1) Iron Deficiency needs a new definition!

Medical experience over the last decades has shown that many women suffering from exhaustion, concentration disorders, depressions, sleep disorders, neck tensions and/or headaches, dizziness or hair loss simply need iron, and they need more iron than currently recommended. The barrier opposing this recognition is the wrongly defined threshold value of the iron storage in our body. This fatal error, however, prolongs the suffering of more than just a few patients, particularly of women. Mainly in their interest it’s high time for a rethink.

Are we waiting for the horse to bolt?

The belief that is currently taught and therefore widely held is that an iron deficiency is not manifest until the quantity of this element available in the body has fallen to a low point that is no longer sufficient for normal blood formation, therefore resulting in Iron Deficiency Anemia (IDA).This view, though, totally ignores that even a much lesser Iron deficit can arouse serious as well as protracted afflictions from which the affected patients may suffer for many years.

An essential element in all areas of the body

The most tragic aspect of this system-relevant error in medical education is that women who suffer from depressive states, irritability, sleep disorders, headaches or impaired concentration are generally not suffering from a “psychosomatic” disorder. On the contrary, in these cases it’s not the psychological state that is to blame for the disturbance in bodily functions, but instead a tangible deficit of the body causes not only physical, but often psychological illness as well. So this could in fact be described as a “somatopsych” problem. Iron is not only required for blood formation but also for dozens of other life processes in our organism such as hormone formation, for example, but ultimately for the formation of cell energy – the energy of life itself. Regarding this, it is hardly surprising that a diminished supply of this important element can lead to the type of symptoms described above.

A lost discovery

It was in the middle of the last century, when the Doctors F. Leibetseder and H. Kosanowski, both working at the Innsbruck University Medical Center, already were guided by this experience. They recognized and described this diverse disease pattern for the first time as a syndrome: Iron Deficiency Syndrome. Unfortunately, this knowledge of big importance for public health fell back into oblivion, soon after – for whatever reasons. It was not until 40 years later, in 1998, that this was rediscovered in Switzerland as a result of intense medical practice and described as Iron Deficiency Syndrome (IDS).It evidently is classified as the symptomatic early stage of an Iron Deficiency which shows one or more of the symptoms described above, long before the threatened onset of anemia.

Is the “tailor-made” finding more important than the patient’s state of health?

Our body stores the iron, normally absorbed from food, in form of a specific compound named Ferritin. The value of this iron-deposit can be identified in the blood and represents both the fill level of our iron stores and the iron concentration in the whole organism. Unfortunately, by medical laboratory aspects a drop of this iron-deposit only is taken seriously when the Ferritin value in the blood has dropped under a concentration of 10 nanograms per milliliter (ng/ml). At this point, mostly an Iron Deficiency-Anemia appears, easy to be recognized! The determination of the normal range for Ferritin in the blood – officially still between 10 and 400 ng/ml – was derived based on this dangerous lower limit. According to this definition, a Ferritin value that reaches or exceeds this ominous value of 10 is still considered normal. The bad thing is that this opinion has been declared sacrosanct. The actual state of health of the affected patient with a finding according to these specifications seems to be of little interest. The patient’s discomfort rather is passed on to other areas of medicine – after all it cannot possibly be related  to Iron Deficiency. But the truth looks different, as we know. After all, for a long while it could be observed that many patients, suffering from the symptoms mentioned above, showed Ferritin values well within this so-called “normal” range – for women at the age of menstruating and children within a range of 30 ng/ml on average, for men however between 150 and 200 ng/ml!

Let’s try it with logic!

If a Ferritin value between 10 and 400 were normal indeed, wouldn’t it have to be normal as well that people with stored iron within this range (even in the lower half of the range) would have none of the above symptoms which then disappear after corresponding iron doses?! Yet reality is that people, particularly women at the age of menstruating, often complain about exactly these symptoms. Thus the norm given by reputable university sources seems not to be really credible. Put frankly: it is plainly wrong! The same connection also shows from a different perspective: Patients with the described symptoms having apparently “normal” Ferritin values rapidly become free of complaints as soon as the substitution treatment is completed. And what’s more – their value of iron storage is now well above the “permitted” lower limit. Following successful treatment, measurements are generally in the range between 100 and 200 ng/ml, which experience shows to be ideal. Should a mutually dependent relationship of this nature between the symptoms and optimum Ferritin level not at least attract the attention of any observant physician?

