Iron preparations with low hemoglobin in adults and children are not infrequent medical prescriptions. Coming to the pharmacy, a person is lost from the abundance of drugs. They differ in the valence of iron (two- or trivalent), by the type of iron compounds (organic – guonates, malates, succinylates, chelate forms and inorganic – sulfates, chlorides, hydroxides), by the route of administration (oral – tablets, drops, syrups and parenteral – intramuscular and intravenous forms).
If, in treating anemia, the best iron medication is recommended by your doctor, then for a prophylactic increase in iron stores, it is often necessary to understand all this. ugliness Diversity has its own. We will deal with the analysis of drugs that are effective in case of iron deficiency.
Causes of iron deficiency
The body contains from 3 to 5 grams of iron. Most of it (75-80%) is in red blood cells, part of the muscle tissue (5-10%), about 1% is part of many body enzymes. The bone marrow, spleen and liver are the storage sites of the reserve iron.
Iron is involved in the vital processes of our body, so it is important to maintain a balance between its intake and loss. When the rate of iron removal is higher than the rate of intake, various iron deficiency states develop.
If a person is healthy, then the removal of iron from our body is insignificant. The iron content is controlled mostly by changing the level of its absorption in the intestine. In food, iron is presented in two forms: Fe III (trivalent) and Fe II (bivalent). When it enters the digestive tract, the inorganic iron dissolves, forming ions and iron chelates.
Chelate forms of iron are best absorbed. The formation of iron chelates is promoted by ascorbic acid. In addition, chelating iron with fructose, succinic and citric acids, amino acids (for example, cysteine, lysine, histidine) helps.
Causes of iron deficiency:
- Reducing the efficiency of iron absorption in the digestive tract (an increase in the speed of passage of food through the digestive tract, the presence of inflammation in the intestine, surgical intervention on the intestine and stomach, digestive disorders, etc.);
- Increasing the body’s need for iron (during intensive growth, pregnancy, lactation, etc.);
- Decrease in iron intake caused by the peculiarities of nutrition (anorexia, vegetarianism, etc.);
- Acute and chronic blood loss (stomach bleeding from ulcers, bleeding in the intestines, kidneys, nasal, uterine, and other localizations);
- As a result of tumor diseases, prolonged inflammatory processes;
- Reduced synthesis of iron transport proteins (for example, transferrin);
- The destruction of blood cells with subsequent loss of iron (hemolytic anemia);
- Increased intake of calcium in the body – more than 2 g / day;
- The lack of trace elements (cobalt, copper).
The body constantly loses iron with feces, urine, sweat, hair, nails, during menstruation.
Male body loses a day
Iron deficiency often occurs in women because their iron stores are 3 times less than in men. And incoming iron does not always cover costs.
The use of iron supplements in pregnant women to reduce the risk of anemia is justified in the third trimester, and reception continues for 2-3 months after delivery. Additional iron sources are not assigned to full-term newborns in the first 3 months. Preterm supplements are given with iron at an earlier date.
What can reduce the intake of iron with food:
- Excess phosphate in food;
- Oxalic acid in some plants;
- Tannin, giving a tart taste, reduces the absorption of iron;
- Tea reduces iron intake by 60%, coffee by 40%;
- Phytate contained in wheat bran, rice, nuts and corn;
- Excess fiber content in food;
- Substances that neutralize the hydrochloric acid of the stomach – antacids;
- Egg white, soy protein and milk;
- Some preservatives, such as EDTA.
Rules for taking iron
Iron preparations are used to reduce the risk of iron deficiency, as well as in the treatment of anemia.
Traditionally, treatment begins with tablets for oral administration. Preference is given to drugs that can give rapid growth of hemoglobin in the blood with a low risk of side effects.
Usually begin with the appointment of high dosages of iron: 100-200 mg / day. Such an amount of iron can compensate for the body’s costs of producing the right amount of hemoglobin. If you exceed the dosage of 200 mg / day, side effects are much more common.
