UK CLL Forum, UKCLLFORUM

Iron and Ferritin Levels/Stores

Topic Made On: Jan 03, 2008 12:00pm
Robert Cork

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Gender: Male
Posts: 160
Since I received Fludarabine back in 2002 I have had low Iron Stores. Here are some details about this.

The iron that you eat is usually in the form of ferric iron bound to some kind of carrier. First it must be separated from the carrier and then it must be altered to ferrous iron by the action of stomach acid in order for it to be absorbed. All of this must be done by the time it reaches a certain section of the intestine which is the only place that iron can be absorbed. So where are the problems here.

1. The proteins that bind iron can be in the form of heme or non-heme molecules. Food that has heme-iron binding is very easy to separate. Iron that is bound in non-heme carriers such as phytates are very difficulty to separate. So if the only iron you get is in the form of non-heme iron then the iron might not be available to be absorbed in a timely fashion.

2. Other proteins such as milk proteins actually rebind the freed iron in the stomach and once again the iron is not available for absorption.

3. Medications such as omeprazole decrease the action of stomach cells to make that acid so, as a consequence, iron is not made available to be absorbed. (You can and do ingest iron that is in the form of ferrous. Most supplements are ferrous sulfate for example.).

If you want to increase iron absorption - eat heme iron with some sort of acid. For example - take your iron pill with orange juice and not tea. Postpone your tea drinking for one or two hours after a meal. Eat slowly making sure that you actually do what your mother always told you - chew your food well!

GI bleeding can be diagnosed by a variety of techniques ranging from that occult blood test that is performed in your physician's office to endoscopy.

Iron metabolism is fairly easy to follow. Iron is absorbed and bound immediately to several carrier proteins, the main one of which is transferrin. This combination wanders to the marrow and other sites that need iron or to storage. Storage comes in short term or long term kinds. Ferritin is the short term version while hemosiderin is the long term storage.

Serum iron tests the total amount of iron in the blood figuring that it should be iron bound to transferrin and other transport proteins and ferritin. TIBC measures every protein that can carry iron (Albumin can do this, for example.) Ferritin assays, well, ferritin. Since it is the main short term storage molecule, it should give important information. It is hampered by the fact that inflammation and other conditions can modify the transferrin amounts so it is not a value to take a total face value. You want ferritin to be higher because it is your first line of support should you have a stressed need for more iron. Lowered ferritin levels usually suggests that there is a lot going on with iron moving out of storage into active use.

Regards

Robert




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