Iron deficiency principles

Besides anemia associated with cancer and CKD, anemia of chronic disease can result from inflammatory processes and occurs commonly in autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus. In treating these types of anemia of chronic disease, the most important principle is treating the underlying disease. These patients also may have iron deficiency and should be treated in the manner already discussed. Erythropoietin therapy such as epoetin-alfa therapy at a dose of 150 units/kg three times a week also may be used in these patients. 

Ahmad I, Gibson PR. Management of iron deficiency in patients admitted to hospital time for a rethink of treatment principles. Intern Med J 2006 36 347-54. 

The discussion of the defects in FeO has so far been only structural. Now we turn our attention to the balancing of the charges within the crystal. In principle the compensation for the iron deficiency can be made either by oxidation of some Fe(II) ions or by reduction of some oxide anions. It is energetically more favourable to oxidise Fe(II). For each Fe vacancy, two Fe cations must be oxidised to Fe ". In the overwhelming majority of cases, defect creation involves changes in the cation oxidation state. In the case of metal excess in simple compounds, we would usually expect to find that neighbouring cation(s) would be reduced. 

Galian P, Thibault H, Preziosi P and Hercberg S (1992) Interleukin 2 production in iron-deficient children. Biol Trace Element Res 32 421-426. Gibson RS (1990) Principles of Nutritional Assessment. Oxford University Press, New York. 

GENERAL THERAPEUTIC PRINCIPLES The response of iron-deficiency anemia to iron therapy is influenced by several factors, including the severity of anemia, the ability of the patient to tolerate and absorb medicinal iron, and the presence of other complicating illnesses. Therapeutic effectiveness is best measured by the resulting increase in the rate of production of red cells. The magnitude of the marrow response to iron therapy is proportional to the severity of the anemia (level of erythropoietin stimulation) and the amount of iron delivered to marrow precursors. 

Hoffman, R. et al.. Disorders of iron metabolism Iron deficiency and overload, in Hematology Basic Principles and Practice, 3rd edn, Churchill Livingstone, Harcourt Brace Co, New York, 2000, Chap. 26. 

Iodine is essential in the mammalian diet to produce the thyroid hormone thyroxine deficiency in humans causes goitre. Collectively, deficiencies of iodine, iron, zinc and vitamin A in humans are thought to be at least as widespread and debilitating as calorie deficiencies (Welch and Graham, 1999). The main source of iodine in soils is oceanic salts rather than parent rock, and so deficiency is most widespread in areas remote from the sea (Fuge, 1996). In principle deficiency is easily corrected with dairy supplements. However in practice this is not always feasible. Addition of iodate to irrigation water has successfully corrected widespread iodine deficiency in parts of China where the usual methods of supplementation had failed (Cao et al., 1994 Jiang et al 1997). However there is not much information on the behaviour of iodine in soil and water systems. 

The lack of emphasis on the relationship between basic chemical principles and chemical health and safety is a serious deficiency in chemical education. Health and safety is a valid application of chemical science and is a large component of many chemistry-related professions. Failure to directly address health and safety leads to poor chemical handling when students enter laboratories and other work environments. Ironically, safety is a basic concern of nearly every person. This direct relationship provides an excellent opportunity for chemical educators to apply science to the lives of students, achieving a high level of buy-in, yet most instructors do not take advantage. 

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