Measurements For Nutritional Deficiency

Question 1

List the common causes of iron deficiency

Answer 1

Physiological - demand, eg growing children

Pathological - inadequate intake, blood loss, malabsorption (eg coeliac)

Question 2

What are the main causes of iron overload

Answer 2

Can be hereditary - HFE haemochromotosis, non HFE haemochromotosis
Or can be acquired - caused by iron loading anemias, chronic liver disease (hepatitis b or c, alcoholic liver),
or fatty liver (steatosis)

Question 3

What is the role of ferritin in the body? In what type of anemia can it be elevated?

Answer 3

Ferritin is mobilizable stored iron, also an acute phase reactant which is elevated in anemia of inflammation.
Can be falsely elevated in patients with anemia of inflammation AND iron deficiency

Question 4

What is the role of transferrin

Answer 4

Transport of iron

Question 5

What is the role of ‘soluble transferrin receptor’ and what happens to its levels in iron deficiency and why?

Answer 5

Expressed by all cells, allows uptake of iron.

Is upregulated in iron deficiency to enable cells to compete for available iron

Question 6

What is the role of vitamin C in relation to iron

Answer 6

Vitamin c aids the absorption of iron

Question 7

What are the stages leading to iron deficiency anemia and what are the characteristics of each

Answer 7

Iron depletion - Hb normal, ferritin low but above 10ug/L

Iron deficiency - Hb normal, ferritin

Question 8

What is Hepcidin and what does it do?

Answer 8

Hepcidin is a peptide hormone. It regulates iron storage and transport by reducing the concentration of the transmembrane iron transporter ferroportin. This reduces dietary iron absorption, reduces iron exit from macrophages and reduces iron exit from the liver.

Question 9

What are symptoms of iron deficiency?

Answer 9

It’s often asymptomatic but you’re more likely to get symptoms if also anaemiac. These could inclue weakness, headache, irritability, fatigue and brittle nails.

Question 10

What is the most common cause of iron overload?

Answer 10

HFE-haemochromatosis type 1

Question 11

What does a biochemical assessment or iron include?

Answer 11

• Ferritin - reflects iron stores
• Iron
• Transferrin
• % transferrin saturation

Question 12

What test results would you see in iron overload?

Answer 12

Increased transferrin saturation, maybe increased ferritin

Question 13

What is a vitamin?

Answer 13

Any group of organic compound, which are essential for normal growth and nutrition, and are required in small quantities in the diet because the body cannot synthesize them

Question 14

Which vitamins are fat soluble?

Answer 14

A, D, E, K