Dr Joseph Kamugisha It’s rare in our culture to go for routine check-ups without any health discomfort. But some body deficiencies develop in a tricky manner and only manifest or become symptomatic at an advanced stage. Iron deficiency is one of the body ailments with tricky clinical presentation. Iron is a key mineral component in our body. Iron plays various biochemical roles in our body most importantly it’s a central element in hemoglobin function that helps in blood oxygen circulation. Iron deficiency is common in patients with anemia but can occur secondary to other body ailments as well. Iron deficiency in anemic patients occurs due to death or reduced dysfunction of red blood cells. Anemia due to iron deficiency is reversible in most cases especially if there is no other associated health problems. Patients with iron deficiency usually present with symptoms like tiredness and generalised body weakness, rapid heartbeat, shortness of breath, especially on effort, increased risk of infections, and lightheadedness. However,, it’s possible to suffer from anemia and iron overload at the same time because some types of anemia can lead to iron overload. Symptoms such as generalised body weakness and lethargy are common in both cases of anemia and iron overload. Therefore, you need to consult your physician for accurate diagnosis once you feel any of the mentioned symptoms. An early diagnosis will always help get a better and deserved solution. Taking iron supplements before completion of diagnostic measures is not acceptable. Iron supplements might lead to iron overload in anemic patient. Based on an individual lifestyle, it is always advisable to carry out blood tests for iron regularly and at least two times a year. Once there is an indication of low serum iron levels especially in asymptomatic patient for more than 18 months, the physician will have to carry out advanced investigative blood work to trace the origin. Low iron levels in the body can originate from medications, chronic health conditions like asthma or colitis or dietary habits. There are usually two types of dietary iron; non-heme and heme. The heme iron is found in meat, fish and poultry only. The heme iron is much better absorbed than the non-heme iron found in vegetables, iron supplements and fortified foods. This information also explains why some vegetarians may have to take iron supplements when they suffer iron deficiency. Foods with high calcium content like milk interfere with iron absorption. High-fiber meals like the grains that contain phytates diminish the amount of iron absorbed in the blood stream. Vitamin C and other acids that are present in fruits, fruit juices and some vegetables increase iron absorption. Another phenomenon associated with iron overload is hemochromatosis associated with genetic mutations that cause excess absorption of iron by some vital organs in the body. Common complications with this kind of overload include; joint pains, generalised body weakness, sexual dysfunction, liver damage as seen in cirrhosis, heart failure, and diabetes mellitus. For diabetes mellitus, this occurs due to the reduction of pancreatic enzyme activity as well as insulin secretion. The potent solution for iron overload is frequent blood donation to minimise excess iron that gets deposited in some vital organs like the heart, liver and pancreas. For the heart; usually associated with cardiac arrhythmias and eventually chronic heart insufficiency. For the liver; it’s associated with liver cirrhosis and sometimes can lead to liver cancer. For the pancreas as said before the direct complication is diabetes mellitus. Donation of blood by people with high levels of stored iron helps reduce their insulin sensitivity and diminishes the risk of diabetes. While the risk of cancer from too much iron is very low except in people with genetic mutations or hemochromatosis. The evidence has been indicated in the links between high levels of red meat consumption and very few cases of colon cancer. Iron overload is also associated with neuro-degenerative diseases like the Parkinson’s syndrome and Alzheimer’s disease.