Conditions Associated with Iron Deficiency

Some of the conditions below are caused by a lack of iron, others may cause a lack of iron, but most have only an association with iron deficiency. This means that there isn’t enough evidence to claim that iron deficiency causes them or that they cause iron deficiency.

Some are also complex conditions that have multiple causes, and iron deficiency may only play a minor part in their development.

Remember, just because your iron may be low, that doesn’t mean you have any of the conditions listed below.

If your iron is low, work with your doctor to find out what’s the cause and to treat any underlying health issues!

Cognitive Function and Development

In terms of brain development and brain health, iron is critical for [R, R, R, R]:

• brain and neurological development
• normal functioning of the brain
• neurotransmitter production (dopamine and noradrenaline)
• myelination of nerve cells

There is research that suggests that iron deficiency contributes to psychiatric and developmental disorders.

1) Attention Deficit Hyperactivity Disorder

Lower iron and ferritin levels have been associated with increased hyperactivity in children with ADHD [R, R].

Blood ferritin levels were low (<30 ng/mL) in 84% of the children with ADHD as compared to 18% of healthy children [R, R, R].

In addition, among people with ADHD, low blood ferritin levels were associated with the severity of ADHD symptoms and worse cognitive function [R, R].

There are a couple of studies that found a link between iron deficiency anemia and an increased risk of ADHD [R, R].

Research suggests that low brain iron stores may contribute to ADHD symptoms because low iron levels in the brain can alter the activity of dopamine, a neurotransmitter involved in movement, cognitive functions, and attention [R].

Several studies found that iron supplementation improved ADHD symptoms in children with low blood ferritin levels [R, R, R].

2) Autism

Iron deficiency and anemia are prevalent among autistic children [R

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Iron Overload

Lab Cutoffs for Iron Overload

Most labs consider blood ferritin levels greater than 150 – 200 ng/mL in women and greater than 400 ng/mL in men to be abnormal and indicative of excess iron stores (in the absence of chronic illness and inflammatory disorders) [R].

Additionally, transferrin saturation values above 55 – 60% may be indicative of iron overload [R].

If your ferritin or transferrin is high, work with your doctor to find the cause. Your doctor will interpret your results, taking into account your medical history, symptoms, and other test results.

Iron Overload from High Iron Intake

The risk of iron overload from dietary sources in adults with normal gut function is negligible. A tolerable upper intake level of iron is 40 mg/day per kg body weight for infants and children age 13, and 45 mg/day for people aged 14 and older [R, R].

Iron intake without food can cause gastric upset, constipation, nausea, abdominal pain, vomiting, and faintness. Stools often appear darker in color [R].

In severe cases, iron overdose can cause diarrhea, blood loss, hypovolemic shock, multiple organ dysfunctions, and death [R].

Why Excess Iron is Bad

Excess iron can accumulate in vital organs like the heart, liver, pancreas, and endocrine glands. This stimulates the formation of free radicals, which damage proteins, DNA, membranes, and can lead to cell death [R].

Studies suggest that left untreated, chronic iron overload raises the risk of liver disease, cancer, sexual dysfunction, arthritis, heart disease, eye disease, and diabetes [R].

Health Conditions That Can Cause Iron Overload

Conditions listed below can cause iron overload. But your iron may be high but that doesn’t mean you have any of these conditions. Work with your doctor or another health care professional to get an accurate diagnosis.

1) Genetic Disorders

Hereditary hemochromatosis is the most common genetic iron overload disorder. It’s caused by mutations in genes that affect hormones controlling iron levels such as ferroportin and hepcidin [R].

This disorder is characterized by increased absorption of dietary iron and its buildup in the heart, liver, pancreas, hormone-producing glands, tissue and joints, where it causes injury and organ damage [R].

Aceruloplasminemia is another disorder caused by mutations in the gene encoding

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What is Iron?

Iron (Fe) is an essential element critical for the growth and survival of nearly all organisms [R].

