What Is Iron? Other Names: Carbonate de Fer Anhydre, Ferric Ammonium Citrate, Lactoferrin
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What is Iron?
This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Iron is a vital micronutrient that plays a crucial role in various physiological processes in the human body. It is essential for the production of red blood cells, muscle cells, DNA replication, and the development of the brain, nervous, and immune systems. Despite its importance, iron deficiency remains the most common micronutrient deficiency worldwide, affecting various populations, including children, female athletes, and vegetarians. Other names include: Atomic Number 26, Carbonate de Fer Anhydre, Carbonyl Iron, Chélate de Fer, Chelated Iron, Citrate de Fer, Elemental Iron, Fe, Fer, Fer Chélaté, Fer Élémentaire, Ferric Ammonium Citrate, Ferric Carboxymaltose, Ferric Iron, Ferric Hydroxide Polymaltose, Ferric Maltol, Ferric Orthophosphate, Ferric Oxide Saccharide, Ferric Sodium Citrate, Ferrous Ascorbate, Ferrous Aspartic Glycinate, Ferrous Carbonate Anhydrous, Ferrous Citrate, Ferrous Fumarate, Ferrous Gluconate, Ferrous Iron, Ferrous Pyrophosphate, Ferrous Succinate, Ferrous Sulfate, Ferrum Phosphoricum, Fumarate de Fer, Gluconate de Fer, Glycérophosphate de Fer, Heme Iron Polypeptide, Hierro, Hierro Quelado, Iron Amino Acid Chelate, Iron Ascorbate, Iron Chelate, Iron Chondroitin Sulfuric Acid, Iron Dextran, Iron Glycerophosphate, Iron Isomaltoside, Iron Polymaltose, Iron Polysaccharide, Iron Sorbitol Citric Acid, Iron Sucrose, Lactoferrin, Orthophosphate de Fer, Orthophosphate Ferrique, Numéro Atomique 26, Polypeptide de Fer de Heme, Pyrophosphate de Fer, Quelato de Hierro, Sodium Feredate, Sulfate de Fer.
Importance of Iron in Development
Iron is indispensable for a child’s proper development at every growth stage. It is crucial for the production of red blood cells and muscle cells, DNA replication, and the development of the brain, nervous, and immune systems. Iron deficiency in children can lead to significant developmental issues, highlighting the need for adequate iron intake through diet or supplementation. A study assessing the impact of nutritional education on children’s iron status found that even non-targeted dietary interventions could significantly improve iron levels, suggesting the necessity of targeted nutritional interventions to manage iron deficiency effectively1.
Iron and Physical Performance
Iron is also critical for oxidative metabolism and exercise performance, particularly in female athletes. Active women are at a higher risk of iron deficiency due to various factors, including menstrual blood loss and increased iron demands from physical activity. Poor iron status can negatively impact overall health and physical performance. Randomized, placebo-controlled trials have shown that oral iron supplementation can improve iron status and potentially enhance physical performance in iron-depleted female athletes. It is recommended that female athletes at risk of iron deficiency be screened regularly and provided with appropriate dietary or supplementation recommendations2.
Iron in Vegetarian Diets
Iron intake and metabolism require special consideration in plant-based diets. There is a common belief that meat is the best source of iron, and a vegetarian diet may increase the risk of iron deficiency. However, studies have shown that vegetarians and vegans can maintain adequate iron levels with proper dietary planning. Research comparing iron intake and metabolism in vegetarians and vegans to a control group found that while the mean daily intake of iron was higher in female vegans, the ferritin concentration, an indicator of iron storage, was significantly decreased in female vegetarians and both vegan groups. This suggests that while vegetarians and vegans can achieve normal iron levels, they may have lower iron stores, indicating the need for careful dietary planning to ensure sufficient iron intake3.
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Uses of Iron
Medical Treatments
Intravenous Iron in Surgery and Chronic Conditions
IV iron reduces the need for blood transfusions in patients undergoing major abdominal surgery and is associated with shorter hospital stays and improved hemoglobin levels post-surgery1 4.
