Some of the things discussed in our post-op health can be a bit confusing. Iron is one of those things, IMHO. So how about a session just on iron?
What is iron?
Iron is a mineral that can be found in plants, animals, soil, air, water, meteorites, and rocks, including on the surface of the moon. Here on earth, plants absorb iron through their root systems; animals eat these plants. Humans consume these plants and animals. Many think iron is a heavy metal, which it is not. Iron is an essential micronutrient. Essential used in this way means that the body does not produce the nutrient; micronutrient means that the body only requires tiny amounts to function.
Types of iron?
There are two forms of iron – heme and nonheme. Nonheme iron primarily comes from plants and heme iron comes primarily from meat.
Nonheme iron represents the majority of iron humans consume in their diets and is the type of iron in most supplements. Nonheme iron is inorganic and is found in grains such as rice, wheat and oats. It’s also found in nuts, fruits, vegetables, most iron pills, fortificants, or contaminant iron such as from water, soil or cooking utensils.
Meat, especially red meat is the best source of heme iron. Heme iron is easily absorbed by the body and the best source of iron for people who are iron deficient.
- Transferrin – a protein that is the major transporter of iron and ideally is saturated with 25-35% iron; when working properly, transferrin binds to iron and transports it to all tissues, vital organs, and bone marrow so that normal metabolism, DNA synthesis, and red blood cell production can take place
- Ferritin - a protein that acts like a large holding vessel; contains iron that we don’t presently need
- Hemaglobin (hgb) – a protein that transports oxygen to the body
- Hematocrit (hct) – proportion of blood volume that is occupied by red blood cells
So someone who is anemic can still have normal hemaglobin and hematicrit numbers because their ferritin is being depleted in order to maintain those counts. But if the ferritin is in the toilet and no relief comes, the hgb and hct will eventually fall as well.
Types of non-heme supplemental iron:
- Ferric salts: These include ferrous sulfate, gluconate, and fumarate. Typically, the way these compounds are made is that pure iron is dissolved in sulfuric or hydrochloric acid. Once dissolved, a counter ion is added and the pH is adjusted to make neutral once again. When this happens, the iron binds to the counter-ion and drops out of the liquid solution. The slurry is then dehydrated and the dry stuff that is left is the iron salt. Ferric salts, especially ferrous sulfate, are not known to be easy on the digestive tract. Once ingested, it is imperative that the stomach contains acid to dissolve the iron salt. If a person is taking antacids or H2 blockers, their stomach will be “achlorhydric” – their stomach won’t contain acid and the iron salt will not dissolve.
- Carbonyl iron is often used by physicians because it is less toxic to accidental overdose.
- Polysaccharide iron is a newer form that is coming up in popularity, absorbs better than the ferric salts, but is more expensive than the standard supplementation routes.
About Proferrin(tm): Performance studies indicate that iron absorption rates are between 15% and 20% withoute erythropoietin (EPO) therapy and as high as 30% with EPO therapy even in patients with high serum ferritin values (>600 ng/ml). In one study, the change in serum iron from Proferrin(tm) was nearly 23 times greater than from an identical dose of ferrous fumarate. Also, study participants were able to tolerate up to 60 mgs per dose on an empty stomach with fewer gastrointestinal side effects; a common complaint from patients taking traditional oral iron preparations. An additional benefit of heme iron supplementation is that patients can take it with their meals, unlike ionic iron preparations, which must be taken on an empty stomach between meals.
Info courtesy of the Iron Disorders Institute