American Journal of Clinical Nutrition, Vol 21, 1149-1155, Copyright © 1968 by The American Society for Clinical Nutrition, Inc.

Geographic Pathology of Iron Deficiency with Special Reference to India

II. Quantitation of Iron Stores by Repeated Phlebotomy in Indian Volunteers

¹ From the Department of Pathology, All-India Institute of Medical Sciences, New Delhi, India

In this communication, evaluation of iron reserves was based on the estimation of mobilized iron from stores for hemoglobin synthesis in response to repeated phlebotomy.

Thirteen healthy, hematologically normal, adult Indian prisoners from the local jail were selected for phlebotomy study. Whole blood equal to 10% of the red cell mass was withdrawn each week for 4 consecutive weeks. Hemoglobin, hematocrit, reticulocyte count, serum iron, and iron-binding capacity were estimated each week during the period of phlebotomy and the following 6 weeks.

A small stress of removal of blood equivalent to 500-700 mg of iron resulted in decompensation and dieficiency in replacement of removed iron during the period of study in 5 of the 13 subjects. In another four subjects there was questionable evidence of decompensation. This study supports the concept that an iron-deficiency state may exist without manifest anemia, as all the individuals had normal hematological values to start with.