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» LymeNet Flash » Questions and Discussion » Medical Questions » Never Ends - New Issue - Iron Deficiency

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Author Topic: Never Ends - New Issue - Iron Deficiency
seekhelp
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MY ID doc re-ran my Babesia WA-1 IgG titer. It was borderline now. Titer was 1:256. Normal is <1:256. He called it 'equivocal' and most likely won't treat it.

Well, now I have a new issue. My blood iron levels tanked. They have always been normal and my TIBC has always been low normal. Apparently, my blood iron level is less than 50% of the low end of normal! My number is 15. Normal is 40-175.

I have been really feeling ill the last month. COuld this be it? I have EVERY symptom of iron deficiency to the tee. I'm not sure how my CBC came back. RBC count has always been normal oddly. I'll see on this one. I'm waiting for results. My TIBC is also very, very low they said.

They want me on an iron supplement and are doing a bunch more tests to look for stuff like internal bleeding and more. I just had a clean colonoscopy 4 months ago. Clean fecal occult blood stool sample test last September. However, I wasn't as weak as I am now so who knows.

Again, what the hell is happening to me? My legs were too weak to make dinner last evening. Every muscle is like jello. It's like I'm not getting the oxygen I need to function.

I'm a train wreck. [Frown]

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jmb
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Seek, Gut instinct tells me to chase Babesia. When I read your posts I tend to think Babesia, and I think you have responded to at least part of a Babesia abx cocktail. You should be able to find a doc who will treat you based on your labs and sensations.

From Doc Kl "Amazingly, the most depleted minerals in our Lyme patients are often copper, magnesium, manganese (in Lyme) and iron (in Babesiosis)." He said it back in 2005, though I don't think he would feel otherwise now, in: http://www.samento.com.ec/sciencelib/4lyme/beyondantibiotics.html, accessed just now.

--------------------
enjoy the day.

-jmb

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Keebler
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-
Ditto to jmb -- this just screams BABESIA

I had all the same symptoms you describe. My iron levels were nearly nonexistent and they were all upset over that, thinking it had to be internal bleeding. It was not.

They did a full upper and lower BARIUM GI test - an it showed nothing.

But I felt nearly poisoned from drinking all that BARIUM.

I will never do that again. It caused so many problems for me. I couldn't even walk out of the hospital after the test, needed a wheelchair for months after that.

A year later: positive for lyme; babesia & HME.

For iron, I could not tolerate the iron pills (even with the OJ they suggested) -- but the herb STINGING NETTLE brought it up nicely.

And it also helps to lower cytokines.

Now, of course the reason needs to be addressed but, along the way, I think Stinging Nettle can be a good help to nourish your cells and lower inflammation.

your cells may have a much better chance at grabbing hold of the nutrition from a food sourced herb.

Of course, too, I hope you can be assessed for BABESIA. Be sure to check both kinds that they test for -- but know there are others, too.

I was unable to get the Rx for this but have done well with some targeted herbs, especially CRYTPOLEPIS.
-

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Tammy N.
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Also check into Mold.
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karenl
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Happens with parasites as well.
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Annelet
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Are you taking Zinc for the KPU protocol? That can cause iron deficiency.
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whitmore
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My doctor(non LLMD) gives me monthly Infed shots. The oral route can take forever.

Of course, when we discovered the anemia, I hadn't really tanked physically, but wanted to take them to help me to take thyroid medicine. I've been taking the shots for over 2 years now, and they help with the RLS.

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seekhelp
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Thanks everyone. Babesia certainly does seem like the likely culprit here. I'm just shocked my IgG titer keeps going down on the WA-1 test. A part of me thinks LabCorp/Focus Labs may be tightening their test to get these titer levels lower as so many reported positives??

Mold, parasites....who knows. I did read hookworms steal your iron. I'm not sure how mold poisoning would affect iron reserves? I'm not saying it doesn't. I did mention before our home air testing showed VERY LOW levels of mold. If this is reliable??

I am not taking any zinc at all.

I sure hope I don't need to drink any barium! Yuck. I've had so many invasive tests over the years already. I have to say I'm shocked the iron levels tanked as they were OK less than two years ago.

I'm kind of scared of whatever is hitting my body and caused those 103 deg temps over the last month. I'm so out of breath trying to take the garbage out. My blood pressure will not go down either as my body is very stressed. My readings keep staying around 160-170 over mid 100s anytime I stand up and do anything. [Frown]

This is the weakest I have felt since I first fell ill back in 2007.

