiency anemia;
• excessive physical activity;
• chronic renal failure, cholestasis, nephrotic syndrome;
• profuse menstruation;
• hepatitis, cirrhosis;
• hypothyroidism;
• thrombocytopenia;
• chronic fatigue;
• gastritis with a decreased secretory capacity;
• enterocolitis, enteritis;
• neoplasm in the stomach and intestines;
• bleeding in the gastrointestinal tract, including because of tumors;
• third trimester of pregnancy;
• uterine bleeding;
• continued infection;
• blood loss during surgical interventions;
• period of lactation;
• anorexia;
• menopause;
• osteomyelitis, rheumatism;
• myocardial infarction.

With normal hemoglobin

The lack of ferrum at a normal level of hemoglobin indicates a latent( latent) iron deficiency. It is due to the fact that at an early stage of the shortage of this microelement, the body strains its own enzyme systems and withdraws it from its own reserves. For this reason, the remaining blood counts remain normal, the number of erythrocytes and hemoglobin does not decrease-only the total iron binding capacity of the serum changes. All this is explained by the fact that ferrum in the body is present in 3 types:

• cellular - in the hemoglobin;
• extracellular - in the form of plasma free microelements, transport proteins;
• in the form of stocks - hemosiridine, ferritin.

Hemoglobin only affects the level of cellular ferrum, but the decrease in the amount of extracellular iron in the beginning proceeds without anemia. Hemoglobin decreases, but only with time. This is diagnosed after the latent iron deficiency due to the complete depletion of its reserves is transformed into iron deficiency anemia. Iron deficiency in normal hemoglobin is noted in the following cases:

• in the case of mineral exchange disorders;
• after hemodialysis, forced diuresis;
• after procedures associated with the stimulation of defecation or urination.

How to improve

Severe anemia is treated for six months and longer, a lighter form - for 2 months. An overwhelming number of patients are prescribed iron-containing preparations, but, in addition to taking them, a person needs to follow a special diet. Since iron deficiency is often associated with nutritional errors, the first thing to do is to revise your menu. In the diet must necessarily include products containing the maximum amount of this element:

• buckwheat;
• liver;
• pistachios;
• spinach;
• lentils;
• oatmeal;
• corn;Cashew
• ;
• cornel;
• broccoli;
• sea kale;
• beef;
• dried apricots;
• chicken;
• beet;
• apples;
• fish;
• beans;
• chicken yolk;
• pumpkin seeds;
• dried mushrooms.

Protein products are consumed daily, as the protein participates in the construction of hemoglobin, which later participates in the enrichment of the body with oxygen. To increase the absorption of ferrule in the intestine, it is necessary to introduce ascorbic acid( vitamin C) into the diet - it is contained in citrus fruits and sauerkraut. In pregnancy, iron deficiency is caused by a lack of folic acid. In this case, women are prescribed it in the form of drugs, although it is also found in foods such as cabbage and kefir.

The second way to combat iron deficiency is to take iron-containing preparations. If absorption of drugs from the gastrointestinal tract can not be carried out, the patient is prescribed parenteral forms of these drugs. They are administered intravenously or intramuscularly with a critical decrease in hemoglobin or ferrum. In the first case, a test dose is first administered, which will help to avoid adverse reactions. Often, injection procedures are combined with blood transfusions. Injections are produced mainly on the basis of ferric iron:

• Ferbitol;
• Farkoven;
• Ferrum Lek.

They are administered intramuscularly, because with intravenous infusion the risk of allergy is high. Drugs are administered with diluted saline at a rate of 50 mg / min. Each week, 2 injections are done. The average dosage for an adult is 100 mg per 1 administration. The course of treatment lasts 2-3 weeks. Indications for intravenous administration are diseases of the gastrointestinal tract, which reduce the absorption of iron.

When using oral forms of iron-containing drugs, the patient should receive 20-30 mg of the missing nutrient per day. For this purpose, drugs based on:

• of bivalent iron are used. They are considered obsolete, but have a lower cost. Assign with increased acidity of the stomach, as hydrochloric acid disrupts the absorption of trivalent ferrum. Examples of this group of drugs are sulfate, gluconate and ferric chloride. The effect of treatment by them is noticeable already on the 10th-12th day of the course of therapy.
• of ferric iron. They are chosen primarily at the initial stage of iron deficiency therapy. These drugs are highly effective and do not require strict intervals between meals and tablets. Minus - their bioavailability is lower in comparison with bivalent. Examples of preparations based on ferric iron are Ferrocene, Ferrum lek, Maltofer.

Elevated iron content in the blood

A condition in which the level of ferruin in the blood is elevated is more rare in comparison with iron deficiency. An excess of this element is diagnosed when its intake into the body exceeds expenditure and allocation. The critical value is 30.4 μmol / l. If this number is exceeded, the patient finds an excess of ferrum. This is possible with some diseases and an overdose of iron-containing drugs. Symptoms of this deviation are:

• pain and swelling of the joints;
• loss of appetite;
• arthritis;
• nausea, vomiting, heartburn;
• constipation or diarrhea;
• hair loss;
• muscle soreness;
• decreased libido.

Causes of

A less dangerous cause of excess of this trace element is an overdose of iron-containing drugs. In this case, they are canceled, after which the level of iron for a couple of days should be normalized. Overdosing occurs when you use up to 200 mg of ferrum per day. To the causes of excess are some diseases and special cases:

• hemochromatosis;
• different types of anemia( hemolytic, aplastic, sideroblastic, hypoplastic)
• hemosiderosis;
• thalassemia;
• premenstrual period;
• frequent blood transfusions;
• viral and acute hepatitis;
• violation of iron exchange;
• acute liver necrosis;
• chronic cholecystitis;
• hepatopathy.

How to reduce

Unlike iron deficiency treatment, in order to reduce the level of ferrum, it is required to exclude products with high content, which were listed above. This meat, beans, mushrooms, seafood, apples, pears, etc. It is also necessary to refuse preparations that improve the absorption of this element in the intestine. This applies to the vitamins of group B and C, folic acid. Of the medicines to lower the level of ferrum help:

• heptapeptides;
• hepatoprotectors;
• preparations of zinc;
• complexing agents.

Iron bonding agents such as Tetacin calcium, Deferoxamine, Desferal can also be used. In addition to medicines, special procedures are carried out:

• Phlebotomy - periodic bloodletting. Every week, about 350 ml of blood is taken from a person.
• Hirudotherapy. This treatment is leeches that feed on human blood. This process reduces the level of iron. This is due to the fact that the blood loses hemoglobin. Donor blood transfusion. Such a donation is also called exchange. It is in the collection of blood from the bloodstream and a simultaneous infusion of donor blood.

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