IV iron is used to treat iron deficiency anemia in patients with chronic kidney disease (CKD), improving functional status and cardiac biomarkers in heart failure patients2 9.
However, IV iron in CKD patients is associated with an increased risk of serious adverse events, including cardiovascular issues and infections3.
Nutritional Interventions
Iron Supplementation in Athletes and Infants
Oral iron supplements, often combined with probiotics like Lactobacillus plantarum, can improve iron status and mood in female athletes, although the impact on physical performance is inconclusive5.
Iron fortification in infants, especially in developing countries, can adversely affect the gut microbiome, increasing pathogen abundance and intestinal inflammation6.
Nutritional education for parents can significantly improve iron status in children, highlighting the importance of dietary interventions7.
Physiological Functions
Iron’s Role in Growth and Immunity
Iron is essential for oxygen transport, mitochondrial metabolism, and overall physical performance, particularly in athletes and growing children5 7.
Excessive dietary iron can negatively impact gut microbiota and increase diarrheal risk, as seen in animal models8.
Iron treatment in dialysis patients can modulate immune function, with potential short-term activation of immune pathways but also impaired immune responses with high ferritin levels10.
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Adverse Effects of Iron
Gastrointestinal Issues
Oral iron supplements, such as ferrous sulfate, are associated with gastrointestinal side effects including diarrhea, constipation, and nausea5 7 9.
In infants, iron fortification can lead to increased gastrointestinal issues such as diarrhea and intestinal inflammation4.
Infectious Risks
Iron supplementation can increase susceptibility to infections, including malaria and bacterial infections, due to changes in the gut microbiome and increased pathogen abundance2 3 4 6.
Inflammation
Iron fortification and supplementation can cause intestinal inflammation, as indicated by increased levels of fecal calprotectin2 4.
Adverse Effects in Chronic Kidney Disease (CKD) Patients
Intravenous iron therapy in CKD patients is associated with a higher risk of serious adverse events, including cardiovascular issues and infections6.
Oral iron supplements in CKD patients can also cause gastrointestinal disorders, though they are generally considered safe5 8.
Impact on Development in Infants
Iron deficiency anemia in infants can lead to lower mental and psychomotor development scores, particularly affecting language capabilities and body balance-coordination skills1.
Contrasting Effects with Other Supplements
Zinc supplementation can worsen iron status, while multivitamin supplementation can improve it, indicating that the combination of supplements can influence the adverse effects of iron10.
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How has Iron Improved Patient Outcomes?
Improvement in Quality of Life and Functional Status
IV iron significantly improves quality of life and functional status in patients with chronic kidney disease (CKD) and iron deficiency anemia, as well as in those undergoing major abdominal surgery and colorectal cancer surgery1 4 6.
Patients with non-dialysis dependent CKD receiving IV iron showed numerical improvements in quality of life measures and functional status4.
Reduction in Blood Transfusion Requirements
Preoperative IV iron reduces the need for allogeneic blood transfusions in patients undergoing major abdominal surgery and colorectal cancer surgery1 3 5.
A 60% reduction in blood transfusion was observed in patients receiving IV iron compared to those receiving usual care3 5.
Enhanced Hemoglobin Levels
IV iron leads to greater increases in hemoglobin levels compared to oral iron or no iron supplementation in patients with chemotherapy-related anemia and those undergoing major surgeries1 3 5 8.
In patients with chemotherapy-related anemia, IV iron combined with recombinant human erythropoietin (rHuEPO) resulted in higher hemoglobin increases and improved quality of life8.
Reduction in Hospitalization and Mortality
IV iron reduces the risk of recurrent heart failure hospitalizations and cardiovascular death in patients with heart failure and iron deficiency6.
Lower iron burden, achieved through phlebotomy or IV iron, predicted improved outcomes in patients with peripheral arterial disease, including reduced all-cause mortality and nonfatal myocardial infarction2.