I wonder if taking Androgel impacts iron levels at all? I stopped it two weeks ago.

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glm1111
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Yes seek...you are right about hookworms being the cause of low iron. Have you been taking any antiparasitics lately since you were dx with roundworms/tapeworms in the past? Maybe a combo of Ivermectin and doxy could work for you?

Gael

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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TerryK
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Perhaps babesia is the reason you have low iron??

http://www.betterhealthguy.com/joomla/blog/238-bioresource-2011-conference

Borrelia uses magnesium for metabolism and is fed by magnesium; whereas Babesia is fed by iron.

Terry

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seekhelp
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Gael, no I have had no anti-parasitic treatments. No docs I see would ever use Ivermectin. None took that test seriously from Diagnos-techs. I think I better jump on the Parastroy, but from what GiGi said many times, it sounds hopeless to use non-pharmaceuticals.

Terryk/others, are you saying no matter how much iron you supplement, Babesia will just eat it all at the end if the infection is left untreated? Hmmmm. Is it like feeding fuel to a fire? Maybe it happened gradually, but I'm very surprised my number dropped so severely from a couple years ago. Really makes me think.

I wonder if low iron could result in muscles being tight consistently as they wouldn't get the oxygen they need to work well?

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TerryK
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seek wrote:
Is it like feeding fuel to a fire?

That's my understanding. My LLMD did not want me to take iron because of that.

That said, your body NEEDS iron so you can't let it get too low. I'd get the advice of a doctor who understands if you have one available.

Terry

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seekhelp
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I'm seeing a hematologist tomorrow for an opinion. I doubt he'll buy into Babesia of course, but I need to have some idea how to address this immediate issue given how fast it dropped. I'll let everyone know.

I just wish ONE time, Babs would show in the blood smear so I can know for sure. That's not too much to ask. [Smile]

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glm1111
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seek,

I really don't agree with GiGi's assesment that antiparasitic herbs don't work. If that were true I wouldn't have been able to get rid of all of the parasites pictured on lymephotos, along with a tapeworm, and many roundworms.

If you saw the pictures Gary posted after only a few days on parastroy, it really speaks to what antiparasitic herbs can do.

When I reached a plateau with Parastroy, I added Hanna Kroeger Wormwood, extra cloves, digestive enzymes and HCL.

Of course I was doing salt/c as well. I know you have b/p issues. Anyway, I really wish you would consider the herbs if you can't get the Ivermectin.

FYI, there was a thread recently where people were getting the Ivermectin at a pet store which requires no script.

IMO, Antiparasitics are very key in getting rid of this disease. If you decide on the herbs and you need help, please feel free to pm me.

Gael

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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glm1111
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P. S.

There was a thread a while ago where Dr. K. stated that in order to get rid of Babesia you have to first get rid of the other parasites. That's exactly what worked for me.

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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Sammi
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I agree with those who think Babesiosis. It can cause fevers also. You cannot go only by test results.

seekhelp, when was the last time you treated Babs?

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sammy
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Seek, it does seem never ending.

You think we have so many health problems, we couldn't possibly have any more...

Anyways, if you need a good iron supplement others here have recommended "Blood Builder" by Megafoods brand. I tried another brand first but this one seems to be working better and it is not constipating. My iron levels are finally normal! Thanks for the suggestion LN friends [Smile]

Now we just have to treat the Babesia or whatever is destroying my RBC because it and my hemoglobin, etc is always way alarmingly low.

Good luck with your hematologist appt Seek. I hope that he is able to help you.

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seekhelp
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Sammi #1 lol - It's been over a year since I took anything for Babesia, except for my short Clindamycin dose. That caused such a stiffness in my scapula muscle I couldn't barely breathe. Had to stop. It wasn't for Babesia anyways.

Sammy #2 - the strangest part is my hemoglobin levels are NEVER abnormal. Just the iron level. Not sure what that means. However, I always have other signs of hemolysis such as mildly elevated free plasma hemoglobin, elevated cold agglutinins, etc. My RBC and WBC counts are always normal. I'm a real mystery. [Smile]

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sixgoofykids
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I had babesiosis and anemia .... I had to take iron the entire time I was sick (and still have to supplement for other reasons). I can't imagine not having taken it. It's not like you can starve the babesia out of the body by not supplementing iron, I think you'd die first .....

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seekhelp
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Six, did you have low hemoglobin numbers on your CBC or just low iron like I have?
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glm1111
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A low production of hydrochloric acid can result in malabsorption of iron. One of the causes can be hypothyroidism.

