Hulk has She Hulk, Captain America has Captain Marvel but Iron Man does not have his female counterpart. Is it because Marvel has taken the deficiency of iron more pressingly than the female masses and has realised that releasing something like ‘Iron Woman’ or ‘Iron Lady’ would be too ironic? Iron deficiency among women is now one of the most common health concerns. With symptoms overlapping other diseases, women generally do not realise that their body is demanding a vital micronutrient instead of a treatment for a disease they are not even suffering from. It is vital that this deficiency is detected before it is too late.

This article will address the issue of iron deficiency. Its causes, symptoms, treatment, cure and other topics regarding the same will be briefly elucidated but primarily in regard to the Indian female population.

According to a report by World Health Organisation, nearly 37% of pregnant women and 30% of women aged between 15-49 years suffer from iron deficiency worldwide. Citing data from the National Family Health Survey (NFHS) statistics, the report claims that among all women aged 15-49, the prevalence of anaemia has risen to 57 per cent in 2019-21 (NFHS-5) from 53 per cent in 2015-16 (NFHS-4). That is, more than half of the female population in our country is iron deficient! India has also recorded the third-highest female population of non-pregnant women suffering from iron deficiency. Viewing the regional variations, Assam has observed the steepest rise in deficiency cases followed by Jammu & Kashmir and Ladakh trailing by. Sharp rises have also been noted in eastern states including West Bengal. Aren’t these figures and data alarming? The numbers speak for themselves that it is the crying need of the hour to treat this issue among women before these numbers have a humongous upsurge and pose as a scathing medical emergency that nobody could have imagined.

CAUSES

The above-mentioned statistics should not be misunderstood in the sense that men are not iron deficient. Men too are iron deficient but the figures concerning women are daunting. The issue becomes even more underlined when it affects the reproductive health of women. Why is this discrepancy observed? It is because women lose a lot of blood due to menstruation and pregnancy. The make-up for this loss of blood requires excessive iron. Iron obtained from a regular diet barely suffices for normal body function, how can it keep up to these excessive demands?

According to Professor Aparajita Chattopadhyay of the International Institute of Population Sciences, one of the paramount causes for this deficiency is the lack of nutritional diversity an Indian middle-class plate serves. With the absence of high-quality proteins, micro-nutrients, etc, it becomes apparent as to why we suffer from such deficiencies. The income levels of our people foremostly limit their dietary options because people believe in saving their pockets than their lives. Low income leads to minimal exposure to some exotic fruits and vegetables, restricting the Indian masses to potatoes, cauliflowers, etc. Also, the highly compromised quality of fruits and vegetables available commonly affects the health cynically. One is forced to stick to these inferior-quality goods because the organic farm products are priced more than they should be. Meagre knowledge regarding the nutritional values of different fruits and vegetables can also be blamed for such deficiencies. Micro-nutrients (including iron) are found in specific fruits and vegetables. Knowing these sources and including them in your daily meals can cater the problem easily. However, a lack of awareness in this regard prohibits us from maintaining a balanced diet. More awareness about these micro-nutrients and their sources needs to be engendered so that people stick to natural sources rather than feigned lab-made supplements. This article will also address this issue in the latter part.

WHAT CAN IRON DEFICIENCY LEAD TO?

Any deficiency is a potential disease if not detected and treated in time. The same is the case for iron deficiency. A simple lack of a micro-nutrient can actuate into a grave disease, especially for women. When left untreated, it can pave the way for several health issues like heart complications, acute headaches, fatigue, dizziness, mouth ulcers etc.

The deficiency leads to complications in pregnancies, risking both mother's and fetal health. It can also curtail the growth and development of babies.

SIGNS AND SYMPTOMS

As previously mentioned, symptoms of iron deficiency overlap with other diseases, some grievous ones, leading to confusion, wrong treatment and ultimately ignorance. For the treatment of any disease, however big or small, it is important that it is detected in time. One needs to be vigilant towards the symptoms the body shows before the disease takes up a massive and incurable form.

Every disease has three forms or perhaps stages, namely mild, moderate and severe and each stage has its own symptoms to discern from each other. The symptoms for different stages of iron deficiency are discussed below-

• Mild: Symptoms of mild iron deficiency are subtle which include feeling grumpy, weak or tired more often than usual, headaches, finding difficulty in concentrating at a particular task, etc. Feeling grumpy, tired and having headaches are also linked to problems due to hormonal imbalance during puberty among girls. These symptoms get masked under pre-menstrual problems and hence, women turn a blind eye to these signs.
• Moderate: Symptoms for this stage include extreme weakness and tiredness, shortness of breath, pale or yellowish shin, irregular heartbeat, chest pain, cold hands and feet, etc.
• Severe: The symptoms for this ultimate stage comprise abnormal paleness of skin, increased heart rate which is called tachycardia, sore and swollen tongue, etc. Cravings for peculiar things such as dirt and ice (a condition called pica), which are usually blinked at, actually stipulate towards the extreme case of the deficiency.

Medically, this condition is determined through blood tests which check complete blood count (CBC), haemoglobin levels and ferritin levels (ferritin is a blood protein containing iron) of the patient.

TREATMENT

Several methods are opted to treat iron deficiency. The customarily used ones are mentioned below-

Iron supplements, also called iron pills or oral iron, help increase the iron in your body. This is the most common treatment for treating iron-deficiency. It often takes three to six months to restore your iron levels to normal. Doctor generally prescribes these supplements during pregnancy. Consult your doctor if you have side effects such as a bad metallic taste, vomiting, diarrhoea, constipation, or upset stomach. Your doctor may suggest taking your supplements with food, lowering the dose, or trying a different type of iron supplement.

Intravenous or IV iron is sometimes used to put iron into your body through one of your veins. This helps increase iron levels in your blood. It often takes only one or a few sessions to restore your iron levels. People who have serious iron-deficiency or who have long-term conditions are more likely to receive iron this way. Side effects include vomiting or headaches right after the treatment, but these are usually temporary and go away within a day or two.

Blood transfusions quickly increase the amount of red blood cells and iron in your blood. They may be used to treat serious iron deficiency anaemia.

PREVENTION

One of the first proverbs that children are taught is “prevention is better than cure”. But how many of us actually abide by that? A disease not only tampers physical health, but also adversely affects mental and psychological well-being. Hence, it is better to prevent the disease by keeping an eye on the symptoms and maintaining a balanced diet.

In light of the issue being addressed in this article, that is iron deficiency, the following section will discuss some iron-rich sources to prevent this health concern.

It is also always a good idea to help the body keep iron levels where they need to be by maintaining a healthy diet that includes good sources of iron and vitamin C.

• Good sources of iron include beans, dried fruits, eggs, lean red meat, salmon, iron-fortified bread and cereals, peas, tofu, and dark green leafy vegetables.
• Vitamin C-rich foods such as oranges, strawberries, and tomatoes help your body absorb iron.
• Ensure that toddlers eat enough solid foods that are rich in iron.

A question might arise that what is the apt amount of iron intake for an individual? The answer is- it depends on a person’s age and sex. For women, the additional parameters are whether they are pregnant or lactating.

Generally, a diet that includes beans, dried fruits, eggs, lean red meat, salmon, iron-fortified bread and cereals, peas, tofu, and dark green leafy vegetables will provide the iron level that your body needs.

This article has created an outline for this issue and people, especially women, who are on the precipice of initiating this issue in their body, can take this as a wake-up call and those of us who have already detected the deficiency can work on it before this deficiency further exacerbates.

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