Iron Deficiency Anemia & The Iron Recycling System
In the women’s health and wellness space, iron deficiency anemia is a commonly known diagnosis given. Iron deficiency anemia is “a condition in which blood lacks adequate healthy red blood cells due to insufficient iron” (1). Conventionally, iron deficiency anemia is “corrected” with iron supplementation. The standard train of thought with treating iron deficiency anemia is that if the body is deficient in iron (whether from not consuming adequate sources of iron or losing too much iron via for example the blood), supplemental iron will make up for the insufficient iron status.
In today’s blog post, I am going to be diving into why there can be more to the story of iron deficiency anemia than what’s conventionally shared. To start, I think it’s important you know about the body’s Iron Recycling System.
The Iron Recycling System
As shared above, iron is an essential metal for producing red blood cells in the body. Our bodies need 25 mg of iron per day to support the production of red blood cells. What’s actually really amazing about the body is that it produces a majority of our daily iron needs via the Iron Recycling System. Every day the Iron Recycling System produces 24 mg of iron. This means that when consuming iron-rich food sources like animal products, it’s very easy to meet the additional ~1 mg of iron needs per day.
However, with conditions like iron deficiency anemia being so common even though our bodies produce a majority of our iron needs per day, it’s important we understand how the Iron Recycling System works. To do that, let’s first distinguish between the two different places where iron can be found in the body.
Serum Iron vs. Tissue Iron
Serum Iron: Approximately 70% of our iron should be found in hemoglobin. This means that a majority of our bodies’ iron is meant to be in the serum or red blood cells.
Tissue Iron: Iron that isn’t in the serum and gets stored in enterocytes, hepatocytes, and macrophages. The important thing to note here before moving forward, is that when iron is stored in excess in the tissues, iron is linked to oxidation and inflammation.
Copper’s Connection to Iron
So what causes excessive tissue iron storage? In order for iron to travel from the tissues to the serum, it needs the help of:
1. ferroportin
2. ferroxidase enzymes (hephaestin in enterocytes and ceruloplasmin in other cell types).
Think of ferroportin as the doorway for the iron to travel through.
Think of the ferroxidase enzymes as the hands that help iron safely step through the doorway.
The important thing to note about these two key pieces needed for iron to travel from the tissues to the serum is that ceruloplasmin is a copper-dependent enzyme. If bioavailable copper and any of its supporting nutrients or cofactors (magnesium and vitamin A) are depleted, then ceruloplasmin can’t help move iron from the tissues to the blood.
How does this relate to iron deficiency anemia? Iron deficiency anemia (aka low serum iron) can appear on lab results if iron gets stuck and becomes elevated in the tissues.
You can now see why adding more iron into the mix by supplementing iron doesn’t actually address a potential root cause as to why iron is low in the serum in the first place. In this case, iron is low in the serum due to inadequate bioavailable copper.
A Quick Recap
So let’s take a moment to recap the basics of what we’ve covered in today’s post! Our bodies have an Iron Recycling System that produces a majority of our iron needs per day to prevent inadequate iron status. However, iron deficiency anemia can occur if our bodies don’t have the adequate bioavailable copper status which is needed for ceruloplasmin to help move iron from the tissues to serum. So if your serum iron levels are coming back low, there can be more to the story than just iron alone.
Working 1:1 to Truly Overcome Iron Deficiency Anemia
Being there’s more to the iron deficiency anemia picture than just iron, our team of practitioners ensures you get the proper lab work paired with personalized nutrition, supplement, and lifestyle protocols to truly overcome your symptoms. To apply for a free consultation to learn more about what it looks like working 1:1, click here.
Disclaimer: the information in this article is for educational purposes only and is not designed to replace individualized recommendations from a practitioner. Always check with your doctor before adding supplements or making changes to your treatment plan.