Influence of Food Iron Absorption on the Plasma Iron Level in Idiopathic Hemochromatosis

Abstract

The relationship between food iron absorption, iron stores, and plasma iron level was studied. On a low iron diet subjects with idiopathic hemochromatosis (IH) during reaccumulation of iron after phlebotomies showed a fall in plasma iron. Fortification of the diet with 22–135 mg of iron/day for 3 days caused little or no change in the plasma iron in subjects with normal iron stores, whereas in subjects with iron deficiency a significant rise in plasma iron occurred with the addition of 45 mg of iron/day. In subjects with IH with normal iron stores, plasma iron increased with the addition of 22.5 mg/day. These studies indicate that iron absorption is an important determinant of the elevated plasma iron in IH and that the plasma iron tolerance test combined with the serum ferritin may be used to detect excessive absorption of iron.

Severity of iron overload in hemochromatosis: effect of volunteer blood donation before diagnosis

“…This often leads to the development of iron overload, because excretory mechanisms for iron are very limited 3 . After phlebotomy of persons with hemochromatosis, however, there is a further, marked increase in the absorption of inorganic and heme iron 21–24 . This could explain why most persons in our study who donated blood before diagnosis apparently absorbed sufficient quantities of iron to re‐establish their predonation iron stores, even when their donation rate was relatively high.…”

“…3 After phlebotomy of persons with hemochromatosis, however, there is a further, marked increase in the absorption of inorganic and heme iron. [21][22][23][24] This could explain why most persons in our study who donated blood before diagnosis apparently absorbed sufficient quantities of iron to re-establish their predonation iron stores, even when their donation rate was relatively high. Our results imply that the "volunteer" blood donation sometimes recommended by physicians and patient advocacy groups 15.4 (8) 1.9 (1) 1.9 (1) 100.0 (52) * Values given as percentage (n).…”

A diagnostic approach to hyperferritinemia with a non-elevated transferrin saturation

“…Elevated TS depends partly on increased iron absorption, because food iron deprivation causes TS to decrease [7] and supplemental iron increases TS. Increased release of iron from macrophages into plasma also contributes to elevated plasma iron and TS concentrations.…”

The effect of dietary iron intake on the development of iron overload among homozygotes for haemochromatosis

“…Their absorption of both haem and non-haem Fe was higher than in normal individuals. Consistently, two studies suggested that higher dietary Fe intake may accelerate Fe accumulation in patients with HH (22,23) . Current recommendations on the management of HH recommend avoiding vitamin C and Fe supplements, but do not suggest control of dietary Fe intake (24) .…”