Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1969 Dec;45(530):747–753. doi: 10.1136/pgmj.45.530.747

Controversy on iron needs, intake levels, deficiency stigmata and benefits from iron supplementation

Alexander R P Walker
PMCID: PMC2466943  PMID: 4905446

Abstract

At present there is considerable controversy over many aspects of iron nutrition, including: (1) iron needs and intake levels; (2) the bearing of iron intake on haematological levels; (3) iron deficiency anaemia and deficiency stigmata; and (4) iron therapy, prophylaxis, and the haematological and clinical benefits accruing.

Differences of opinion prevail because of inadequacies of knowledge of the level of haemoglobin (or other parameter of iron status) below which unequivocal signs and symptoms of ill-health become manifest in the major proportion of those affected. Difficulties arise equally from lack of knowledge of the level of haemoglobin above which no clinical benefit, short-term or long-term, can be detected from iron supplementation.

Clarification of the situation can be obtained only by carrying out the same meticulous and time-consuming procedures that have been used in respect of requirements and deficiency stigmata of other nutrients. Comprehensive iron depletion studies, real and simulated, and repletion studies, including the use of placebos, will be required.

Epidemiological investigations bearing on haematological status and morbidity will also need to be undertaken, and include groups of subjects in both Western, and developing countries.

Full text

PDF
747

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andelman M. B., Sered B. R. Utilization of dietary iron by term infants. A study of 1,048 infants from a low socioeconomic population. Am J Dis Child. 1966 Jan;111(1):45–55. doi: 10.1001/archpedi.1966.02090040081007. [DOI] [PubMed] [Google Scholar]
  2. CONRAD M. E., CROSBY W. H. The natural history of iron deficiency induced by phlebotomy. Blood. 1962 Aug;20:173–185. [PubMed] [Google Scholar]
  3. Cochrane A. L., Elwood P. C. Iron deficiency without anaemia. Lancet. 1968 Mar 16;1(7542):591–591. doi: 10.1016/s0140-6736(68)92859-6. [DOI] [PubMed] [Google Scholar]
  4. DUNCAN D. L., HYTTEN F. E. Iron-deficiency anaemia in the pregnant woman and its relation to normal physiological changes. Nutr Abstr Rev. 1956 Oct;26(4):855–868. [PubMed] [Google Scholar]
  5. Davis R. H., Jacobs A., Rivlin R. Dietary iron and haematological status in normal subjects. Br Med J. 1967 Sep 16;3(5567):711–712. doi: 10.1136/bmj.3.5567.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Elwood P. C. Some epidemiological problems of iron deficiency anaemia. Proc Nutr Soc. 1968 Mar;27(1):14–23. doi: 10.1079/pns19680005. [DOI] [PubMed] [Google Scholar]
  7. Elwood P. C., Waters W. E., Greene W. J., Sweetnam P., Wood M. M. Symptoms and circulating haemoglobin level. J Chronic Dis. 1969 Feb;21(9):615–628. doi: 10.1016/0021-9681(69)90034-4. [DOI] [PubMed] [Google Scholar]
  8. FINCH C. A. IRON BALANCE IN MAN. Nutr Rev. 1965 May;23:129–131. doi: 10.1111/j.1753-4887.1965.tb02108.x. [DOI] [PubMed] [Google Scholar]
  9. FOY H., KONDI A. Anaemias of the tropics; relation to iron intake, absorption and losses during growth, pregnancy and lactation. J Trop Med Hyg. 1957 May;60(5):105–118. [PubMed] [Google Scholar]
  10. FRY J. Clinical patterns and course of anaemias in general practice. Br Med J. 1961 Dec 30;2(5269):1732–1736. doi: 10.1136/bmj.2.5269.1732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. KERR D. N., DAVIDSON S. The prophylaxis of iron-deficiency anaemia in pregnancy. Lancet. 1958 Sep 6;2(7045):483–488. doi: 10.1016/s0140-6736(58)91281-9. [DOI] [PubMed] [Google Scholar]
  12. Kilpatrick G. S. The presymptomatic diagnosis of anaemia. Proc R Soc Med. 1966 Nov;59(11 Pt 2):1220–1222. doi: 10.1177/003591576605911P211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. LILLIE E. W., GATENBY P. B., MOORE H. C. A survey of anaemia in 4,314 cases of pregnancy. Ir J Med Sci. 1954 Jul;(343):304–310. doi: 10.1007/BF02952961. [DOI] [PubMed] [Google Scholar]
  14. MAGEE H. E., MILLIGAN E. H. M. Haemoglobin levels before and after labour. Br Med J. 1951 Dec 1;2(4743):1307–1310. doi: 10.1136/bmj.2.4743.1307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. MANN G. V. THE CONCEPT OF PREDISPOSITION. Arch Environ Health. 1964 Jun;8:840–845. doi: 10.1080/00039896.1964.10663765. [DOI] [PubMed] [Google Scholar]
  16. Mitchell R. G. Nutritional deficiencies in infancy. Proc R Soc Med. 1966 Nov;59(11 Pt 1):1073–1075. doi: 10.1177/003591576605911P106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Murphy E. A., Abbey H. The normal range--a common misuse. J Chronic Dis. 1967 Feb;20(2):79–88. doi: 10.1016/0021-9681(67)90099-9. [DOI] [PubMed] [Google Scholar]
  18. STURGEON P. Studies of iron requirements in infants. III. Influence of supplemental iron during normal pregnancy on mother and infant. B. The infant. Br J Haematol. 1959 Jan;5(1):45–55. doi: 10.1111/j.1365-2141.1959.tb04012.x. [DOI] [PubMed] [Google Scholar]
  19. WALKER A. R. Problems in nutritional supplementation and enrichment. Am J Clin Nutr. 1963 Feb;12:157–160. doi: 10.1093/ajcn/12.2.157. [DOI] [PubMed] [Google Scholar]
  20. Walker A. R. Interpretation of biological data on one ethnic or regional group may not be equally applicable to other groups. Am J Clin Nutr. 1967 Sep;20(9):1025–1039. doi: 10.1093/ajcn/20.9.1025. [DOI] [PubMed] [Google Scholar]
  21. Wood M. M., Elwood P. C. Symptoms of iron deficiency anaemia. A community survey. Br J Prev Soc Med. 1966 Jul;20(3):117–121. doi: 10.1136/jech.20.3.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. YUDKIN J. Fatty acids and coronary disease. Practitioner. 1961 Aug;187:150–158. [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES