Issue 2 • 2021

Australian-European research improves best practice updates for managing iron deficiency

Iron deficiency is experienced by two billion people worldwide, including one in 20 Australians. Around 12 per cent of Australian women are iron deficient, and one in 10 Australians have experienced iron deficiency at some point in their lifetime.
As a major cause of anaemia – a lack of oxygen-carrying red blood cells or haemoglobin – those who are iron deficient, especially children, are susceptible to serious long-term health consequences. These include heart complications and child developmental issues. Iron deficiency can also be a sign of underlying health conditions such as bowel cancer and coeliac disease, making it a serious worldwide health problem. A new review in The Lancet by Australian and European researchers updates evidence-based best practice for clinicians to effectively diagnose and manage iron deficiency, contributing to significant long-term health benefits for Australians and others around the world experiencing iron deficiency. The Clinical Seminar was published by Walter and Eliza Hall Institute (WEHI) clinician scientists: Associate Professor Sant-Rayn Pasricha FRACP and Associate Professor Jason Tye-Din FRACP (both also physicians at The Royal Melbourne Hospital), Professor Martina Muckenthaler (University of Heidelberg in Germany) and Professor Dorine Swinkels (Radboud University Medical Centre in the Netherlands). Associate Professor Pasricha’s laboratory focuses on new solutions for resolving anaemia in low-income settings. These include a program of randomised controlled trials which are testing the use of modern intravenous iron drugs for pregnant women with anaemia in villages of Bangladesh and Malawi. He also undertakes basic experimental research with the aim of revealing new information on fundamental mechanisms of the body’s iron regulation. “There have been tremendous advances in our understanding of the biology of systemic iron homeostasis, which are translating into breakthroughs in how iron deficiency is diagnosed, investigated and treated. “It’s important physicians consider the underlying cause of iron deficiency in their patient. “It’s critical to distinguish absolute iron deficiency, where body iron stores are diminished, from functional iron deficiency, where iron is present in the body but withheld from erythropoiesis,” says Associate Professor Pasricha. Associate Professor Tye-Din, a gastroenterologist, often sees patients with iron deficiency caused by gastroenterological conditions. “It’s crucial that the cause of iron deficiency is properly investigated rather than simply instructing patients to take iron supplements. Doctors should take iron deficiency seriously and investigate why it is happening otherwise serious health problems can be overlooked." With a research interest in coeliac disease, a common cause of low iron, Associate Professor Tye-Din’s contribution to the clinical updates was to highlight the importance of looking for a cause of iron deficiency rather than just simply treating the low iron. “In some cases, these [causes of low iron] can be potentially life-threatening, like colorectal cancer, or greatly impact health and quality of life, like coeliac disease,” says Associate Professor Tye-Din. The best practice updates are a new hope for those experiencing iron deficiency and will better equip physicians in Australia and the world with clear-cut information on how best to improve the diagnosis and management of iron deficiency in patients.
© 2021 The Royal Australasian College of Physicians