It plays many essential roles in the body. Iron is needed for [R, R, R, R, R, R]:

• Red blood cell production
• Oxygen and carbon dioxide transport in the blood (as part of hemoglobin)
• Oxygen transport and storage in muscles (as part of myoglobin)
• Energy production in the heart and muscles
• Brain development and normal brain function
• Immune system development and immune response
• Resistance to infections
• Production and degradation of DNA
• Protecting cells against the accumulation of reactive oxygen species, as a part (cofactor) of enzymes that break down the reactive oxygen species, including oxidases, peroxidases, and catalases

Because of these powerful roles, low iron levels can lead to detrimental effects and eventually, death [R].

However, excessive levels of iron can form reactive oxygen species which lead to tissue and DNA damage [R].

Therefore, it’s important to keep iron levels in balance.

Iron Balance

Iron is one of the most abundant metals in the human body. Most well-nourished adults have approximately 3 – 5 g [R].

Nearly 60% of iron inside the body is incorporated into hemoglobin (in the blood), and 10% into myoglobin (in muscle tissue) [R, R, R].

In healthy individuals, the remaining 20 – 30% of iron is stored bound to special proteins, such as transferrin, ferritin, and hemosiderin [R, R, R]. These proteins prevent free iron from causing oxidative damage in the body [R, R, R, R, R].

The liver has the largest capacity to store excess iron [R].

To maintain iron homeostasis, hepcidin, a protein hormone secreted by the liver, inhibits dietary iron absorption in the gut and reduces blood iron levels when iron stores are sufficient [R,

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Sources of Iron

Iron-rich foods include [R, R]:

• meat and poultry, including organ meats like liver, heart, kidney, and blood
• fish, including shellfish and sardines

Plant-based foods that are high in iron in the non-heme form (but may also be high in substances that prevent iron absorption) include:

• pulses, including chickpeas, beans, peas, and lentils
• seeds, including sesame and pumpkin seeds
• green leafy vegetables, including broccoli and kale

Some (not necessarily healthy) foods are fortified with iron. These include flour, grains, cereals, pasta, rice, bakery products, milk and dairy products, chocolate drinks, and infant formulas [R, R].

A number of iron supplements are available in the form of ferrous sulfate, ferrous gluconate, ferrous fumarate, and heme iron. They are indicated for the prevention and treatment of iron deficiency and iron deficiency anemia [R, R].

Adequate Iron Intake

Adults require at least 8 mg of iron per day [R, R].

Women of childbearing age (19 – 50 yrs) should get more iron (around) 18 mg/day, because they lose more iron due to menstrual bleeding.

Infants and children 1 to 3 years require 11 and 7 mg/day, respectively, while children aged 4 – 8 and 9 – 13 require at least 10 and 8 mg/day, respectively, in order to prevent developmental delays and behavioral disturbances [R, R].

Iron Supplementation

If you have iron deficiency anemia, your doctor may prescribe iron therapy [R]. Keep in mind that It may take several months of supplementation to correct iron deficiency.

In many populations, the amount of iron absorbed from the diet is not enough to meet most individual requirements, especially during infancy, intense exercise, and pregnancy, where biological iron needs are the highest [R, R].

If the amount of absorbable iron in the diet cannot be readily improved, iron supplementation is required to prevent iron deficiency anemia. This is often the case for children 6-24 months of age and pregnant women [R, R, R].

Iron supplements are necessary for the rapid treatment of severe iron deficiency anemia in males and females from all age groups

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What are Thyroid Hormones?

The thyroid gland produces and secretes thyroid hormones T3 (triiodothyronine) and T4 (thyroxine).

T3 contains three iodine atoms and is created from the breakdown of T4. The breakdown of T4 is encouraged by the Thyroid Stimulating Hormone (TSH).

T4 is synthesized from the amino acid tyrosine, found in thyroglobulin (a protein created in the thyroid). It contains four iodine atoms.

Lack of T3 early in human development causes stunted growth.

T3 is very important in increasing energy production.

Roles & Functions

• Breathing
• Energy production
• Heart rate
• Cognitive function
• Mood
• Body weight
• Muscle strength
• Menstrual cycles
• Body temperature
• Cholesterol levels
• Growth and development
• Intestinal flow
• Digestion

If you notice any of the symptoms described below and suspect a thyroid disorder, seek medical attention. Most thyroid conditions can be successfully treated if diagnosed on time.

