Historically (1500 B C) in Ayurvedic literature Charak Samhita described fatigue and pallor due to bloodlessness, which can be cured by Lauha bhasma (Calcified iron). During the same period, Egyptian manual of therapeutics 'Ebers Papyrus' described the disease characterized by pallor, dyspnoea and edema. In Greek literature (1554 - 1700) "Chlorosis/Demeorbo Virgineo or green sickness were described as curable by drinking iron rust dissolved in water or wine.

Anemia is the late manifestation of deficiency of nutrient(s) needed for hemoglobin synthesis. Most of the anemias are due to inadequate supply of nutrients like iron, folic acid and vitamin B12, Proteins, amino acids, vitamins A, C and other vitamins of B-complex group i.e. niacin and pantothenic acid are also involved in the maintenance of hemoglobin level. (1)

In India, anemia affects an estimated 50 percent of the population (2). In women, anemia may become the underlying cause of maternal mortality and perinatal mortality (3). Anemia also results in an increased risk of premature delivery and low birth weights. Iron deficiency in late pregnancy results in poor fetal iron stores (4,5). Latent iron deficiency is known to alter brain iron content and neurotransmitters irreversibly in fetal life and postnatal babies (6). These aspects have been reviewed. (7)

Current knowledge in the development of iron deficiency : (1,2)

Iron deficiency is an end result of a long period of negative iron balance mainly due to poor dietary availability, rapid growth and blood loss. The pathological stages are :

Prelatent deficiency:
hepatic (Hepatocytes and macrophages), spleen and bone marrow show reduced iron stores (Reduced bone marrow iron and serum ferritin).

Latent deficiency:
As the bone marrow iron stores become absent, plasma iron decreases and bone marrow receives little iron for hemoglobin regeneration (Bone marrow iron absent, serum ferritin < 12ug/l, transferrin saturation < 16% and free erythrocyte porphyrin is increased), however, hemoglobin concentration remains normal.

Iron deficiency anemia:
This is a very late stage of iron deficiency with progressive fall in hemoglobin and mean corpuscular volume (Table 1).