Description

Iron is an essential element as it takes part in a wide variety of metabolic processes, including oxygen transport, deoxyribonucleic acid (DNA) synthesis, and electron transport. Disorders of iron metabolism are very common and include a broad spectrum of diseases with diverse clinical manifestations, ranging from anemia to iron overload (1).

Bioavailability

Heme and nonheme are two different forms of dietary iron. The sources of heme iron are hemoglobin and myoglobin found in meat, poultry, and fish, whereas sources of nonheme iron are cereals, pulses, legumes, fruits, and vegetables. Heme iron is highly bioavailable (15%-35%) and dietary factors show little effect on its absorption, whereas nonheme iron absorption is much lower (2%-20%) and is influenced by the presence of other food components. The major inhibitors of iron absorption are phytic acid, polyphenols, calcium, and peptides from partially digested proteins. Ascorbic acid is an enhancer of iron absorption (1).

Dietary iron from plant foods is called nonheme iron and is usually in ferric form. Heme iron is absorbed better than nonheme iron because heme iron can be absorbed directly into the small intestine, whereas nonheme iron requires a carrier. Vitamin C acts as a carrier and increases iron absorption (2).

Iron requirements

Iron deficiency is commonly found in parts of a population that have inadequate access to foods rich in absorbable iron & during stages of high iron demand. Children, adolescents, and women of reproductive age, in particular during pregnancy are at a higher risk of iron deficiency (1)

Iron demand is more in infants and adolescents as a result of rapid growth. Women of reproductive age require more iron due to excessive blood loss during menstruation. During pregnancy, there is a significant increase in iron requirement because of the rapid growth of the placenta and the fetus. Adult men and postmenopausal women are at low risk of iron deficiency as the amount of iron in a normal diet are usually sufficient to cover their physiological requirements (1).

Iron deficiency anemia

When Fe stores (i.e. serum ferritin- sFer) have become depleted but Hemoglobin (Hgb) has not yet declined to a level indicative of anemia, this is the beginning of functional or subclinical iron deficiency (ID). Under conditions of severe Iron Deficiency, Hemoglobin synthesis may become compromised in addition to depleted iron stores causing iron deficiency anemia (IDA). With IDA, a range of physical performance measures are affected due to reduced oxygen transport.

Supports immunity

Iron works as cofactor for many enzymes of the immune system. Its deficiency is reported to cause impairment of cell-mediated immunity, mucosal immunity and proliferation of T- cells.

It is very important to monitor the ferritin levels which indicate the iron stores of the body. 

The Unived difference

Dietary iron occurs in three major forms: ferrous iron (Fe2+), ferric iron (Fe3+), and heme iron (Fe2+ chelated into a complex organic compound to complete the heme structure, which occurs in hemoglobin, myoglobin, and certain enzymes). Oral Iron supplements are commercially available as Fe salts and heme supplements, with the latter being more bioavailable. All of the ferrous salts have comparable rates of absorption and incidence of gastrointestinal adverse effects (e.g., constipation, nausea, vomiting, diarrhea and darkened stools). Ferrous form of iron is more close to heme iron (3). Ferrous BisGlycinate is an iron amino acid chelate. It is formed by reaction of ferrous iron with two molecules of the amino acid glycine by a covalent bound in a process called chelation. Ferrous bisglycinate is known to have better compliance because of fewer gastrointestinal tract side effects. It also improves iron absorption, storage and increase hemoglobin level better than the conventionally used iron salts (3).

Evidence-Based or Bust

We use nutrients backed by a significant body of research that is growing each day.

1. Review on iron and its importance for human health
   Abbaspour, N., Hurrell, R., & Kelishadi, R. (2014). Review on iron and its importance for human health. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 19(2), 164.
2. Interaction Of Vitamin C And Iron
   Sean R. Lynch and James D. Cook, “Interaction Of Vitamin C And Iron”, Annals New York Academy of Sciences, 1980.
3. Comparison of the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of iron deficiency anemia among pregnant women seen at the out-patient department of a tertiary medical center on 2016-2017
   By Ma. Agnes A. Santiago, et. al., “Comparison of the efficacy of iron amino acid chelate and ferrous sulfate in the treatment of iron deficiency anemia among pregnant women seen at the out-patient department of a tertiary medical center on 2016-2017*”, Volume 42, Number 6, PJOG November-December 2018