Seek, what was it that you were dx with a while back that had to do with your esophagus/eosinaphelia???? can't quite remember.

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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seekhelp
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Gael, I was diagnosed with Eosinophilic Esophagitis (Ee). No one could determine the cause. All food allergy testing was negative.

Ironically, I had a chiropractor do Asyra testing and he said my body is not absorbing fats well at all (seems impossible given I'm obese). He said my gallbladder / liver were in poor shape and wanted me on a bunch of digestive enzymes and a Standard Process supplement to help the gallbladder. I was suspicious they just wanted supplement sales.

My TSH ranges between 2.5-3.5. Normal free T3 / T4. No auto-immune Ab to the thyroid. I know it could be better, but nothing showed it's crazy defective.

Now, I'm giving this a second thought.

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glm1111
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seek,

Sounds like you have an absorption problem, and if that's the case, it would make sense that low iron could be a problem. This just doesn't scream babesia to me, esp with an equivocal test and normal hemaglobin.

Eosinophellia can be indicative of parasites as well. Your chiropractor was right in suggesting digestive enzymes and the gallbladder supplement.

I would give that a try, along with some antiparasitic herbs. Eating some liver along with b-12 supplements might help as well to bring up your iron.

Gael

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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sixgoofykids
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quote:
Originally posted by seekhelp:
Six, did you have low hemoglobin numbers on your CBC or just low iron like I have?

Low hemoglobin since I was a teenager. Low ferritin, too. I got my ferritin up just last year, finally.

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sixgoofykids.blogspot.com

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glm1111
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LOW IRON

HIGH EOSINOPHILLS

POSITIVE TEST FOR PARASITES

High Probability that all of these put together would indicate a parasite infestation.

Seek,

Also google weight gain + parasites

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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sammy
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Interesting glm, my doctors (including hematologists...) are always stumped when my eosinophils are constantly at least 10x above normal range. They've been like this for years.
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seibertneurolyme
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Sammy,

Have you ever done the eosinophil cationic protein test? Hubby is getting ready to repeat that test. It is a test suggested by Dr S -- the one who wrote the book on babesia. I have posted several times on this topic if you do a search.

High eosinophils may be an indication of babesia.

Seek -- Hubby has struggled with low RBC, low hematocrit and low hemoglobin for the last year ever since he started his aggressive babesia treatment and ran the high fevers.

His iron was slightly low but we have not checked it again in probably 6 months or so. His PCP actually prescribed an iron supplement but hubby did not take it. He was on so many meds he was worried that it would interfere with med absorption. Anyway we plan to get his iron status retested soon.

Personally I think any parasite -- G.I. parasites and also blood borne parasites such as babesia -- can cause low iron.

Hubby used to have routine urinalysis testing under another LLMD -- when he was treating babesia with bactrim at that time he sometimes had a few red blood cells in his urine. That is actually a textbook babesia symptom.

So you could be losing miniscule amounts of blood thru your urine which over time adds up.

Hubby has been on betaine HCL, pancreatin (digestive enzymes) and ox bile supplements for years. He has problems absorbing fats -- that is the reason for the ox bile supplements.

I think it is highly likely that you have both G.I. parasites and babesia. And in my opinion that is what is causing the low iron.

With most minerals once you become low it is very difficult to get the levels back to normal. Just supplementing usually will not work unless you can also find the underlying cause.

This is not medical advice, just my opinion based on hubby's experiences.

Bea Seibert

Seek -- I agree that obesity can be an indicator of poor food/nutrient absorption and impaired digestion.

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glm1111
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So were mine sammy and according to E Medicine, the most common cause of Eosinophilia worldwide is due to the high prevelance of helminthic parasite infections.

Gael

--------------------
PARASITES/WORMS ARE NOW
RECOGNIZED AS THE NUMBER 1 CO-INFECTION IN LYME DISEASE BY ILADS*

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seekhelp
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Well, the hematologist appt was useless today. He had no concerns over my low iron really given my CBC-hemoglobin was fine. Weird. My elevated cold agglutinins and free plasma hemoglobin seemed not too important to him either.

He said low iron itself causes no symptoms. Not sure if I believe that at all! Of course, he said no way to parasites and said my blood eosinophils would be much, much higher if I had that.

But I certainly cannot ignore the very high Eosinophil counts in my throat/esophagus. I'm shocked my GI doc doesn't take it more seriously.

Six, it sounds like you're a much more classic case than me of anemia.

It's really getting difficult not to consider parasites more strongly at this point. My hematologist re-did my iron testing. I'll see if it matches what was done last week. I'm doubtful, but it could've been a flawed result.

