An Insight into the Practice of Iron Therapy: Contribution to the On-going Debate with Special Reference to Low- and Middle-income Countries

Abstract

Background: Iron deficiency anemia is a public health problem of a sizable proportion in developing countries. Recently, emerging biochemical knowledge coupled with the discovery of Hepcidin have greatly advanced our understanding of iron metabolism and offered a better insight into its associated pathophysiology. This knowledge should be applied to iron-deficiency anemia therapy to avoid subsequent sequelae of tissue damage associated with reactive oxygen radicals that are catalyzed by iron, because current practices do not include these advances in the treatment guidelines. In the light of recent progress, the existing iron therapy program in many healthcare settings is controversial. This necessitates adjusting the magnitude of iron dose with respect to the very limited iron bioavailability, as gauged by Hepcidin. The current study was therefore aimed to incorporate newly emerging biochemical knowledge into the current iron-deficiency anemia treatment practice Methods: Literature relevant to iron-deficiency studies published in English between 1964 and 2020 and available online was covered. Conclusion: Evidently, the existing iron-therapy schedule is both inefficient and toxic. The intricate metabolism of iron should be translated into a more rational iron intervention program with special bias towards low- and middle-income countries requiring a more individualized approach. Key words: iron deficiency anemia, hepcidin, oxidative stress, iron therapy