Iron from Gastrointestinal Sources Excreted in the Feces of Human Subjects

Ingalls, Ruth L.; Johnston, Frances A.

doi:10.1093/jn/53.3.351

Cited by 19 publications

(3 citation statements)

References 9 publications

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“…This is different from reduced iron absorption caused by a reduction in dietary iron intake (61), which is common in undeveloped countries (87). In this condition, stimulated duodenal iron transport mechanisms can increase the fraction of iron absorbed from an iron-deficient diet.…”

Section: Discussionmentioning

confidence: 86%

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Is achlorhydria a cause of iron deficiency anemia?

Betesh

Ana

Cole

et al. 2015

The American Journal of Clinical Nutrition

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We re-evaluated the old hypothesis that gastritis-induced achlorhydria is a cause of iron deficiency anemia (IDA) in humans. First, we analyzed the currently available research on the association between achlorhydria and IDA. When gastric acid secretion was measured after maximal stimulation, the frequency of achlorhydria (or severe hypochlorhydria) was 44% in patients with idiopathic IDA and 1.8% in healthy controls. In some patients with pernicious anemia, presumed achlorhydria preceded the development of IDA in time. However, we found no credible evidence that IDA caused gastritis or that IDA preceded the development of achlorhydria. Thus, correlational results favor achlorhydria as the causal factor in the association between achlorhydria and IDA. Second, we sought to determine whether gastritis and achlorhydria cause negative iron balance. When biosynthetic methods were used to isotopically label iron in food, achlorhydric patients were found to have severe malabsorption of nonheme iron, which persisted after the development of IDA. In 1 study, achlorhydria reduced the normal increase in heme-iron absorption from hemoglobin in response to iron deficiency. After an injection of isotopic iron into normal men, the physiologic loss of iron from the body was found to be 1 mg/d. Patients with chronic gastritis had excess fecal loss of isotopically tagged plasma iron. Calculations based on these results indicate that the absorption of iron from a typical Western diet by achlorhydric patients would be less than physiologic iron losses, creating a negative iron balance that could not be overcome by the adaptive increase in duodenal iron absorptive capacity that occurs in response to iron deficiency. The combination of results from these correlational and pathophysiologic studies supports the hypothesis that gastritis-induced achlorhydria can be an independent cause of IDA.

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Section: Discussionmentioning

confidence: 86%

“…The meticulous requirements for accurate measurement of iron intake and output by this method have been well described (61). In one such experiment (62), iron intake averaged 11 mg/d and average iron balance was +0.5 mg/d in normal subjects and 22 mg/d in achlorhydric subjects (P = 0.01).…”

Section: Chemical Measurement Of Iron Intake and Iron Excretion In Stmentioning

confidence: 99%

Is achlorhydria a cause of iron deficiency anemia?

Betesh

Ana

Cole

et al. 2015

The American Journal of Clinical Nutrition

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“…McCance & Widdowson (1938) found no increase in the faecal excretion of iron after intravenous injection, and concluded that the gastrointestinal excretion of iron was negligible. Later, Ingalis & Johnston (1954) reported that traces of endogenous iron were constantly excreted in faeces of healthy adult human subjects. Dubach et al (1955) showed that radioactive iron when injected intravenously in human subjects was excreted in the faeces and thus demonstrated a continuous loss of minute amounts of endogenous iron by the gastrointestinal tract.…”

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confidence: 99%

Excretion of Endogenous Non‐haem Iron by the Gastrointestinal Tract in Human Subjects and its Influence on the Size of Body Store of Iron with Particular Reference to Coeliac Disease

Singh

1970

Br J Haematol

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The present study demonstrates that there is continuous loss of endogenous non‐haem iron by the gastrointestinal tract in man, and underlines its importance in patients with coeliac disease and in those with iron overload. The findings suggest that this loss occurs mainly as a result of desquamation of villous epithelium. The faecal loss of endogenous non‐haem iron is markedly increased in patients with coeliac disease in whom the cell turnover of the small intestinal mucosa is increased and it seems that it could be mainly responsible for the causation of iron deficiency amongst a considerable number of these patients. In subjects with normal mucosal structure of the small intestine this loss increases progressively with iron load at high levels of labile iron store and thus reduces the total iron store in the body.

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Eisenstoffwechsel

Keiderling¹

1961

Radioactive Isotopes in Physiology Diagnostics and Therapy / Künstliche Radioaktive Isotope in Physiologie Diagnostik Und Thera

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Iron from Gastrointestinal Sources Excreted in the Feces of Human Subjects

Cited by 19 publications

References 9 publications

Is achlorhydria a cause of iron deficiency anemia?

Is achlorhydria a cause of iron deficiency anemia?

Excretion of Endogenous Non‐haem Iron by the Gastrointestinal Tract in Human Subjects and its Influence on the Size of Body Store of Iron with Particular Reference to Coeliac Disease

Eisenstoffwechsel

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