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Treatments for Iron Deficiency Anemia and the Need for Phytoferritin Research

KEY WORDS:

Anemia: A condition defined by low levels of haemoglobin in the body. Symptoms include fatigue, heart palpitations, headaches and chest pains.
Iron- deficiency anemia (IDA): A common type of anemia caused by iron deficiency due to bleeding, poor diet, or malabsorption. As iron plays a vital role in the body, IDA can lead to cognitive, motor and growth defects in children.
Ferritin: A protein found in high levels in humans, animals and plants. Its principal role is to bind and sequester iron. As such, ferritin is an organic source of iron.
Phytoferritin: Plant ferritin that is similar in structure and function to human ferritin. Supplementation with phytoferritin is well-tolerated unlike some inorganic sources of iron.
Ferrous Sulfate: An inorganic form of iron used for supplementation in IDA. There are a number of side effects associated with ferrous supplementation including nausea, constipation and heartburn.

What is Anemia?

Anemia is a major public health problem, affecting as much as one-third of the world’s population. Anemia is defined as a low level of haemoglobin (the protein which carries oxygen) in the blood. Common symptoms include fatigue, heart palpitations, headaches, lightheadedness, paleness, and angina (chest pain) in individuals with pre-existing coronary artery disease.

What is Iron Deficiency Anemia?

Iron deficiency anemia (IDA), is anemia caused by iron deficiency and is the most common type of anemia. Iron is necessary for the formation of heme, a component of haemoglobin. Without heme, there is less haemoglobin carried by red blood cells. There are a variety of causes of IDA. Bleeding, such as during menstruation (up to 14% of women are affected by IDA), or because of peptic ulcer disease can lead to IDA. Poor diet is also a significant contributor to IDA. Lack of iron is the most common nutritional deficiency in the world, and up to a third of the world’s population do not have an adequate iron intake. Finally, poor absorption by the gut, such as in celiac disease or due to a gastrectomy can lead to the development of IDA.
IDA is particularly problematic during pregnancy and can lead to various health problems for the mother and the baby, such as fetal growth retardation, during pregnancy or after delivery. Children are also at high risk, and IDA continues to be a major health challenge due to undernutrition or malnutrition and can cause adverse effects on growth, motor and cognitive development, as well as compromised immune function. It is believed that IDA in some children contributes to poor academic performance in school.

Iron Supplementation

One approach for the treatment of IDA is to provide iron-containing supplements to boost bioavailability and replace unavailable dietary iron. However, supplementing with different sources of iron has variable results. While inorganic iron sources have constituted the primary type of supplement used today, there is growing evidence that a better alternative is to use organic iron sources. It has been proposed that these organic iron sources have better potential for boosting plasma iron levels and preventing the development of IDA. Ferritin is a protein that contains iron and is present in almost all living cells. Plant-derived ferritin (phytoferritin) is a well-known organic form of iron that can be isolated from plant sources such as legumes for use as an ingredient in the manufacturing of iron-containing nutraceutical supplements. 

Based on the global problem of IDA, there is a ready market for phytoferritin, especially to replace currently used inorganic iron supplements such as ferrous sulphate. Inorganic iron supplements have been associated with negative side effects such as constipation, heartburn and nausea. These side effects contribute to a high rate of non-compliance with iron therapy, which leads to increased intensity of the anemia and associated health symptoms. 

Various clinical trials have shown that oral consumption of ferritin does not produce the negative symptoms associated with inorganic iron supplement consumption. Therefore, there is a high potential for compliance with a therapeutic dose if phytoferritin is used as a supplement to prevent IDA. The expected high compliance rate coupled with the therapeutic efficiency could make ferritin a highly sought-after supplement in the health industry.

Finally, while there are a number of animal sources of ferritin (iron heme) from red meats, fish and seafood, plant products (non-heme ferritin) are cheaper to produce and meet the requirements of vegetarians and vegans. Thus, the necessity to research phytoferritin is substantial with potential implications for improvements in health and well-being.

References

1. Sandberg AS. Bioavailability of minerals in legumes. Br J Nutr. 2002; 88(Suppl):S281-S285.
2. Zielinska-Dawidziak M, et al. Effect of elevated accumulation of iron in ferritin on the antioxidants content in soybean sprouts. Eur Food Res Technol. 2012; 234: 1005-1012.
3. Kalgaonkar S, et al. Effects of dietary factors on iron uptake from ferritin by Caco-2 cells. J Nutr Biochem. 2008; 19:33-39.
4. Beard JL, et al. Purified ferritin and soybean meal can be sources if iron for treating iron deficiency in rats. J Nutr. 1996; 126:154-160.
5. Walker SP, Wachs TD, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007; 369:145-157.
6. Pollitt E. Iron deficiency and cognitive function. Annu Rev Nutr. 1993; 13:521-537.
7. Hunt JR. Supplements bioavailability or iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr. 2003; 78:633S-639S.
8. Stoltzfus RJ, et al. Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. ILSI Press, Washington, 1998.
9. Theil EC. Iron, ferritin, and nutrition. Annu Rev Nutr. 2004; 24:327-343.

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About The Author

Dr. Traj Nibber is the Director of AOR, he has a degree in Pharmacy, a Masters in Toxicology and a PhD in Pathology. Dr. Nibber founded AOR to clear the misdirection prevalent in the nutraceutical world, and provide people with highly effective, research backed products.

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