The whole medical system is completely broken. Little accountability ever takes place. It sickens me.

His recommendation....wants me to go to a large university hospital and see a hematologist and infectious disease doctor there to address the cold agglutinins. I AM SO DAMN SICK OF DOCTORS REFERRING OUT TO OTHER DOCTORS AND NOT TAKING CHARGE. [Frown] That doesn't sound too hot to have a hematologist say go see a hematologist. lol.

Bea, I had a very elevated ECP blood test, but not as high as your hubby. My number was mid 40s. I was not even on anti-parasitics at the time.

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seibertneurolyme
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Seek -- So sorry you are getting the run around. Hubby just tries to avoid standard AMA docs (even his PCP) as much as possible. He just gets so frustrated trying to deal with them. And as you said large University hospitals are even worse -- they are always trying to diagnose some rare genetic disorder.

I definitely do not think that a low iron count would cause no symptoms regardless of what your other blood work says. Hemaocrit and hemoglobin are affected by more than just iron. B12 and folic acid and there are probably more factors.

In my opinion any nutrient which is considered low based on medical testing is significant and needs to be treated and evaluated.

Years ago before lyme and company hubby was having some dizziness issues. His PCP at the time referred him to a neurologist. The neuro did test his B12 and told him it was normal. At that time hubby was pretty healthy and did not follow-up and request a copy of the bloodwork. The PCP requested a copy. Hubby's B12 was 206 I think -- the low end of normal range was 200. So technically his B12 was normal. His PCP said that most of her patients did better when their B12 levels were around 600. She gave him B12 shots for 10 weeks and retested. His levels went up to over 2500 I think -- whatever the top end of the scale was. But the important point was that his dizziness improved -- did not go back entirely to normal but it wasn't long after that that we found his mercury problem which was also probably a contributing factor.

My point is that even if nutrients are in the so called normal range that might not be the optimal range for a person.

I really wish you could find an ACAM doc who could help you figure out what is going on.

Bea Seibert

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sixgoofykids
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quote:
Originally posted by seekhelp:

Six, it sounds like you're a much more classic case than me of anemia.

Yes, it does. Though Lyme and co. made me need a much higher dose of iron (more than double), I have a classic case of anemia not related to Lyme.

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Hambone
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quote:
Originally posted by seekhelp:


He said low iron itself causes no symptoms.

OMG that is such BS !!!!!! It is really a sad state of affairs when we have doctors who actually believe this crap. That is just flat out malpractice. [cussing] [rant] [Mad]

My hemoglobin was fine but my Ferritin was ZERO. I could barely lift my arms and was so weak I couldn't wash my hair or stand more than a minute. Started taking iron and the weakness got waaaaaay better.

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Lymeorsomething
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Don't listen to any typical hemo doc. Men need more iron than women so if you have the iron level of a menstruating woman then you should treat. By low iron, I mean low ferritin. Serum iron can look good but you have to go by ferritin.

I did some research on this recently. Mean ferritin for men falls roughly between 90-125. So shoot for at least 100.

It's good for energy, muscle strength, hair, and thyroid function. Just do not let it go too high obviously.

Iron supps have doubled my weight lifting performance.

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"Whatever can go wrong will go wrong."

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Hambone
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http://www.thewayup.com/newsletters/081504.htm


Lets get on with
WHAT YOU NEED TO KNOW ABOUT IRON DEFICIENCY

This newsletter is coming to you because I am tired of all the costly misunderstanding about iron deficiency; tired of patients who are iron deficient being told by their doctors they are fine because they do not have anemia. I am tired of seriously iron deficient patients discontinuing their iron pills every time they hear from the media about the over hyped risks of iron excess.

I diagnose iron deficiency in my patients quite commonly and have only seen a problem with excess iron a handful of times. Iron excess is a genetic problem called hemochromatosis occurring mostly in men who are of Northern European background, when it does occur. It rarely develops from the excess supplementation of iron.

I have found that those prone to iron deficiency either by dietary habits, faulty absorption, or some other unknown malfunctioning or risk factor will almost never be able to accumulate excess iron. Indeed, even with supplementation, they have difficulty achieving the security of mid normal levels. I have had to refer a few patients for IV administration of iron because they either could not achieve adequate levels by oral dosages, or they had intolerable side effects from the oral iron.

WHO IS AT RISK FOR IRON DEFICIENCY?

