The role of iron in the body: deficiency, excess, sources

Iron is responsible for many processes, among the main ones are the delivery of oxygen to organs, regulation of respiration, and metabolism. All the most important things about the mineral are in this article.

The material was commented on and checked by Natalya Polenova, family doctor, cardiologist and nutritionist at GMS Clinic

The body does not produce iron on its own; a person receives 1-2 mg of this element with food. Each of us loses approximately the same amount through dead skin and intestinal cells.

What criteria influence the degree of iron accumulation?

The fundamental criteria include the amount of iron consumed in food, taking medications containing iron, the condition of internal organs and tissues, the distinctive characteristics of the menstrual cycle and genetics.

With a lack of iron, iron deficiency anemia can form. However, the most dangerous is the level of iron in the body that exceeds the norm. The substance accumulates in the internal organs, after which it passes into the skin, heart muscle, types of glands, and joints. Such processes have a dark connection with the development of rapid “aging” and disruption of the activity of these organs. The threats of developing cirrhosis and liver cancer, diabetes mellitus, severe heart failure, and dysfunction of the thyroid and gonads are increasing.

The main reasons that can contribute to the accumulation of excess substances include mutations in genes, abuse of certain medications, regular blood transfusions, destruction of red blood cells and chronic dysfunction in the liver.

causes of increased iron in the blood

At this point, these kinds of events can be caused by heredity. The disease in question is called primary hemochromatosis, abnormal genes of which are found in every 250 inhabitants of Northern Europe. The same applies to Russia. The disease is mainly found in representatives of the stronger sex in adulthood, and in representatives of the fair sex - after menopause.

Initially, similar genes with disorders may not be expressed in anything, however, with the further development of liver disease into a chronic form, the genes fully manifest themselves. Approximately 1/4 of cases can be associated with fatty liver disease due to abuse of alcoholic beverages and so on, viral hepatitis of various degrees and forms.

Excess iron

An overdose of iron in a healthy person is quite difficult to achieve as part of a normal diet. Iron is a rather ungrateful mineral component and is only absorbed to a small extent.

Additionally, many other food ingredients can effectively prevent this. We are talking about black tea, coffee, products containing calcium, phytic acids, fiber or polyphenols, which are almost impossible to get rid of.

This looks a little different with iron supplements. A large dose of the element is concentrated into a small tablet that is easy to swallow. Supplement overdose can result from taking too much or too many different medications, most of which contain iron.

In a healthy person, a situation in which the body cannot cope with excessive iron intake is unlikely, including due to natural protective mechanisms. This is an HFE protein that blocks the absorption of iron in the intestines when levels are high. Specific genes are responsible for its production.

Unfortunately, there are people for whom these mechanisms do not work properly. These people suffer from hemochromatosis.

Hemochromatosis is a genetically determined disease. Serious symptoms occur when there is a significant excess of iron in the tissues and hemochromatosis is detected only after 30-40 years. In women, the first symptoms of the disease and its detection may occur even later.

Symptoms of too much substance

Symptoms of excess iron in the body:

1. Detection of liver enlargement in size or transformation of biochemical criteria. Their reason may not be clear.
2. Detection of increased hemoglobin, iron, ferritin, transferrin in the blood.
3. The presence of dark spots, cracked skin in the area of ​​the armpits, groin folds, old scars.
4. Various combinations of diseases: liver cirrhosis, diabetes mellitus, joint damage, pathology of the heart and endocrine glands.
5. Having close blood relatives with hemochromatosis or PWS.

What you should know about increasing iron levels in the body

It is well known that iron is an essential element for all living organisms living in an oxygen environment. It is necessary for the transfer of oxygen (as part of hemoglobin) to all organs and tissues. Also, iron is part of the enzymes involved in “cellular respiration.”

The human body contains no more than 3-4 grams of iron and this amount is carefully maintained by regulating its absorption in the small intestine. The daily food requirement for this element is about 10 mg for men and 20 mg for women of childbearing age.

What factors affect iron levels?

Various factors influence iron levels in the body. The most important of which are: the amount of iron entering the body with food, taking medications containing iron, the fact of blood transfusion, the condition of the liver, the mucous membrane of the stomach and small intestine, the presence of blood loss, features of the menstrual cycle and hereditary causes.

If there is not enough iron in the body, iron deficiency anemia develops. But even more dangerous is the excess iron content, which accumulates excessively in the liver, spleen, and then in the skin, heart muscle, pancreas, thyroid and gonads, in the joints, which leads to an accelerated rate of “aging” and damage to these organs, growth in them connective tissue and disruption of their work. The risks of cirrhosis and liver cancer, diabetes mellitus, severe heart failure, and dysfunction of the thyroid and gonads increase.

