hi everyone. This lesson is on atypical or weird signs and symptoms of iron deficiency. Before we talk about those weird signs and symptoms, let's talk about what iron is and why we need it. So, iron is an essential dietary nutrient, essential meaning that we require it for certain cellular functions, which we're going to talk about in a moment, and it comes from our diet. Some of the dietary sources for iron include meat and leafy green vegetables. So, in the case of meat, iron comes as what we would call heme iron, and this is actually an easier form of iron to absorb, whereas in leafy green vegetables and other vegetables that contain iron, this would be considered non-heme iron, which is more difficult for us to absorb. Now, we need iron for several functions in the body. Iron is required for the synthesis of hemoglobin, myoglobin, and DNA. So, hemoglobin is that protein complex within red blood cells that helps to transport oxygen to tissues. Myoglobin is the protein complex within skeletal muscle that helps to take oxygen out of

the blood for use in skeletal muscles. Iron is also utilized for processes of cell regulation and also important for the electron transport chain, which is involved in energy production. Now, iron efficiency is the most common nutritional deficiency in the world. Now, iron deficiency can cause a wide variety of signs and symptoms and conditions and because it's required for hemoglobin synthesis, an iron deficiency can lead to an iron deficiency anemia. So, iron deficiency anemia leads to particular findings, including fatigue, pallor, conjunctival pallor. Pallor would be where the skin is more pale, conjunctival pallor would be where the conjunctiva of the eyes are more pale, and this would be seen in cases where hemoglobin is quite low, and then weakness as well. So, these are some of the more common signs and symptoms that can occur with iron deficiency anemia, and they can also occur in other types of anemia, but the topic of this lesson is that in iron deficiency, more specifically, there can be also other atypical or weird signs.

and symptoms, which we're going to talk about in the upcoming slides. So, the first strange symptom we're going to talk about is pica. So, Pica is a craving to eat inedible objects or materials. This actually occurs quite commonly in patients with iron deficiency and can occur in up to 50 percent of patients. Some common examples of inedible objects that patients may crave include dirt, paper, rocks, and pebbles, clay, chalk, crayons, eggshells, coffee grounds, soap, hair, and pet food. So, these are some of the examples, and there are others that I didn't include here, but there is one type of Pica that is more common in iron deficiency that I want to briefly talk about here, and that is known as pagophagium. So, pagophagia is actually going to be more specific to iron deficiency, and it is a craving for and eating of ice. So, patients may crave ice cubes or may want to chew on ice cubes. This can be very important to recognize as this can be a common type of Pica in

Iron deficiency patients. Now, another object that patients may crave that is not Pica-related because it is an edible object is that patients with iron deficiency may crave or eat cold vegetables. An example is celery. So, this is something else I want to mention here. Now, the next atypical finding in iron deficiency can include issues with the nails. These can include koilonychia and brittle nails syndrome. So, fingernail health can be adversely affected by iron deficiency. So, koilonychia can occur in some cases. Now, koilonychia is spoon-shaped nails, and you can see in this image here. So, it is the shape of a spoon. Another important nail finding that can occur from iron deficiency is brittle nail syndrome. In fact, iron deficiency is an important cause of brittle nail syndrome. Now, brittle nail syndrome can be broken down into two hallmark findings. One is onychorexis, and the other one is anicoscisia. So, this is what onychorexis looks like.

and this is what on ecosia looks like. So onychorrhexis is where there is longitudinal ridging on the nail. So if you look here, you can see these longitudinal ridges on the nail. And in onychorrhexis, the nail undergoes splitting and peeling. So those are the two hallmark findings in brittle nail syndrome. And what can also be noted in brittle nail syndrome is that there is increased nail plate fragility. The nails are more easily breakable and they are unable to grow past a certain length. So the nails may not be able to grow very long. So again, iron deficiency can lead to koilonychia and brittle nail syndrome. Now other important clinical features of iron deficiency can be found in the mouth or around the mouth. So mouth signs and symptoms are common in iron deficiency. These include angular cheilitis or koilosis. So this is what angular cheilitis looks like. So it's inflammation and cracking on the corners of the lips. And then we can also see if this ulcers.

