Can low iron cause diarrhea

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Can Low Iron Cause Diarrhea?

Iron Deficiency and Gut Health

Iron is a crucial nutrient for many bodily functions, including oxygen transport and DNA synthesis. However, its role in gut health is complex and multifaceted. While iron deficiency itself does not directly cause diarrhea, the relationship between iron levels and gastrointestinal health is significant.

Iron Supplementation and Diarrhea Risk

Several studies have investigated the impact of iron supplementation on diarrhea, particularly in infants and young children. Iron fortification and supplementation can lead to increased colonic iron, which adversely affects the gut microbiome. This can result in a decrease in beneficial bacteria like bifidobacteria and lactobacilli, and an increase in pathogenic bacteria such as Escherichia coli, leading to gut inflammation and a higher risk of diarrhea 45710.

Iron-Fortified Formula and Diarrhea in Infants

Research comparing iron-fortified formula to low-iron formula in breastfed infants found no significant difference in the frequency of diarrhea between the two groups. This suggests that iron-fortified formula does not increase the risk of diarrhea in breastfed infants . However, other studies have shown that chronic iron intake can increase the incidence of diarrhea, particularly in environments with poor sanitation .

Iron Intake and Chronic Diarrhea in Adults

In adults, higher iron intake has been associated with an increased risk of chronic diarrheal symptoms. This relationship appears to be modified by sex, with men showing a stronger association between high iron intake and chronic diarrhea .

Mechanisms Behind Iron-Induced Diarrhea

The adverse effects of iron on the gut microbiome and subsequent diarrhea can be attributed to several mechanisms. High levels of iron in the colon can promote the growth of pathogenic bacteria, which outcompete beneficial bacteria. This imbalance can lead to increased gut inflammation and a higher incidence of diarrhea 69.

Conclusion

While low iron levels themselves do not directly cause diarrhea, iron supplementation and fortification can increase the risk of diarrhea by disrupting the gut microbiome and promoting gut inflammation. This effect is particularly pronounced in infants and young children, as well as in environments with inadequate sanitation. Therefore, careful consideration of iron supplementation strategies is essential to balance the benefits of preventing iron deficiency anemia with the potential risks of increased gastrointestinal morbidity.

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Most relevant research papers on this topic

Transcriptional response of Clostridium difficile to low iron conditions

Clostridium difficile shows significant changes in gene expression when exposed to low iron conditions, affecting iron transport, metabolism, and virulence.

2018·

20citations

·Jessica L. Hastie et al.

Risk of diarrhea related to iron content of infant formula: lack of evidence to support the use of low-iron formula as a supplement for breastfed infants.

No evidence supports the hypothesis that breastfed infants given iron-fortified formula are at greater risk of having diarrhea, supporting the current recommendation for all infant formula to be fortified with iron.

Observational Study

1997·

24citations

·P. Scariati et al.

Chronic iron intake and diarrhoeal disease in infants. A field study in a less-developed country.

Chronic iron supplementation in infants in areas with inadequate environmental sanitation may increase diarrhoeal morbidity, despite improving iron nutritional status.

Observational Study

1993·

33citations

·O. Brunser et al.

Effects of a Micronutrient Powder Containing Low‐dose Iron and Galacto‐oligosaccharides on the Gut Microbiome and Iron Absorption: a Stable Iron Isotope Study and a Randomized Controlled Trial in Kenyan Infants

Low-dose iron micronutrient powders for infants can be a safer alternative to high-dose iron powders, reducing diarrhea risk and gut inflammation.

RCT

2017·

0citations

·D. Paganini et al.

Iron fortification adversely affects the gut microbiome, increases pathogen abundance and induces intestinal inflammation in Kenyan infants

In-home iron fortification in Kenyan infants negatively affects gut microbiome, increases pathogen abundance, and induces intestinal inflammation.

RCTRigorous JournalHighly Cited

2014·

505citations

·Tanja Jaeggi et al.

Guts, Germs, and Iron: A Systematic Review on Iron Supplementation, Iron Fortification, and Diarrhea in Children Aged 4–59 Months

Oral iron supplementation and fortification may increase diarrhea incidence in children aged 4–59 months, but most studies show no clear relation between iron intake and diarrhea.

Systematic ReviewVery Rigorous Journal

2019·

20citations

·A. Ghanchi et al.

The effects of iron fortification and supplementation on the gut microbiome and diarrhea in infants and children: a review.

Iron fortification and supplementation in infants and young children can slightly increase diarrhea risk due to adverse effects on the gut microbiome.

Literature ReviewVery Rigorous JournalHighly Cited

2017·

183citations

·D. Paganini et al.

Associations Between Iron Intake and Serum Iron with Inflammatory Bowel Disease and Chronic Diarrheal Symptoms in Adults: the National Health and Nutrition Examination Survey, 2007–2010

Higher iron intake is associated with a higher risk of chronic diarrheal symptoms in adults, but not with the risk of inflammatory bowel disease.

Observational StudyRigorous Journal

2021·

5citations

·Fen-Rong Chen et al.

G297(P) Guts, germs and iron: a systematic review of the effect of iron supplementation and fortification on diarrhoea in children aged 4 to 59 months

Iron supplementation in children aged 4 to 59 months may increase the risk of diarrhoea, especially in those already iron replete.

Observational Study

2018·

0citations

·H. Nabwera et al.

Iron Fortification of Foods for Infants and Children in Low-Income Countries: Effects on the Gut Microbiome, Gut Inflammation, and Diarrhea

Iron fortification in low-income countries effectively reduces iron deficiency anemia in infants and young children, but may increase gastrointestinal morbidity and diarrhea risk.

Very Rigorous JournalHighly Cited

2016·

87citations

·D. Paganini et al.

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