Iron deficiency is defined as having a ferritin level of under 40ng/ml or iron saturation of Ferritin under 20%.
Iron deficiency is the most common cause of Chronic Telogen
Effluvium ( CTE) in premenopausal women ('During one period, a woman will
lose around 10-15 mg of iron, while throughout a pregnancy around 600-1000mg
will be lost) . 72% of women in the premenopausal group were found to have iron
deficiency as the cause of Chronic Telogen Effluvium (CTE).
In postmenopausal women; medications are the most common cause of
telogen effluvium.
The
loss of this ferritin from the follicle cells can affect the ability of the
hair to grow. This leads to the development of vellus (non pigmented fine
hairs), which can be an early indication of deficiency. The presence of vellus
hairs is easily mistaken for miniaturized hair seen in androgenic alopecia. We
should note here that Iron deficiency hair loss could therefore mimic the
pattern of androgenic alopecia hair loss.
When low ferritin
levels and female hair loss coexist, the patient is most likely diagnosed with
Chronic Telogen Effluvium, or CTE. This hair loss condition usually occurs in
women of childbearing age (18-50 years old), and results in evenly-distributed
hair loss. Women with low serum ferritin hair loss usually notice one of two
things:
- Increased loss of hair during shampooing or brushing.
- Less density of hair, as in a thinner feeling ponytail,
or less hair to clip back.
If iron levels
are insufficient to maintain blood health, the body "robs" iron from
other cells. Since hair is not as essential to the body as is blood, the body
often sacrifices the less important function of hair growth for the essential
function of blood maintenance.
It is
important to note that hemoglobin is the standard measure for iron in the
blood, and while hemoglobin levels can diagnose anemia, they do not always
correspond with low serum ferritin hair loss. A woman can have plenty of
hemoglobin, yet still suffer from low serum ferritin levels
Rushton suggests that serum
ferritin concentrations of 40 ng/mL or greater are required for maintaining
good hair while 70ng/ml is required for regrowth
Iron metabolism
Total body iron averages
approximately 3.8 g in men and 2.3 g in women.
Typically about 65% of the iron
is in hemoglobin (in red blood cells) and about 4% in myoglobin (in skeletal
muscle). About 30% of the iron in the body is stored (as ferritin or
hemosiderin) in liver, bone marrow, and the spleen other tissues cells. A small
percentage of the body's iron is in transport between various compartments of
the body (in association with transferrin) or is a component of enzymes in
cells throughout the body.
Iron
Deficiency and Ferritin:
Iron is stored mainly in the
liver, within the iron storage proteins ferritin and hemosiderin. Iron
stimulates the liver to make ferritin, and serum ferritin provides a reliable
estimate of body iron stores. Ferritin is a
protein found inside cells that stores iron so your body can use it later. Some
Ferritin is released in the blood when the cell uses the iron. The amount of
ferritin in your blood (serum ferritin level) is directly related to the amount
of iron stored in your body.
Lower-than-normal
levels may be due to:
- Heavy menstrual bleeding
- Intestinal
conditions that cause poor absorption of iron
- Iron deficiency anemia
The fall of iron stores normally
passes through several stages: lowered iron stores, iron depletion and iron
deficiency anemia.
1) Lowered iron stores: This is indicated when the iron stores are
reduced but not exhausted. No clinical effects are detected.
2) Iron depletion: Shows up in laboratory tests. Hemoglobin concentration may be well below ‘normal’ for that individual’s reference range. This can be detected by Ferittin Test.
3) Iron deficiency anemia: No iron is left remaining in the bone marrow. Hemoglobin production falls to the point where concentration is well below the reference range.
2) Iron depletion: Shows up in laboratory tests. Hemoglobin concentration may be well below ‘normal’ for that individual’s reference range. This can be detected by Ferittin Test.
3) Iron deficiency anemia: No iron is left remaining in the bone marrow. Hemoglobin production falls to the point where concentration is well below the reference range.
It
is important to note, therefore, that iron deficiency (low iron stores, i.e.
low ferritin) can occur even if the patient is not clinically anemic and has
normal haemoglobin levels
The deleterious effects of iron deficiency
are partly due to impaired delivery of oxygen to the tissues and to a
deficiency of iron-containing compounds. Clinical features include restlessness
and irritability lower IQ scores in adolescent girls fatigue in nonanaemic women,
and abnormalities in response to infection and impaired T-cell proliferation.
It is believed that as people
have reduced or do not have red meat intake
There may be a number of reasons why the
amount of iron absorbed is not sufficient. Firstly, only about 10% of ingested
iron is absorbed into the blood each day, and this is dependent on the type of
food in the diet. Certain foods may
inhibit the absorption of iron, such as tanins
found in tea and coffee, also bran
and egg albumin.
One can lose iron by: intestinal
bleeding, excessive menstrual bleeding, poor digestion, long-term illness,
ulcers, and heavy use of anti-acids. [Irritable bowel syndrome too]
Controlling
iron deficiency
You can maximize your iron absorption by
eating a combination of iron-rich foods such as red meat, green, leafy
vegetables, shellfish, egg yolk, nuts and cereals with food or drinks that are
high in vitamin C for example, a glass of freshly squeezed orange juice. Avoid tea until at least an hour after
eating as it contains tannin, which interferes with iron absorption.
One method of controlling iron deficiency in the body is to stimulate the liver to synthesize ferritin, the protein that stores iron in order to maintain the correct balance. Hair follicles are known to contain ferritin, and when the circulating stores of ferritin decline then these stores are called upon to ensure support for more essential cells, such as bone marrow.
One method of controlling iron deficiency in the body is to stimulate the liver to synthesize ferritin, the protein that stores iron in order to maintain the correct balance. Hair follicles are known to contain ferritin, and when the circulating stores of ferritin decline then these stores are called upon to ensure support for more essential cells, such as bone marrow.
Treatment:
1.
Eat a balanced diet that includes plenty of iron. Sources include red meat,
spinach, broccoli, prune juice, kidney beans and chickpeas.
2.
Add Vitamin
C-rich foods
to your diet to help boost absorption of iron: Vitamin C sources are citrus
fruits and juices, berries, green peppers, tomatoes, broccoli and spinach.
3.
Iron supplementation. The use of an
iron supplement may help low ferritin hair loss by adding more iron to your
system. The rationale for iron supplementation is that once the serum level is
raised to the necessary threshold point, hair growth will resume. However, one of
the biggest drawbacks to this type of treatment is that it takes a long time,
because ferritin levels must be increased gradually. Allow 2-3 months for hair
to stop shedding, and 6 - 12 months for new hairs to become long
enough to make a visible impact. Woman
usually needs between 18 and 30 mg dailyExcess iron can accumulate in the body. This increases the risk of heart disease, cancer, and some other conditions that are worse than hair loss.
Many people find that eating red meat is a better option than pills when serum ferritin levels are low. The iron in red meat is absorbed well.
"If you need to take iron
supplements, do not take them at the same time as vitamin E, Antacids, tea or coffee. And choose
an organic form of iron such as ferrous gluconate or ferrous fulmerate.
Inorganic forms of iron, such as ferrous sulfate, can oxidize vitamin E.
Only about 10% of ingested
iron is absorbed into the blood each day, and this is dependent on the type of
food in the diet.
Take after food to reduce GI side effects. Continue treatment for 3 months after the hemoglobin reruns to normal so as to ensure replenish the storage.
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