Iron deficiency is a significant global problem. It is essential we address the iron issue so as to attend to those at risk. Did you know that one third of the worlds population is iron deficient? Did you know that iron deficiency is the most common nutrient deficiency in the world, exacting incalculable tolls which we shall later discuss? Iron deficiency is the most common cause of anemia worldwide. Granted, the problem is four times greater in developing countries than in the U.S. Still, at least 10% of the U.S. population is deficient and since they are rarely males, that means 20% of the women and children are clearly deficient. Iron deficiency is the most common nutrient deficiency in American children.

Check out the following list of those at risk for low iron levels, and you will see at least half of the population is at risk. Only males are relatively safe, unless quite elderly and malnourished, or with specific risk factors.

High risk groups for increased likelihood of iron deficiency are:

Babies given cows milk instead of breast milk or iron fortified formula. Cow and goats milk are very low sources of iron and the iron is poorly absorbed. Breast milk is a good source of bioavailable iron, assuming the mother has adequate iron stores.
Embryos in formation. Low maternal iron may result in intrauterine growth retardation, low birth weight, increased infant mortality, and increased maternal complications and mortality.
Children 1-4 years old are at risk because of rapid growth unless iron fortified food or supplements are given.

Iron deficiency early in childhood can have long-term effects on mental development that may be irreversible. Iron deficiency is not easy to detect without a blood test. Most babies, particularly those who are premature or have low birth weight, need an iron supplement. Give as an iron fortified formula or as a separate liquid supplement to breastfed babies.

Teenagers are at risk because of rapid growth rates, and poor eating habits.
Menstruating women, especially those who have heavy periods. Menstrual bleeding is one of the most common causes of low iron. Such women require twice as much iron as do men. Thirty five-fifty percent of young otherwise healthy women have some degree of iron deficiency. More so in pregnancy.
Women using an IUD (because they generally have heavier periods)
Pregnant, postpartum and breastfeeding women
Women with more than one child
People who repeatedly crash diet
Vegetarians, (since animal products contain the most usable forms of iron.)
Athletes in training, as they may have exercise induced iron loss, especially with endurance sports and body building
People with kidney failure
People with worm infestation, or chronic parasites
Low income earners
The elderly have both decreased intake and absorption
Regular blood donors. Each 500ml of donated blood costs 200-250mg of iron.
People with conditions that predispose them to bleeding, such as gum disease or stomach ulcers, polyps or cancers of the bowel
Those with gastrointestinal disorders such as low or absent stomach acid, celiac disease, ulcerative colitis, Crohns Disease, partial removal of the intestines
People taking aspirin as a regular medication
Those with low thyroid functioning

All of those at high risk should take some form of daily iron supplement, and focus on eating iron rich foods, as listed later. The iron can be part of a multivitamin mineral supplement. Women who are not menstruating and men should not supplement iron unless they have a known problem or are at high risk for deficiency.

WHAT ARE THE SYMPTOMS OF IRON DEFICIENCY

With all the possible consequences from iron deficiency, you can see the extraordinary impact of low iron and why this is such an important topic. An iron deficient person would not have all of these symptoms, but some constellation of them. With 5 or more, consider iron problems.

Depression
Fatigue
Listlessness, weakness, decreased work productivity
Impaired learning and cognitive function
ADD and ADHD type behavioral disturbances
Developmental delay in infants and young children
Poor memory
Decreased attention span and increased distractibility
Impaired reactivity and coordination
Irritability
Dizziness
Appetite loss
Cravings for non foods such as ice, dirt or clay
Constipation
Difficulty swallowing (because low iron may cause a thin membrane to grow across the esophagus)
Joint soreness
Night time leg cramps
Asthma
Sores on skin, or itching
Poor wound healing
Can cause excessive menstrual bleeding
Hair loss (LOW IRON IS A FREQUENTLY OVERLOOKED CAUSE OF HAIR LOSS)
Headaches
Sore or burning tongue
Soreness in corners of the mouth
Brittle, flat, or spoon shaped nails
Longitudinal ridges on nails
Heart palpitations on exertion
Shortness of breath
Cold extremities, with decreased resistance to cold and poor regulation of body temperature
Tendency to recurrent infections
Chronic bladder infections
Anemia (hypo chromic, microcytic) paleness, weakness, drowsiness, fatigue
Numbness & tingling
Night sweats
Fragile bones
Growth impairment in children
Eye soreness
Vague gastrointestinal symptoms: belching, gas, nausea
Vitiligo (light blotches on the skin)
Swelling in the ankles
Bluish tint to the whites of the eyes
Visual disturbances
Papilledema (swelling inside the eye)
Enhanced heavy metal absorption and risk for toxicity. Those with low iron will have an increased GI absorption of metals which is not specific for iron, so will absorb more lead, cobalt, cadmium, mercury. High blood levels of lead are more common in children with low iron.

