Characteristics of Blood Gas in Response to Iron Treatment and Exercise in Iron-Deficient and Anemic Subjects

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The effects of iron deficiency anemia and iron treatment on blood gas and acid-base balance at rest and during exercise were studied. Eight Sri Lankan males and 13 females were randomly divided into an iron treatment or placebo group. Their initial hemoglobin (Hb) levels were 6.2±0.5 and 5.5±0.7g/ 100ml (mean±SEM) with serum iron levels of 41±8 and 30±6μg/100ml, respectively. Hemoglobin concentration was increased significantly within 7 days after iron treatment to 7.2±0.4g/100ml. Resting lactate was higher than normal, while base excess, buffer base, and actual bicarbonate were lower, maintaining a normal pH. Heart rates during exercise at a given work load and lactate production following exercise decreased after the elevation of Hb. Venous blood PCO2 rose as Hb concentration increased, preceeding a significant increase in resting O2 content, 16 days after iron treatment. With anemia, O2 delivery is potentially maintained by a shift of the O2-dissociation curve to the right due, in part, to 2, 3-diphosphoglycerate. There was no significant change in PO2 or Hb-O2 % saturation following exercise or iron treatment. These data suggest that severe iron deficiency anemia results in lactate accumulation in blood even at rest but pH is maintained within normal limits. It was also suggested that severe anemia may impair CO2 transport capacity of blood which could limit continuation of muscle metabolism.
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