The main reasons leading to oversaturation of the body with iron are genetic mutations, excessive intake of iron into the body from food (in red meat, wine, etc.), abuse of iron preparations (especially when administered intravenously), frequent blood transfusions, destruction (hemolysis ) red blood cells and chronic liver diseases.

Today, the high prevalence of iron oversaturation is known due to hereditary factors. This disease is called primary hemochromatosis, abnormal genes of which are detected in 1 in 250 residents of Northern Europe, and about the same number in Russia. Most often, this disease is detected in men over 40 years of age, less often in women after menopause.

Partially mutant genes for this disease may initially not manifest themselves in any way, but with the development of chronic liver damage, these genes are turned on, and the patient develops iron overload syndrome (IOS). Often, in approximately 20-30% of cases, this is observed with non-alcoholic and alcoholic fatty liver disease, viral hepatitis B and C.

How to suspect an oversaturation of the body with iron?

1. If liver enlargement and/or changes in liver biochemical parameters are detected and their cause is not clear.
2. If there is a chronic liver disease and, despite the treatment, “disturbed” biochemical parameters of the liver remain.
3. If any examination reveals an increase in hemoglobin, iron, ferritin, transferrin in the blood.
4. If you notice darkening of the skin on open areas of the body, hyperpigmentation and dry skin in the area of ​​the armpits, groin folds, and old scars.
5. If there are any combinations of diseases: liver cirrhosis, diabetes mellitus, joint damage, pathology of the heart and endocrine glands.
6. If you have relatives suffering from hemochromatosis or PWS.

What to do if signs of iron oversaturation are detected?

If you identify signs of excess iron in the body, you should consult a doctor who specializes in the treatment of iron metabolism disorders, who will help you understand the cause of this condition, prescribe an examination plan, select the correct treatment and determine follow-up.

Methods for treating iron overload include: strict adherence to a diet limiting iron content to 8 mg/day, avoidance of alcohol, therapeutic bloodletting (phlebotomy), and the use of antioxidants.

Remember, iron accumulated in internal organs remains there forever! Therefore, timely detection and treatment of iron overload syndrome will prevent the occurrence and progression of damage to the liver and many other organs, the development of liver cancer and prolong your life.

GC Expert has developed a special program “Iron overload and hemochromatosis”, within which you can undergo an in-depth examination to determine the causes of iron overload and receive an individual treatment plan.

criteria for an excess of a substance in the body?

In such a situation, we recommend that you contact specialists who treat metabolic dysfunctions. A medical professional will help you find the causes, develop a personal research and treatment plan, and establish strict monitoring of your health.

Methods for treating excess iron :

• compliance with dietary nutrition,
• refusal of alcoholic drinks,
• use of antioxidants.

You should always remember that iron is not removed from the body, but remains in it for life!

This is why it is so important to detect this in the early stages and prevent the spread of dangerous substances to stop the functioning of the liver and many other organs, forming liver cancer, which will help you extend the years of your life.

What is the danger of exceeding the norm?

The consequences of excess iron are very serious. An excess amount negatively affects the work:

1. The liver is the filter of the whole body. If you notice the signs in a timely manner and begin treatment, the functioning of the vital organ will normalize. Otherwise, liver cells may be destroyed. This will lead to diseases: hepatitis and cirrhosis, necrosis, inflammation of the gallbladder.
2. Kidneys. Excess trace elements are collected in the nephrons. They constantly poison the body. The filtration ability decreases, which provokes the occurrence of diabetes mellitus. Protective functions deteriorate, inflammatory processes develop.
3. Impact on the nervous system. The brain suffers, the hypothalamus is overloaded. The head begins to hurt, thinking gradually slows down.
4. Muscles. Excess iron causes fibers to break. Pain appears and muscle tone is lost. The heart is also a muscle. Poisoning it with iron can provoke the development of a micro-stroke or micro-infarction.
5. Spleen. The main function of the organ is part of the metabolic processes occurring in the body, as well as the synthesis of iron. Gradually, iron is deposited on the walls of the organ, and inflammatory processes develop. They can penetrate nearby tissues.

Changes in nutrient balance during pregnancy are dangerous. Not only the expectant mother suffers, but also the child. From the mother's blood he receives all the substances he needs. Iron is an important component of hemoglobin. But in pregnant women, excess iron can provoke pathology of the placenta, to a greater extent the oxidation of free radicals, mitochondria in the placental cells die. Excess can cause gestational diabetes, which leads to miscarriage and subsequent development of infertility.