WHAT ARE THE FUNCTIONS OF IRON IN THE BODY?

Seventy five to ninety percent of the iron in your body is in hemoglobin which carries oxygen to all parts of your body to keep you from being anemic. There is the mistaken belief (even among those who should know better) that if you do not have anemia you have enough iron. Unfortunate and gross misinformation is given to the general public. In truth, the development of anemia is the last stage of iron deficiency occurring after many functions are already impaired.

Iron is a major player in multiple bodily processes and is needed for the function of about 100 enzymes and coenzymes in your body. For more details about these, you can see http://www.expasy.org/enzyme/ . If you go there, click search by cofactor and then click on the 3 listings of iron and the one of heme. These enzymes allow necessary biochemical reactions and transformations to take place. Some of the more studied of these enzymes are cytochrome C, cytochrome C oxidase, catalase, aconitase, and aromatic amino acid hydroxylases. The iron related enzymes are quite sensitive to depletion with even minor iron deficiency.

Hydroxylases are needed for the conversion of the amino acids tyrosine, phenylalanine and tryptophan to form critical brain neurotransmitters which are responsible for essential brain functions. This is why depression, learning and memory problems, and other brain malfunctions may be early signs of iron deficiency. The enzymes can malfunction with minor iron deficiency and before any manifestation of anemia. This is why there are so many symptoms associated with iron deficiency which may not necessarily be related to anemia.

Catalase breaks down and removes hydrogen peroxide from your body by turning it in to harmless water and oxygen. Hydrogen peroxide is a toxic waste product of metabolism which can accumulate and cause symptoms if not removed regularly.

The cytochrome enzymes are located in the inner membrane of the mitochondria, the energy generating part of each cell in your body. These enzymes participate in the process of changing your food to energy. Too little or too much iron in the mitochondria will cause malfunction of energy production.

Iron is also required for the synthesis of collagen and elastin which are the main supportive structures holding your body together.

Iron starvation arrests cell proliferation, presumably because the metal is required by ribonucleotide reductase and other enzymes involved in cell division. It is also required for DNA synthesis which allows cells to multiply and regenerate.

Iron is needed for the synthesis of the amino acid carnitine, which plays a role in fatty acid metabolism.

Iron plays a critical role in the major detoxification pathways of the liver.

HOW CAN YOU EAT MORE IRON?

Foods with high iron

Animal liver, kidney and heart
Oysters, clams, caviar
Iron-fortified bread and cereal, wheat germ and bran, rice bran
Lean red meat
Nuts/seeds (pistachio, pinon nuts, black walnuts, sesame, sunflower, pumpkin)
Egg yolks
Dried beans and legumes
Blackstrap molasses, sorghum syrup, brewers yeast
Dried fruit (apricots)
Dark leafy green vegetables (chives, parsley)
Nettle tea
Foods cooked in an iron skillet
.... Does this sound like what most of you eat???

Foods with medium iron

Seafood ( herring, mackerel, sardines, tuna, swordfish, scallops, shrimp. Abalone)
Meat/Organs (chicken, duck, goose, eggs, pork, veal, beef tongue, heart)
Nuts/seeds (almonds, brazils, cashews, chestnuts, peanuts, coconut, pecans, walnuts)
Grains (barley, brown rice, rye, wheat, buckwheat)
Fruits (gooseberries, dates, figs, raisins, prunes, olives)
Vegetables (beets, radishes, beet greens, brussel sprouts, chard, endive, kale, spinach, watercress, artichokes, lima beans, green beans, broccoli, cauliflower, peas, lentils, red kidney beans, garbanzos)
Dairy (cheddar cheese)
Misc ( maple sugar, brown sugar, bakers yeast, mushrooms)

And I include all of these gory details for two reasons; to see how much iron we may not be eating, and to guide those who are know iron deficients to eat more carefully and consciously.

The average American diet contains about 10-15 mg of iron daily, of which only 10% is absorbed, so about 1-1.5 mg daily. This about equals the daily amount of iron which is lost from the body through shed intestinal cells, sweat, and blood loss ( which may be minor, but chronic). Chronic loss of even small amounts of blood may significantly increase iron requirements. The average daily menstrual loss is 0.6-0.7mg. In Fe depletion, dietary absorption increases but rarely to > 6 mg of Fe unless supplemental Fe is added.

