Lets Talk About Iron Metabolism and Deficiency During my 4th Iron Infusion Treatment.

How am I doing? Great. I'm feeling really good. I feel alert, energized, and cognitively, I feel like I'm doing better. YAY! Let dive into some factoids. SOOOO thrilling :)

The major function of red blood cells is to transport hemoglobin

Hemoglobin carries oxygen from the lungs to the tissues.

Red blood cells have the ability to concentrate iron.

The blood contains an average of 15 grams of hemoglobin per 100 milliliters of blood.

Each gram of pure hemoglobin is capable of combining with 1.3 mL of oxygen, meaning each mL of blood carries about about 20 mL of oxygen.

Are we feeling jazzed yet?

Lets learn some more about iron metabolism

Iron is important for the formation of hemoglobin, myoglobin, cytochromes, cytochrome oxidase, peroxidase and catalase (different enzymes).

On average, we have about 4 to 5 grams grams of iron in our body. About 65% of this is found in the form of hemoglobin.

Remember transferrin? I talked about transferrin in this video.

A small percentage of iron (0.1%) is combined with the protein transferrin in the blood plasma.

Iron gets absorbed through the gut wall (if the gut is functioning well), and is combined with apotransferrin. Bingo, bango, bongo... iron + apotransferrin = transferrin.

Iron bound to transferrin is loosely bound. Think of it like the Amazon delivery truck. It's job is to deliver the packages (of iron) as efficiently as possible.

Iron also combines with a protein called apoferritin to create... drum roll please... ferritin.

The liver stores 15-30% of the body's iron as ferritin.

When the quantity of iron in the plasma (the fluid in our veins and arteries that red blood cells float around in) decreases to less than normal, iron is removed from ferritin quite easily. Transferrin then transports iron to where it is needed.

Transferrin binds to the cell membrane which sucks the iron in through a process called endocytosis.

Once inside the cell the transferrin delivers the iron right to the mitochondria which are the energy producing powerhouses of our cells.

The mitochrondria then put the iron into hemoglobin.

And then the hemoglobin transports the oxygen. HOORAH!

When red blood cells are destroyed at the end of their life, macrophages (a cookie-monster like white blood cell) gobble up the hemoglobin. The iron released as the hemoglobin is broken down goes back into the ferritin pool, and perhaps back into more hemoglobin.

It's the circle of life!

(PS... I'm in Vancouver to see the Lion King... eeeeeee << excited noise... so the reference is both true and topical ;) )

Different types of Anemias

Anemia means deficiency of the blood in Latin.

Iron deficiency and blood loss are major causes of anemia.
Remember... we need the gut to be functioning well to be able to break down the food we eat, extract the iron, and absorb it into the body. More on absorbing iron below.

Normocytic Anemia

This is due to blood loss as in hemorrhage:

• external bleeding - (to the outside of the body) due to wounds, or heavy menstrual bleeding.

• internal bleeding - due to ulcers, perforated things that shouldn't be perforated, like spleens, etc.

Both of these things can lead to...

Microcytic Anemia

If the body doesn't have enough iron (because of hemorrhage, poor diet, poor gut function) the blood cells get smaller and are less able to carry oxygen.

You can be iron deficient before you become anemic, technically. When I'm looking at blood work, a ferritin less than 50 is a warning signal that someone is on their way to becoming anemic and those people are possible candidates for iron infusion IV treatments.

Aplastic Anemia

This is when the bone marrow isn't functioning well and not producing red blood cells effectively.

This can be due to certain types of radiation, intense chemicals (toxins, chemotherapy, certain antibiotics), viral hepatitis or autoimmune disease.

Megaloblastic Anemia

When the body is deficient in the vitamins B12 or folic acid, and/or intrinsic factor (which is produced by the stomach to help absorb B12) the red blood cells don't have the right proper signals and chemical support support to grow into their normal size and shape.

B12 and folic acid are involved in DNA synthesis, and with out them the cells don't properly cleave during cell division, and instead get larger than normal.

This is evident on a Complete Blood Count (CBC) with a measurement called Mean Corpuscular Volume (MCV) if it's over 90.

When I see this on blood work I suspect B12 deficiency even when the serum B12 is normal.

Hemolytic Anemia

This is when the red blood cells are fragile and they break apart as they move through the capillary system.

Different Types Of Iron

Our final note on iron metabolism is that there are two main types of iron.

Heme Iron

This comes from animals and is absorbed far better than plant sources. And it's utilized better in the body as well.

Non heme Iron

This comes from plants and is far less absorbable than heme iron.

You'll need 3x as much plant based iron to absorb same amount of heme iron.

So expecting that you'll get all your iron requirements met on a strictly plant-based diet is setting you up for a lot of disappointment, and fatigue. And brain fog. And heart palpitations. And all the other symptoms that come with iron deficiency or anemia.

Why not supplement iron orally?

Ah yes. Great question.

This is of course an option. Buuuut... 65% of people can' absorb iron because:

• they get too many side effects such as constipation and bloating (furthering the absorption issue)

• take medications such as proton pump inhibitors that hinder iron absorption

• don't take iron with vitamin C which is required for absorption.

• take iron with dairy or caffeine which blocks the absorption.

• take iron too often which turns down the body's willingness to absorb iron.

And some people have deadlines such as baby delivery or upcoming surgeries and need to get their iron stores up quickly. Orally supplementing iron is a slow burn.

In 6 months of supplementing iron at a heavy duty dose, my ferritin went up by 22 points (from 14-36). After 4 iron infusions my ferritin levels were at 108. But more on that in the next installment of that series.

If you're wondering if you are a candidate for iron infusions, check out the criteria here.

You can get that blood work done through me at a cost or through your GP or nurse practitioner.

We can fill up your iron tanks so you have the oxygen you need to do all the things you want to do... even if that's only healing... which is a noble intent indeed.

I'm newly offering IV iron infusions to the drained, depleted, exhausted folks of Nanaimo and Central Vancouver Island, BC…

So that they can increase their energy, focus, stress tolerance, and immune function, etc… 

And keep up with life demands without their health suffering anymore.