Iron metabolism

Objectives
• Classification of minerals
• Introduction of iron meatabolism
• Dietary sources
• RDA (Recommended Dietary Allowance)
• Biochemical function
• Absorption & Excretion
• Serum levels
• Regulation
• Clinical significance
Classification of minerals
Principal (Major) elements (7) (Req. > 100 mg/day)
• Calcium, Phosphorus, Potassium, Sodium,
Magnesium, Chloride, Sulphur
Trace elements (Req. < 100 mg/day)
• Essential
• Iron, Copper, Zinc, Selenium, Manganese,
Cobalt, Fluoride, Iodine, Molybdenum
• Possibly essential
• Nickel, Cadmium, Vanadium, Barium
• Non essential
• Al, Hg, Bo, Ag, Pb
 Fe
• Essential trace element

• Total content in the body: 3 – 5 gms

• 70% present in the blood in erythrocytes

• 5% in muscle as myoglobin

• Rest in the liver, bone marrow & other tissues

Heme Fe proteins
• Hb
• Mb
• Cytochromes
• Xanthine oxidase
• Catalase
• Tryptophan pyrrolase
Non heme Fe containing proteins
• Transferrin

• Ferritin

• Hemosiderin

• Fe S proteins
Sources of Iron
• Rich source: Liver, meat, fish (Heme Iron)

• Good source: Jaggery, Dates, Leafy vegetable,

Pulses, Cereals, Apple

• Poor source: Milk, wheat, polished rice

RDA of Iron
• Adult male: 10 mg

• Premenopausal women: 20 mg

• Post menopausal women: 10 mg

• Pregnancy and lactation: 40 mg

• Growing children: 20-30 mg

Functions of Iron
• Component of hemoglobin and myoglobin

• Component of cytochrome

• Activity of peroxidase/catalase

• Helps in immunity
Absorption of Iron
Site: Upper part of duodenum

Only 10% of Iron is absorbed (1mg)

Only ferrous (Fe2+) is absorbed

Regulation is at the level of absorption

Mucosal Block Theory
• Fe homeostasis is maintained by regulation at
the level of absorption

• Less Fe stores – Absorption enhanced

• Adequate Fe stores – Absorption decreased

Absorption of Iron
Factors promoting Factors inhibiting

• Low pH • Phytates & oxalates

• Ascorbic acid • High phosphate diet
• Small peptides, amino • Calcium, copper, lead
acids (Cysteine) • Malabsorption
• Glutathione syndrome
• Low phosphate diet • Surgical removal of
stomach/intestine

Heme iron is better absorbed than non heme iron

Absorption in mucosal cell

FO
Lumen of GIT
Iron in the food {Ferric (Fe3+) or bound form}

HCl

Fe3+ form released

Ascorbic acid
Cysteine
Enters
mucosal Reduced to Ferrous (Fe2+)
cell DMT1
 In the mucosal cell Hepcidin
Ferrous (Fe2+)
Through Ferroportin
Ferroxidase

Ferric (Fe3+) Enters plasma

Apoferritin

Shed out Ferritin Ferrous (Fe2+)

Ferroreductase
Transport in plasma
Ferrous (Fe2+)
Ferroxidase II
(Ceruloplasmin)
Bone marrow
Ferric (Fe3+)

Apotransferrin

Transferrin Liver
Transport of Fe
Transferrin
• Transports iron in plasma
• 1 mol of Transferrin binds to 2 mols of Fe
• Normal plasma level: 200-300 mg/dl
• Total iron binding capacity (TIBC)
• 250 – 400 mg/dl
Storage of Iron
• Ferritin
• Hemosiderin

Sites:
• In liver

• In bone marrow

• Muscles
 Ferritin

• Storage form of iron

• Ferroxidase activity

• Protein part is Apoferritin

• Single ferritin can bind with about 4500 iron atoms

• Intestinal cells, Liver, Spleen & BM

Hemosiderin
• From partial degradation of Ferritin

• Stores excess Iron

• Liver, spleen & bone marrow

Excretion
• Fe is a one way substrate

• < 1 mg / day of Fe is excreted in feces

• No excretion in urine

• Haptoglobin & hemopexin will prevent Fe loss

Haptoglobin: binds with free hemoglobin
Haemopexin : binds free haem
Other Iron containing proteins
• Haptoglobin: binds with free hemoglobin
& prevents the loss from the kidney

• Haemopexin :bind free haem released during

hemolysis
Conservation of Iron in body
Disorders of Iron Metabolism

• Iron deficiency anemia

• Hemosiderosis

• Hemochromatosis