WHAT IMPROVES IRON ABSORPTION?

The two types of dietary iron are:

Haem iron which is found in animal foods such as beef, chicken and fish. Organ products such as liver and kidney are particularly rich in haem iron. The body absorbs around 15-20% per cent of the iron from animal sources. Liver may be as high as 35%. There are no side effects or gastrointestinal problems caused by the absorption of this form of iron. The amino acid in animal proteins which particularly increases iron absorption is cysteine
Non-haem iron is found in plant foods such as beans and lentils. The body only absorbs between two and eight per cent of the iron from plant sources. Good vegetarian sources of non-haem iron include iron-fortified breakfast cereals, flours and grains. Red meat also contains some non-haem iron.

Defective iron absorption is caused by diets low in iron , high in cereal/grain content, and low in animal protein. Some amino acids in animal protein facilitate the absorption of iron.

Other factors that boost iron absorption

Vitamin C (found in fruits and vegetables) increases iron absorption.
Adequate stomach acid boosts iron absorption. Absorption takes place in the stomach and small intestines.
Copper and folic acid are major enhancers of iron absorption and utilization
Other synergists for iron are Vitamin B12, Selenium, Chlorophyll, and Molybdenum
Meat boosts iron absorption from plant sources.
In most cases, cooking increases the amount of available non-haem iron in vegetables. For example, the body absorbs six per cent of the iron from raw broccoli, compared to 30 per cent from cooked broccoli.
Theoretically, those low in iron will absorb more dietary iron than those with adequate or high levels, so absorption rates adjusts depending upon the baseline levels. This assumes there are no gastrointestinal problems contributing to the low absorption of iron.

Dietary and other factors that reduce iron and iron absorption

Certain foods and drinks reduce your body's ability to absorb iron, including:

Soy proteins can reduce absorption from plant sources.
Tannins from tea, coffee and wine reduce iron absorption by binding to the iron and carrying it out of the body.
The stored phosphorus in bran, called phytate or phytic acid, reduces iron absorption.
High fiber diets can reduce the absorption of iron and other minerals, because food is moved very quickly through the digestive system. A common cause of low iron is a high cereal/grain, low animal protein diet.
Low Vitamin A can lead to iron deficiency because Vitamin A helps to release stored iron.
Calcium, phosphorus, Manganese, Chromium, Magnesium, Zinc, Nickel, and Cadmium reduce the absorption of plant-sourced iron. Zinc is a major antagonist of iron.
Antacid use
Egg Yolk inhibits iron absorption

Iron deficiency is more likely on a dairy rich diet.

Cow's milk products are very low in iron, thus, if they become a major part of one's diet, iron deficiency is more likely. In addition, clinical studies have shown that infants consuming cow's milk lose small amounts of blood from their digestive tracts. For this reason, the American Academy of Pediatrics recommends that infants below one year of age not be given whole cow's milk. "We now think that iron deficiency at that age can lead to brain damage" - Dr. Lewis Barnes, University of Wisconsin Pediatrician. If you consumed only dairy products, you would have to drink 50 cups of milk to reach your RDA's for iron.

WHAT IS THE USUAL REQUIRED MAINTAINANCE DAILY IRON INTAKE?
1-1.5 mg per kg daily 2.2 =1kg
Infants Approx 3-10mg
Children 1-11 years 6-10mg
Teenagers 10-27mg
Menstruating teens and women 12-23mg
Pregnant and nursing women 35-100mg
Non menstruating women 7-9mg
Elderly 8-10mg
Men aged 19 years and over 7-9mg
The above refers to absorbed amounts or iron, which are far less than ingested amounts.



Maintaining iron levels in infants and children

For breast-fed infants who receive insufficient iron from supplementary foods by age 6 months , suggest 1 mg/2.2 pounds per day of iron drops.
For breast-fed infants who were preterm or had a low birth weight, recommend 2-4 mg/2.2 pounds per day of iron drops (to a maximum of 15 mg/day) starting at 1 month after birth and continuing until 12 months after birth.
Use only breast milk or iron-fortified infant formula for any milk-based part of the diet, and avoid use of low-iron milks (e.g., cow's milk, goat's milk, and soy milk) until age 12 months.
Children aged 1-5 years need to consume no more than 24 oz of cow's milk, goat's milk, or soy milk each day.
At age 4-6 months or when the extrusion reflex disappears, introduce infants to plain, iron-fortified infant cereal. Two or more servings per day of iron-fortified infant cereal can meet an infant's requirement for iron at this age.
By approximately age 6 months, encourage one feeding per day of foods rich in vitamin C (e.g., fruits, vegetables, or juice) to improve iron absorption, preferably with meals.
Introduce plain, pureed meats after age 6 months or when the infant is developmentally ready for them.