or at this stomatitis. So after this, ulcers are also known as canker sores. So canker sores are more likely to occur in patients with iron deficiency. Now another potential finding in iron deficiency is atrophic glossitis. So atrophic glossitis is a smoothened, inflamed tongue. So the word glossitis means inflammation of the tongue. So this is where, instead of the tongue having normal ridging or normal texture, atrophic glossitis leads to a very smoothened tongue, and this again can also occur from iron deficiency. Now another potential finding in iron deficiency can include dry mouth as well. So I also want to mention that here for completeness sake. Another important clinical finding that is associated with iron deficiency is restless legs syndrome, or RLS. So iron deficiency is associated with RLS, and the pathophysiology of RLS involves alterations of iron and dopamine activity in the brain. This is why we can see in association with iron deficiency in restless leg syndrome.

if we were to look at the anatomy of the brain, we're not going to get into the detail of the anatomy here, but I just want to mention a couple places in the brain that are affected in restless leg syndrome. One of them is the substantia, and the other one is the thalamus. These have been demonstrated to have decreased iron in restless leg syndrome, and the substantia Niagara is involved in motor use. Now, certain findings can occur from restless leg syndrome, including this feeling of restlessness in the legs that is worse in the evening or at night, and worsens when beginning to rest, and is improved by moving the legs. So, those are some of the Hallmark findings of restless leg syndrome. Another finding that can occur in iron deficiency that is not related to restless leg syndrome is where patients with iron deficiency are more likely to have leg cramps as well. So, I also want to mention that here as well. Now, another clinical finding that can be found in iron deficiency is reduced

appetite so reduced appetite can occur in some cases of iron deficiency anemia, and these are more likely to occur in children in young adolescents. In some cases, reduce appetite may be related to splenomegaly. So, splenomegaly is an enlargement of the spleen, and the reason why splenomegaly can lead to a reduced appetite is because the spleen is located right next to the stomach. What happens is when there is splenomegaly and enlargement of the spleen, it can get larger and start to push on the stomach. So, the amount of room that the stomach has becomes smaller. The reason why splenomegaly occurs in the first place is that if there is iron deficiency anemia, then the spleen can be utilized to produce more red blood cells. This would be what we would call extramedullary hematopoiesis. Because of the spleen's location, if it's enlarged and starts to push on the stomach, this can lead to what we

would call Early satiety. Early satiety means that you get full quicker, so you may feel hungry. You may then try to eat, but then you become full faster than usual because of that enlarged spleen pushing up against the stomach. Some other atypical findings in iron deficiency include hair and skin findings. So, iron deficiency can lead to hair and skin issues. Some of these include thinning hair and hair loss. And then some other findings can include dry skin as well. So again, thinning hair, hair loss, and dry skin can occur in iron deficiency. Although many causes can lead to issues with hair and skin, but if you do see some of those other findings we've talked about in this lesson or related to iron deficiency anemia, these hair and skin issues may be related to iron deficiency. And then we can also see neurological and psychological symptoms in iron deficiency as well. So, some neurological and psychological symptoms can occur from an iron deficiency and iron deficiency anemia. Some of the signs and symptoms that can occur in iron

deficiency include the following paresthesia. So, paresthesis are numbness and tingling sensations in different parts of the body, especially on the arms and the legs. Anxiety and depression can also be associated with iron deficiency as well, and patients with iron deficiency can also be more likely to be irritable. And there can also be findings in younger individuals where they start to have poor academic performance. So, this can be another finding in iron deficiency as well. So, if you want to learn more about other signs and symptoms of iron deficiency, please check out my full lesson on this topic. And if you haven't already, please like and subscribe for more lessons like this one. Thanks much for watching and hope to see you next time.

Weird Symptoms of Iron Deficiency | Nails, Tongue, Skin, Hair & Others

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