Diet is key in ensuring balanced levels of iron in body, say haematologists

The prevalence of iron-deficiency anaemia in India is 10% to 20% higher when compared worldwide. It is estimated that 53% of Indian women and children suffer iron deficiency as against 29.3% to 39.8% globally. On the other hand, India also tops in people with Thalassemia, one of the biggest causes of iron overload in children.

Diet is the key in ensuring balanced levels of iron in the body, emphasised haematologists at The Hindu-Naruvi Hospitals joint webinar on role of iron in human health.

The Sunday (March 30, 2025) webinar was the seventh in a series of 15 under the collaborative Health India Happy India initiative.

The panellists highlighted why iron was the most important biocatalytic element and how shortage or excess of it could mess up the body’s organs.

Padma Shri awardee Mammen Chandy, who is currently working as senior consultant, physician, and haematologist at Naruvi Hospitals, Vellore, said iron provides Haemoglobin (Hb), a protein in the Red Blood Cells, that carries oxygen from the lung to the tissues and executes an important role in enabling the body to live and function well.

An individual’s daily diet should include an iron intake of 7mg/1000 kcal, he said. While it is easier to absorb Iron from animal proteins (up to 27 to 30%) than plant-based food (less than five%), it is also important to excrete excess iron from the body.

The body can naturally excrete only 1% of the protein absorbed through bile, urine, menstrual blood loss, exfoliated cells of skin and epithelial cells of gastro-intestinal tract. “Right amount of iron in the body helps to maintain maternal health, healthy muscles, bone marrow and immune system and regulate proper growth and development in children,” Dr. Chandy added, urging people to eat a normal healthy diet and avoid iron supplements if Hb is good.

His colleague, Mathumithra T, consultant, Clinical Haemotology, delved in detail on deficiency in adults, its causes, diagnosis, treatment and management. She said the body goes into iron-deficient state due to decreased dietary intake, increased physiological demands, inflammation due to chronic diseases, increased needs during pregnancy, infancy and chemotherapy and iron malabsorption due to stomach disorders.

Fatigue, exercise intolerance, headache and apathy, difficulty in focussing, brittle nails, bald smooth tongue, pale conjuctiva and skin, loss of hair are all early signs of iron-deficiency anaemia that need to be recognised by the people, Dr. Mathumithra said.

But one can be iron-deficient without anaemia also and when Hb starts decreasing it is the final manifestation warranting medical intervention, she added.

Basic lab tests

Dr. Revathi Raj, senior consultant and paediatric haematologist from Apollo Hospitals, Chennai, reiterated how iron ties up all that one feels inside and how pale one looks on the exterior. Young girls on weight loss diets, young adults on taxing jobs, multi-tasking women, children with unusual food cravings (such as raw rice, chalk pieces, clay), individuals unable to focus are at risk and need to get the basic lab tests done for blood count and also be fed properly, she said.

“For non-vegetarians, meat and poultry are good source of iron and vegetarians can fulfill their iron requirement from fortified cereals, spinach, broccoli, millets, pumpkin seeds, tofu, cashews, oats, quinoa, lentils at home. In case of iron deficiency, medically prescribed iron supplements are recommended as the dosage and periodicity varies depending on the age group,” Dr. Revathy added.

While there are health benefits of iron, too much of it can also adversely impact organs of the body, warned Ramya Uppuluri, consultant paediatric haematologist, Apollo Hospitals, Chennai. Speaking on body’s challenges in eliminating excess iron and how to manage iron overload, she highlighted the stages of toxicity and also focussed on Thalassemia, which is a huge public health problem in India.

“India has 40 million carriers of Thalassemia including 1,00,000 Thalassemia-majors, 50% of whom will not survive beyond the age of 25,” she said. There are 10,000 livebirths of Thalassemia-major every year while the country’s blood transfusion burden is 2,00,000 units a year. “Thalassemia — a condition in which synthesis of Hb is impaired — can be prevented and controlled by screening, pre-natal diagnosis, genetic counselling, health education and awareness,” Dr. Ramya said, urging people to come forward for blood donation.