Hitting a medical dead end?

Since Iron Deficiency Syndrome has so far not been recognized – let alone taught – in university medical circles, the affected patients are not recognized, in the first place, as Iron Deficiency patients by their physicians. As a result, the cause of their symptoms remains a long way from being treated. But not only this: patients end up in a medical dead end, a “diagnostic-therapeutic trap”. Their complaints are unnecessarily, endlessly clarified at high costs. At the end of such a physician’s odyssey – far from the shores of the true bodily cause – the patient is pushed from pillar to post and the psychiatrist is often recommended as the last hope and unfortunately also the last port of call.

We do not need to end up here!

However, the findings of Leibetseter/Kosanowski and their rediscovery in Basel show that patients affected by early stage of Iron Deficiency can well be protected from this trap. Most are able to make a full and rapid recovery. This is possible if they are given the missing iron after the laboratory testing – at this point their Ferritin values are often way below 100 ng/ml. It has been documented over many years that two out of three of these patients (over 60 percent and particularly women) get back to health by an individually dosed and closely monitored Iron therapy, and this in a sustainable way. The other way around this means: whenever patients get symptom-free after a corresponding giving of Iron, the diagnosis Iron Deficiency is considered assured. Only those patients who still feel unwell must of course be treated with a different – maybe psychotherapeutic – approach. But this should be the second line treatment! Experience shows that this seemingly automatic “setting of the points” takes place relatively quickly, usually within 4 to 6 weeks.
The realization is optimal if – regarding later sustainability – it can be made according to Swiss Iron System SIS, a diagnosis and therapy system currently offered in Medical Iron Clinics in Switzerland as well as Germany and Austria.

This has long become a political issue

The topic Iron Deficiency, however, also has got a political aspect. According to the World Health Organization (WHO) four of eight billion people suffer from Iron Deficiency. 500’000 of them die each year of Iron Deficiency anemia, the late stage of the extraordinarily widespread Iron deficit which is preventable if treated promptly. Should we accept that we as doctors merely “shrug off” this fact? Can we in all good conscience continue to tolerate the antiquated notion whereby the early stages of Iron Deficiency, which we actually should combat, are considered “normal”? And this simply because it corresponds to the laboratory parameters (which are far too low) applied according to an outdated state of knowledge? Switzerland is the first country whose physicians are in the position to successfully recognize the Iron Deficiency pandemic signalized by the WHO and to treat it. (After all, this affects an estimated one million Swiss residents). If all the Iron Deficiency patients over the globe could be treated though, there would be – extrapolated – 2’666 million less (!) patients on our planet. This Iron Blog is intended to explain the most important aspects of this deficiency syndrome, while also presenting a concept whereby the optimum diagnosis, therapy and prevention can take place. It is the Swiss Iron System (SIS) that shall be of help to patients as well as physicians. Necessarily, current health care policy will also be critically examined in this blog. If all Iron Deficiency patients were recognized and treated at the early stage of Iron Deficiency Syndrome, billions of health insurance premiums could be saved thanks to a healthier population, just to be mentioned.

This is mainly a women’s blog

Because it is mainly women (particularly at the age of menstruating) who frequently suffer from Iron Deficiency this blog is primarily, although not exclusively, written for them. It therefore refers mostly to female patients. Naturally men shall be addressed by this information as well and not to forget the children, those in special who suffer from attention deficit disorder, their parents as well, teachers and pediatricians and not least, psychiatrists overwhelmed by a poor medical diagnostic.
Readers of future blog-entries will find a wealth of important information about diagnostic, treatment and prevention of Iron Deficiency. This blog equips all women with the tools for combating the iron problem. Tools that many physicians are unfortunately lacking. Together – and with a certain direct democracy in a typically Swiss manner – the educated patients will be able to form an important alliance with their doctors. As a result they will be treated successfully and do correct a current knowledge deficit in the world of medicine.

Dr. med. Beat Schaub
First Medical Iron Clinic, Binningen (www.eisenzentrum.org)
Swiss Iron Health Organisation SIHO, Basel (www.siho-global.org)
Practice-based study of SIHO (www.eurofer.ch)

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