To prevent this from happening, blood tests are constantly taken from the expectant mother. Women should take medications containing Fe with caution and monitor the dosage.

It is more difficult to treat the consequences resulting from excess iron than from deficiency. Especially if the accumulation in the body has occurred for a long time, or it is a hereditary disease. But if the patient consults a specialist in time, when it is possible to avoid the bitter diagnosis of damage to internal organs, then the prognosis may turn out to be quite favorable.

References

1. Federal clinical guidelines for the diagnosis and treatment of iron deficiency anemia, 2015. - 58 p.
2. Lukina, E.A., Smetanina, N.S., Tsvetaeva, N.V. and others. Iron overload: diagnosis and treatment. National clinical guidelines, 2021. - 14 p.
3. Rumyantsev, A.G., Maschan, A.A., Chernov, V.M. Federal clinical guidelines for the diagnosis and treatment of iron deficiency anemia, 2015. - 43 p.
4. Zaiko, N.N., Byts, Yu.V. Pathological physiology. M.: Medpress, 2008. - 640 p.
5. Ganz, T., Nemeth, E. Iron metabolism: interactions with normal and disordered erythropoiesis. Cold Spring Harb Perspect Med., 2012. - Vol. 2(5).
6. Chaparro, C., Suchdev, P. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann NY Acad Sci., 2021. - Vol. 1450(1). — P. 15-31.

Progress, complications and prognosis

Gradient

The clinic is divided into four stages, which may overlap.

1. Often transient symptoms such as lethargy, nausea, vomiting, diarrhea, abdominal pain. Leftover pills cause gray/black vomit and stool. Symptoms disappear after 6-8 hours. When consumed in large quantities, the local effect causes bloody diarrhea.
2. Symptom of free interval pg transport and distribution of absorbed iron.
3. The acute phase is observed in few patients. It manifests itself in the form of metabolic acidosis, shock, renal failure, and liver necrosis. Possible death within 1-3 days.
4. Tension in the gastrointestinal tract due to damage. Complications: hypotension, shock, metabolic acidosis, liver and kidney failure, gastric fibrosis and pyloric obstruction.

Forecast

• The prognosis can be serious, but in most cases the poisoning is not life-threatening.
• Toxic doses for 2-3 years: 400 mg Fe2+.
• Lethal doses: 50 - 300 mg Fe2 + / kg.
• Patients who are alive 72 hours after administration make a full recovery.

Hidden threat

Hemochromatosis is an insidious disease. For the time being, the disease shows almost nothing about itself. The bitter truth is revealed, as a rule, too late - by the age of 40, when the signs of hemochromatosis are obvious (from severe cirrhosis of the liver to diabetes and life-threatening arrhythmogenic cardiopathy), and it is almost impossible to do anything to save the patient. Unless a donor liver or heart is transplanted.

Article on the topic

Victims of iron deficiency risk anemia and anemia

Such consequences are caused by a congenital disorder of iron metabolism, as a result of which much more of this microelement is absorbed in the small intestine than the body requires. The result is sad: when deposited in the liver, pancreas, and heart muscle, excess iron causes lipid peroxidation, in response to which connective tissue begins to be actively produced in the affected organ, disrupting its structure, and therefore normal functioning.

Doctors can only shrug: if their predecessors had known about the presence of hemochromatosis in such a patient earlier, when he was a child or young adult, such problems could have been avoided.

Treatment regimen

1. Deferoxamine. It binds to Fe and forms a water-soluble compound, ferrioxamine, which is excreted in the urine. She turns pink.
2. Deferoxamine is given intravenously in the hospital if severe gastrointestinal symptoms, shock, or coma develop.
3. Continuously given equivalent to 15 mg/kg/hour. The dose may be increased to a maximum of 35 mg/kg/hour depending on severity.

Typically, treatment lasts about 24 hours. Side effects may include hypotension and acute respiratory distress syndrome.

Treatment

Hemochromacy does not occur on its own, but is provoked by certain risks that the patient should be aware of, be it heredity or frequent blood transfusions. If you notice the first symptoms, you should consult an endocrinologist, since delaying treatment leads to a worsening of the body’s condition.

During the treatment process, the endocrinologist prescribes a special diet to the patient, which excludes foods rich in iron from the diet, including apples, beets, buckwheat, red meat, red grapes, and pomegranates. Any alcoholic drinks are excluded; moreover, alcoholism itself causes hemochromatia.

Excess blood is treated through drug therapy prescribed by a doctor. Another effective way to combat this disease is periodic bloodletting, which also must be carried out under the close supervision of a doctor, as the level of hematocrit and hemoglobin in the blood should be monitored.