Hyperthyroidism Symptoms

Hyperthyroidism (too much T3 or T4) symptoms include:

• Sweating or sensitivity to high temperatures
• Hair loss
• Faster heart rate
• Diarrhea
• Weight loss
• Missed or light menstrual periods

Hypothyroidism Symptoms

Hypothyroidism (insufficient T3 or T4) symptoms include:

• Trouble sleeping
• Tiredness and fatigue
• Difficulty concentrating
• Depression
• Sensitivity to cold temperature
• Frequent, heavy periods
• Slow heart rate
• Weight gain
• Dry skin and hair

The Hypothalamus-Pituitary-Thyroid (HPT) Axis

The hypothalamus, pituitary, and the thyroid gland (also called the hypothalamic/pituitary/thyroid or HPT axis) control thyroid hormone levels (R).

Thyrotropin-releasing hormone (TRH) made in the hypothalamus binds to the receptors in the pituitary, causing it to release the thyroid-stimulating hormone (TSH), which then stimulates T4 production.

If there is too little of the thyroid hormones in the bloodstream, the hypothalamus signals the pituitary gland (via TRH) to produce TSH for the thyroid to release more T3 and T4.

Once there is enough of these hormones, the

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Introduction & Risk Groups

Frank copper deficiency is rare in humans (R).

Most adults living in developed countries obtain proper amounts of copper through their diet, supplements, and drinking water (R).

Groups at risk of copper deficiency include:

• Infants (preterm, recovering from malnutrition, fed only cow’s milk formula, with prolonged diarrhea, with cholestasis) (R, R, R, R)
• Individuals using zinc supplements or zinc-enriched dental creams (R, R)
• Pregnant and breastfeeding women (R)
• Individuals with digestive problems that result in nutrient malabsorption, including Crohn’s disease, celiac disease, and short bowel syndrome (R, R, R)
• Individuals on prolonged parenteral nutrition lacking copper (R)
• Cystic fibrosis patients (R)
• Hypertensive individuals (R)

Causes of Copper Deficiency

1) Inadequate Copper Absorption

• Menkes’ disease (R)
• Weight reduction (gastric bypass) surgery (R, R)
• Gastrectomy (stomach removal) and esophagectomy (esophagus removal) (R, R, R)
• Chronic antacid intake (R)
• Increased zinc consumption (R, R, R).
• Malabsorption syndromes (Crohn’s disease, celiac disease, short bowel syndrome) (R, R)

2) Inadequate Copper Intake

• Low copper infant formula or cow’s milk only formula (R)
• Parenteral nutrition for long periods of time without copper supplementation (R)
• Protein-calorie malnutrition (R)

3) Excessive Copper Losses

• Malabsorptive states (R, R)
• Copper chelating agents such as penicillamine (R)
• Burns (R)
• Nephrotic syndrome (R)

Signs & Symptoms

If you notice the following

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What is Potassium?

Potassium is an essential mineral vital for the proper functioning of all living cells.

It is one of the most abundant positively charged ions (cation) in the human body, present in high concentrations in muscles, bone, liver and red blood cells (R, R).

Concentration difference between potassium inside and outside of a cell is maintained by Na-K-ATPase enzyme that actively pumps potassium into the cell while moving sodium out of the cell (R, R).

Western diets with more processed foods and fewer fruits and vegetables are lower in potassium and higher in sodium. Healthier diets consumed by our ancestors are richer in potassium (R).

Therefore, diets higher in potassium is associated with many positive health outcomes. However, this association may be because diets higher in potassium are generally healthier.

Snapshot

Proponents:

• Protects the heart
• Lowers blood pressure
• Improves glucose metabolism
• Supports the kidneys
• May strengthen the bones

Skeptics:

• Interacts with certain medications
• May not suitable in chronic kidney disease
• Excess levels can be toxic

Roles & Functions

The major functions of potassium are the maintenance of the cell’s membrane potential and regulation of the fluid within the cell (R).