If the drug is chosen correctly, hemoglobin returns to normal in 15-30 days. When blood counts come to the desired values, the iron supplement continues to be taken for at least 2 months to replenish iron stores (in the bone marrow, liver, spleen).
How to take iron supplements:
- Before meals or during meals. Bioavailability does not depend on the time of day, but there are recommendations to take in the evening;
- It is recommended to drink clean water;
- You can not drink milk, coffee, tea due to reduced absorption;
- Do not combine oral iron supplements with agents that block the production or neutralize the action of hydrochloric acid: antacids (baking soda, phosphalugel, almagel, gastal, renny, etc.), proton pump inhibitors (omeprazole, lansoprazole, esomeprazole, etc.);
- Iron preparations have an effect on the action of some antibiotics, so taking these drugs should be divided in time by 2 hours;
- Do not combine iron supplements with alcohol. Alcohol increases iron absorption and increases the risk of iron intoxication;
- The absorption of iron will not be affected by magnesium (magnesium B6, magnelis, cardiomagnyl, magnesium chelate), but extreme calcium dosages of 2 grams and more can reduce it.
Features of iron preparations
In the case of iron deficiency anemia, two (Fe II) and trivalent (Fe III) iron preparations are taken. Preparations with Fe II have a higher bioavailability than trivalent. Molecular iron in these preparations is enclosed in organic and inorganic compounds, also differing in their bioavailability and tolerability (frequency of side effects).
I. Inorganic salts of ferrous iron
The most frequent representative of inorganic iron compounds in preparations with Fe II is ferrous sulfate. It is characterized by relatively low bioavailability (up to 10%) and frequent side effects associated with irritation of the mucous membrane of the digestive tract.
Such iron preparations are usually less expensive than analogues. The most popular representatives that can be found in pharmacies: Sorbifer Durules, Aktiferrin, Aktiferrin compositum, Ferro-Folgamma, Fenuls, Tardiferon, Feroplekt. To increase the bioavailability of iron in the composition often include ascorbic and folic acid.
A fairly modest choice will give you pharmacies if you want to buy an iron supplement with ferric chloride. Ferrous iron, part of the inorganic salt, will not please the bioavailability of 4%, and does not guarantee the absence of side effects. Representative: Hemofer.
Ii. Organic salts of ferrous iron
Combining higher bioavailability of Fe II and organic salts, bioavailability can reach 30-40%. Less common side effects associated with the use of iron. Medication is well tolerated during pregnancy and lactation. In the cons can be written a higher cost of these drugs.
- The combination of organic salts of gluconates of iron, copper and manganese is presented in the French preparation Totem, which is produced in the form of a solution.
- The combination of iron fumarate and folic acid is hidden in a capsule of Austrian origin – Ferretab.
- The complex composition of chelated forms of iron gluconate, ascorbic acid, and herbal synergists can be found in Iron Chelate – Bad American production. It is not a drug, but serves as an excellent source of easily digestible iron with virtually no side effects.
Iii. Inorganic compounds of ferric iron
Characterized by low bioavailability of these forms of iron (up to 10%). The most frequent forms of release are injections.
This form of drugs solves the problem of the manifestation of side effects associated with irritation of the gastrointestinal mucosa. But it adds a number of conditions necessary for fulfilling the conditions for administering the drug and the associated side effects and complications. They are the drugs of choice for severe forms of anemia, with pathologies of the digestive tract, leading to a decrease in the absorbability of iron.
Active ingredient – complexes with iron hydroxide. Folic acid is used as an adjunct. Popular representatives: Ferrum Lek, Maltofer, Maltofer Fall, Biofer, Ferinzhekt, Ferroxide, Ferropol, Venofer, CosmoFer, Likferr, Monofer.
Iv. Organic Ferric Compounds
Presented by the Spanish drug Ferlatum in two versions: with folic acid and without. Available in the form of oral solution.