When I was pregnant for the first time, I asked myself questions about how much iron to get while pregnant. This led me to do a lot of research and eventually write this post on how much iron to get while pregnant. And after reading it, if you have any more questions on how much iron to get while pregnant, please feel free to leave a comment at the end of this article.
When it comes to pregnancy, you will want to explore as many avenues for your baby’s well-being. So, what should you know about iron?
How Much Iron To Get While Pregnant
Iron supply discrepancies. In the second stage of deficient erythropoiesis, the decreased rate is ascribed to inadequate iron supply to the bone marrow. While Hb has still normal values (>115g/L), ferritin further reduces (<20 μg/L) together with Tf saturation (<16%). Contrariwise, there is an increase of the sTfR (>1.75 mg/dL). When the functional requirements are not met by dietary absorption or storage release, serum iron (i.e., the amount of Fe3+ in the blood bound to Tf) decreases while Tf increases. Because of this liaison, three assays that measure the potential of iron supply are generally performed concomitantly, being the serum iron, the Tf concentration (reported as the quantity of iron that can be bound to Tf = total iron binding capacity, TIBC), and the percentage of Tf saturation (serum iron × 100/TIBC). Serum iron can be measured by either colorimetric assays (most used) or atomic absorption spectrophotometry. The concentration of serum transferrin can be measured by immunologic methods (direct) or throughout the determination of TIBC, whose assay is identical to the serum iron assay, but applies an additional step (saturation of iron-binding sites of the transferrin molecule with excess iron) followed by the removal of the unbound iron. Several analyzers measure also the unsaturated iron binding capacity (UIBC), with TIBC being subsequently calculated by summing UIBC to serum iron. Serum iron, TIBC, and transferrin saturation are indexes of an adequate iron supply, but their utility as screening tools for iron deficiency is limited by several factors, such as the circadian rhythm (e.g., morning peak of serum iron and Tf saturation), diet, and oral contraceptive use .
Nevertheless, a Tf saturation < 16% is known to reflect a suboptimal iron supply for the proper erythrocyte development . Normal values of serum iron range between 65 μg/dL to 170 μg/dL in adult males and 50 μg/dL to 170 μg/dL in adult females. TIBC and Tf saturation normal ranges are 250–450 μg/dL and 20–60%, respectively, in both adult males and females . The serum is the best sample matrix, but also heparin-plasma may be used, whilst EDTA- and citrate-plasma are unsuitable due to the chelating properties of these anticoagulants. Cellular ion demands , the erythroid proliferation rate , and the stainable bone marrow iron  are known to be linked to the concentrations of the soluble form of the serine protease-cleaved membrane receptor (sTfR) that circulates in plasma bound to Tf. Several lifestyle factors affect sTfR, such as smoking, alcoholic drinking, sedentary behaviors, and hypernutrition . Latex-enhanced immunoassays (nephelometry and turbidimetry) and the more recent immunofluorometric assays have been implemented to evaluate sTfR. However, the usefulness of commercial kits is limited by the poor comparability between different tools, comprising the calibrators (free vs. transferrin-complexed form, tissue origin), the antibodies (monoclonal vs. polyclonal), and reporting units (mg/L vs. nmol/L) . This lack of commutability together with the relatively high cost of reagents are some of the reasons why sTfR measurements have not been widely adopted in clinical practice. Normal range of sTfR are 0.30–1.75 mg/dL. The serum is the best matrix and it should be separated within 8 h from blood drawings in order to get reliable results . Of note, the sTfR/serum ferritin ratio may be more reliable than each parameter alone for the identification of iron deficiency.
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