Iron absorption is the crucial physiological process by which dietary iron is extracted from ingested food within the gastrointestinal tract and subsequently transported across the intestinal epithelium into the systemic circulation. This process is tightly regulated by the body’s iron stores and erythropoietic demands to prevent both deficiency and overload, with the duodenum being the primary site of uptake. Efficient iron absorption is essential for numerous physiological functions, including oxygen transport, DNA synthesis, and cellular energy production, all of which are intrinsically linked to optimal hormonal signaling and overall metabolic vitality.
Origin
The understanding of iron absorption and its regulatory mechanisms advanced significantly in the mid-20th century with the use of radioisotopes to trace iron pathways, culminating in the discovery of key transport proteins. The term itself is descriptive, referring to the assimilation of the mineral. In the context of hormonal health, the origin of the clinical focus lies in the discovery of hepcidin, a peptide hormone produced by the liver, which acts as the master regulator of systemic iron homeostasis, directly linking iron metabolism to hepatic and endocrine function.
Mechanism
The mechanism is bifurcated, handling heme and non-heme iron via separate pathways in the duodenal enterocytes. Non-heme iron, typically in the ferric (Fe³⁺) state, must first be reduced to the ferrous (Fe²⁺) state by the DcytB enzyme before being transported into the cell via the Divalent Metal Transporter 1 (DMT1). Heme iron is absorbed intact via the HCP1 receptor. Once inside the enterocyte, iron is either stored as ferritin or exported into the bloodstream via the ferroportin channel. The peptide hormone hepcidin controls the systemic iron flow by binding to and degrading ferroportin, thereby regulating the amount of iron released into the circulation.
A long-term strategy for optimal hematocrit involves a diet rich in iron, B-vitamins, and anti-inflammatory compounds to support hormonal signaling and red blood cell production.
Strategic diet and hydration significantly modulate hematocrit levels during TRT, influencing blood viscosity and cardiovascular health through complex physiological pathways.
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