Potassium is important for (R, R):

• muscle contraction
• nerve impulse transmission
• normal heart functioning
• prevention of excessive fluid retention
• maintenance of proper pH within the body
• normal growth and muscle building

Potassium is required for the production of carbohydrates, proteins, and energy in the form of adenosine triphosphate (ATP) (R).

A large number of enzymes that participate in several major metabolic processes require the presence of potassium to function properly (R).

Antioxidant and Anti-inflammatory Effects

An increase in potassium concentration blocks dangerous oxygen species formation by blood vessel cells or white blood cells.

Dietary potassium may protect against cardiovascular damage through its antioxidant effects. It has a blocking effect on interleukin IL-17A production in T lymphocytes (R, R

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Copper Roles in the Body

Copper (Cu) is an essential trace mineral in the human body. It is required for growth, bone strength, immune function, as well as heart function, and brain development [R, R].

Copper is an integral part (cofactor) of a group of enzymes called cuproenzymes, which are important for [R]:

• Energy production in the cell (cytochrome C oxidase) (R)
• Formation of strong and flexible connective tissue (lysyl oxidase) (R)
• Iron metabolism (multiple copper oxidases, ferroxidases) (R)
• The normal function of the brain and nervous system (dopamine β-hydroxylase, cytochrome C oxidase) (R)
• Antioxidant activity (superoxide dismutase, ceruloplasmin) (R)
• Formation of the pigment melanin (tyrosinase) (R)

Due to its potent antimicrobial properties, copper is also used as a biocide in agriculture, wood preservation, paints, and in hospitals (R, R, R, R).

Health Benefits

Likely Effective:

1) Copper Deficiency

Oral or intravenous copper is effective for copper deficiency, which may cause anemia, heart disease, bone deformations, and more. Copper deficiency is rare and usually limited to people receiving parenteral (intravenous) nutrition [R, R].

Copper supplementation reverses bone abnormalities and stimulates bone formation in copper-deficient infants and older patients (R, R).

It improves heart function and may reverse heart enlargement caused by copper deficiency (R, R, R, R, R, R).

Possibly Effective:

2) Skin Health

Copper increases the production of collagen (which provides strength and structure) and elastin (which provides skin elasticity and resilience) (R, R).

Copper-impregnated socks, due to Cu antimicrobial and antifungal properties, were effective against athlete’s foot infections (tinea pedis) in a trial of 56 patients (

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What is Glutamate?

Definition

Glutamate, also called glutamic acid, is one of the most abundant amino acids in the human body. The highest concentrations are present in the brain and muscles (R, R).

It also plays an important role in cell energy production and protein synthesis (R, R).

On the other hand, some researchers have hypothesized that excessive brain levels contribute to neurological and mental diseases (R).

Glutamate Vs. Glutamic Acid

Glutamate is interchangeable with glutamic acid, but it is chemically distinct from glutamine. The distinction is that, in one place, glutamate has a hydroxyl (-OH) group, whereas glutamine has an ammonia (-NH3) group. Read this post to learn more about glutamine.

Roles of Glutamate in the Body

1) Supports Brain Function

Glutamate is an important neurotransmitter for normal brain function (R).

Nearly all excitatory neurons in the brain and spinal cord (central nervous system) are glutamatergic (R).

As the main excitatory neurotransmitter, it sends signals to the brain and throughout the body. It helps cognitive function, memory, learning, and other brain functions (R).

Glutamate is a non-essential amino acid that does not cross the blood-brain barrier and must be generated inside the brain cells locally from glutamine and other precursors (R).

However, glutamate in the blood may enter the brain if the blood-brain barrier is “leaky” (increased permeability due to blood-brain barrier injury or dysfunction) (R).

Glutamate plays an important role in brain development (R).

The brain appears to need glutamate to form memories (R).

Limited research has linked low brain levels of glutamate with neurological and psychiatric disorders. For example, glutamate levels were lower in schizophrenic adults than healthy adults in one study (R, R).

Low amounts of metabotropic glutamate receptor type 5 (mGluR5) indicated poor brain development in epilepsy patients (R).

In mice, low glutamate release has been used to model autism spectrum disorders (R).

In rats, leucine increases glutamate entry

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