Dietary iron is an essential mineral from food, crucial for physiological functions. It exists as heme iron from animal sources and non-heme iron from plants. Both forms contribute to body iron status, though their distinct structures lead to varying absorption efficiencies.
Context
Consumed dietary iron absorbs in the small intestine, then binds to transferrin for systemic transport. This mineral is vital for hemoglobin in red blood cells, enabling oxygen delivery to tissues, and is present in myoglobin for muscle oxygen storage. Iron also serves as a critical cofactor for enzymes in cellular respiration and DNA synthesis, supporting metabolic processes.
Significance
Adequate dietary iron intake prevents iron deficiency anemia, a common deficit. Insufficient iron manifests as fatigue, weakness, pallor, and diminished cognitive function. For pregnant individuals, proper iron levels are essential for fetal development. Sufficient iron supports energy production, immune function, and cellular vitality, impacting physical capacity.
Mechanism
Heme iron absorbs efficiently via specific enterocyte transporters. Non-heme iron requires reduction to ferrous state before transport into enterocyte by DMT1. Inside the cell, iron stores as ferritin or releases into bloodstream via ferroportin. Hepcidin, a regulatory hormone, controls ferroportin activity, modulating systemic iron levels.
Application
Clinical practice involves recommending iron-rich foods, especially for those at higher deficiency risk like menstruating women or vegetarians. Dietary strategies include pairing non-heme iron with vitamin C to enhance absorption. Oral iron supplementation is prescribed when intake is insufficient or malabsorption occurs. In severe cases, intravenous iron may be indicated to restore iron stores.
Metric
Iron status assessment includes serum ferritin, the most reliable indicator of body iron stores. Other metrics are serum iron, TIBC, and transferrin saturation, reflecting circulating iron and transport capacity. A complete blood count (CBC), with hemoglobin and hematocrit, aids anemia diagnosis. Clinical evaluation of symptoms like fatigue also guides assessment.
Risk
Improper dietary iron management, especially excessive supplementation, carries significant risks. Iron overload (hemochromatosis) can lead to iron deposition and damage in organs like the liver, heart, and pancreas. Acute iron poisoning, a serious concern in children, results from accidental ingestion of large doses. Common oral supplementation side effects include gastrointestinal upset, constipation, and nausea. Iron supplementation therefore requires medical guidance.
Lifestyle adjustments, including hydration, exercise, and dietary choices, can effectively modulate hematocrit levels during testosterone replacement therapy.
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