Improvement in Fatigue and Physical Function
IV iron improves fatigue severity and physical function in patients with iron deficiency anemia, including those with chronic kidney disease and cyanotic congenital heart disease4 7 10.
A brief intervention to boost patient expectations before IV iron infusion significantly reduced fatigue at four weeks post-treatment10.
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Iron Mechanisms of Action
Iron and Oxidative Stress
Iron can cause oxidative stress by producing reactive oxygen species (ROS) through the Fenton reaction, leading to lipid peroxidation and cellular damage5 6.
Excess iron is associated with increased oxidative stress markers and inflammation, which can contribute to conditions like obesity and type 2 diabetes5.
Iron in Mitochondrial Function
Iron is a key component of mitochondrial enzymes involved in energy production, such as cytochrome c and aconitase. Iron deficiency can lead to mitochondrial dysfunction and impaired energy metabolism1 3.
Iron repletion can enhance mitochondrial function and improve muscle energetics, as evidenced by faster phosphocreatine recovery times in heart failure patients8.
Iron and Enzyme Regulation
Iron influences the activity of various enzymes, including Na,K-ATPase in erythrocytes, which is modulated by iron levels and oxidative stress6.
Iron-containing enzymes like catalase and aconitase are upregulated by magnetic stimulation, suggesting a role in neuronal survival and function3.
Iron and Inflammatory Pathways
Iron can modulate inflammatory pathways, such as the TNF-α/TNFR1 pathway, leading to apoptosis in liver cells when exposed to superparamagnetic iron oxide nanoparticles10.
Iron overload can increase the expression of inflammatory cytokines and oxidative stress markers, contributing to bone abnormalities and increased bone resorption7.
Iron Homeostasis and Hepcidin
Hepcidin is a key regulator of iron homeostasis, controlling iron absorption and release. Exercise and iron supplementation can influence hepcidin levels, affecting iron availability2 4 9.
Molidustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, can modulate iron metabolism by increasing erythropoietin production and improving iron availability in chronic kidney disease patients4.
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Common Complaints Associated with Iron Use
Gastrointestinal Issues
Traditional oral iron salts are often associated with gastrointestinal toxicity, including symptoms like diarrhea and constipation3 6.
Hypophosphatemia
Intravenous iron, particularly ferric carboxymaltose (FCM), can cause hypophosphatemia, a condition characterized by low serum phosphate levels. This was significantly more common with FCM compared to ferric derisomaltose (FDI)2.
Fatigue and Cognitive Impairments
Iron deficiency, even without anemia, can lead to fatigue, headaches, and cognitive impairments. Iron supplementation can improve these symptoms, but the type of iron used can affect the rate and extent of improvement1 3.
Restless Legs Syndrome (RLS) and Sleep Disorders
Iron deficiency is linked to restless legs syndrome and sleep disorders. Iron supplementation has been shown to significantly improve these conditions1.
Cardiovascular and Infectious Risks
Intravenous iron therapy in patients with chronic kidney disease (CKD) and iron deficiency anemia (IDA) is associated with an increased risk of serious adverse events, including cardiovascular events and infections7.
Lack of Hemoglobin Response
In some populations, such as anemic children with multiple micronutrient deficiencies, iron supplementation alone may not resolve anemia. This lack of response can be due to other underlying nutritional deficiencies5.
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Disclaimer
The content presented in this blog is generated by Consensus, an AI-powered academic search engine, and is based on publicly available scientific literature. While every effort is made to provide accurate, up-to-date, and well-researched information, the content is intended for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional before making any decisions regarding medical conditions, treatments, or medications. The AI system’s analysis may not cover all perspectives, emerging research, or individual cases, and it is not a substitute for professional expertise. Neither the blog publisher nor the developers of the AI-powered search engine are responsible for any actions taken based on the information provided in this content. Use of this information is at your own risk. Citations to the original scientific studies are included for reference, but these studies should be reviewed in full and interpreted with the guidance of a healthcare or research professional.
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