Hello and welcome to the zero definals podcast. My name is Tom and in this episode I'm going to be

talking to you about iron deficiency anemia. And if you want to follow along with written notes on the

topic, you can follow along at serodifinals.com slash iron deficiency anemia or in the hematology section of the zero definals medicine book.

So let's get straight into it. The bone marrow requires iron in order to produce hemoglobin.

Remember that hemoglobin is an essential molecule inside red blood cells that carries oxygen in the blood to the tissues of the body.

There are several scenarios where iron stores can be used up and the patient can become

iron deficient and struggle to create hemoglobin because of the iron deficiency.

These scenarios could be insufficient dietary iron,

increased iron requirements, for example in pregnancy, when iron is being lost, for example,

slow bleeding from a colon cancer, and where there's inadequate iron absorption in the GI tract.

Now iron is mainly absorbed in the duodenum and the geogenum and it requires acid from the

stomach to keep the iron in its soluble form, which is ferrous or FE2 plus.

When the acid level drops, it changes into the insoluble form, which is ferric,

which is FE3 plus. Therefore, medications that reduce the stomach acid, such as proton pump

inhibitors, remember two key examples of Lanzoprosol and Ometprosol, can interfere with the iron

absorption and lead to iron deficiency.

Conditions that result in inflammation of the duodenum or the jejunum, like celiac disease or Crohn's

disease, can also cause inadequate iron absorption. So what are the most common causes? Well, blood loss is the most

common cause in adults, and this could be from heavy menstrual periods, or a chronic blood

loss from a GI source such as a gastrointestinal cancer. Dietary insufficiency is the most common cause in growing children, as they have slightly

higher iron requirements, and it's easy for them not to meet these requirements.

Poor iron absorption and increased requirements in pregnancy are also common causes.

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