IDA

*iron deficiency is a problem in both  
developed & developing countries
 * there is approximately  4 g Fe in the body of adult man of which 2.4 g is present as Hb
* Around 30%of total world population  is anaemic& half of these, 600 million people , have iron deficiency  , 370 million women of childbearing age and young children .
* Anemia is defined as reduction in the number of circulating red blood cells with the resultant of Hb level in the blood below the normal rang  appropriate for age and sex .  
*the anemia is classified on the basis of red cell size & Hb content as
-normal MCV (normocytic anaemia), suggest acute blood loss or anemia of chronic disease 
 - low MCV ( microcytic anemia ) suggest iron deficiency or thalassaemia
- high MCV  (macrocytic anaemia ) suggest vitamin B12 or folate deficiency .  
The most common nutritional anemia is iron deficiency anemia .
IDA : is characterized by the production of small erythrocyte & a diminished level of circulating Hb. This is actually the last stage of iron deficiency & it represent the end point of long period of iron deprivation.
As haemoglobin :
-transport of oxygen
- cell respiration
As myoglobin:
- oxygen storage in muscles
-other functions :
Component  of enzymes , including those involved in immune functions , & cytochromes , which are essential for energy production .
Symptoms and Signs
Pallor
 (reduced amount of oxyhemoglobin in skin or mucous membrane),
fatigue and weakness.
dyspnea (trouble breathing)
. Hair loss 
 Breathlessness on exertion  ,
  Poor appetite
, . .

- Depression   , reduction in work capacity , behavioral and itellectual impairment .
-Twitching muscles     ,  numbness , burning sensations
-Missed menstrual cycle,  Heavy menstrual period -
-Angular cheilitis)
 
Koilonychia (spoon-shaped nails) or nails that are weak or brittle
causes iron-deficiency anemia
1- diets low in iron Iron is obtained from foods in our diet, however, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested. A person unable to have a balanced iron-rich diet may suffer from some degree of iron-deficiency anemia.
2-body changes An increased iron requirement and increased red blood cell production is required when the body is going through changes such as growth spurts in children and adolescents, or during pregnancy and lactation.
. 2
3- gastrointestinal tract abnormalities
Malabsorption of iron is common after some forms of gastrointestinal surgeries. (e.g. resection of the stomach or small bowel which lead to malabsorption of iron & lor vitamin B12 ). Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and result in iron-deficiency anemia.
4- blood loss Loss of blood can cause a decrease of iron and result in iron-deficiency anemia. Sources of blood loss may include GI bleeding, menstrual bleeding, or injury, hemoglobinuria, repeated labour & abortion, parasite , polyps , hemorrhoid
High risk groups for iron deficiency
1- children , adolescent , pregnant & lactating women .
2- menstruating females , those with frank or occult hemorrhoid or surgery and those who use aspirin and other prostoglandine inhibitor drugs due to increased losses .
3- vegetarians
4-malabsorption syndrome, low Vit C intake
Heavy use of tea , coffee , and antacid , high dietary intake of oxalate, phosphate and phytate & chronic exposure to lead and cadmium. 
How is iron-deficiency anemia diagnosed?