Maintaining iron levels in athletes

Endurance performers are susceptible to iron-deficiency because the absorption of iron cannot balance the losses incurred through training. Women in intensive athletic training may particularly need 100-200 mg of supplemental iron daily.


All those in the high risk groups should receive some form of supplemental iron and attempt to eat a diet high in iron. Doses would range from 15-100 mg of elemental iron. The amino acid chelated organic forms of iron or something such as liver extracts would be better tolerated from a gastrointestinal perspective than the inorganic forms such as ferrous sulfate. The supplement, ferritin, is an iron binding protein which is rapidly absorbed, bioavailable and free of gastrointestinal side effects.

HOW DO YOU TEST FOR IRON DEFICIENCY?

I hate to tell you that the usual screening tests doctors order to check for iron deficiency are hemoglobin (Hgb) and hematocrit (Hct) which are tests for anemia only!!! We have already visited that area. Secondly, they may check a serum iron level which may be fine if adequate iron has been absorbed in the last 24 hours (even if the person is suffering from iron deficiency and has very low storage levels available for daily life processes). This method of testing is partially economic as these tests are cheaper, but what use if only measuring the extremes? Cheaper for whom? Not those who will suffer lasting consequences from iron deficiency.

Because changes in Hgb concentration and Hct occur only at the late stages of iron deficiency, both tests are late indicators of iron deficiency; nevertheless, these tests are essential for determining anemia caused by low iron.

Total body iron averages 3800mg in men and 2300mg in women. Iron is stored primarily as ferritin, but some is stored as hemosiderin. Iron is transported in the blood by the protein, transferrin. Ferritin is an active soluble storage fraction found in the serum, liver, bone marrow, spleen, and red blood cells. Hemosiderin is relatively insoluble and in stored primarily in the liver and bone marrow.

.Serum ferritin is a test for total body iron storage and is my favorite and the best test to measure iron status. Low serum ferritin ALWAYS identifies iron deficiency.

A problem is that serum ferritin levels may be falsely increased with liver damage, inflammation, some infections and some cancers. In these unusual cases, it would fail to identify iron deficiency.

The normal range of serum ferritin in most labs is 30-300 mcg/L. In the United States, the average serum ferritin concentration is 135 mcg/L for men , 43 mcg/L for women , and approximately 30 mcg/L for children aged 6-24 months. Serum ferritin 1 mcg/L concentration is equivalent to approximately 10 mg of stored iron. So a level of 30 would equal 300 mg of stored iron.

A study found a positive response to iron treatment in those with ferritin levels less than 50. Another study found that those with ferritin levels less than 50 had a 50% chance of iron deficiency in the bone marrow.

WHAT IS THE TREATMENT DOSAGE FOR SOMEONE WITH LOW IRON?

When actually diagnosed with low serum ferritin levels, iron treatment needs to be in higher doses than that used for supplemental maintenance and higher still if there are many symptoms of deficiency or the actual onset of anemia. It takes 6-12 months of iron treatment to replenish the stores of iron in the body after becoming depleted. It is a mistake to discontinue treatment too soon. Further, my position is that once stores are back to normal the person prone to low iron should decrease their treatment dose to a maintenance dose, but continue to take some iron indefinitely. When they stop completely, the problem tends to recur over timeusually because the precipitating cause is not recognized or understood.

Ferrous sulfate, 325 mg three times daily, is the usual prescriptive treatment. Only 10mg of this is usually absorbed since it has about a 3% absorption rate. Patients who cannot tolerate iron on an empty stomach should take it with food.

Inorganic salts are ferrous sulfate and carbonate.

Chelated forms are ferrous citrate, lactate, fumerate, gluconate, succinate, glycinate ,picolinate. These may be better absorbed and better tolerated by the stomach. Avoid enteric coated supplements as they are not well absorbed.

The most common side effect of iron supplements is dark colored or black stools, so don't be alarmed by this change to your bowel habits.
Other common side effects include nausea, vomiting, constipation and diarrhea. See your doctor for advice but, generally speaking, treatment involves lowering the recommended dose for a short time to give the body time to adjust.

Take iron supplements in several small doses, since one large dose is likely to be unabsorbed and unutilized! It is useful to give with Vitamin C and L-cysteine to enhance iron absorption. Those low in stomach acid may need to add Betaine HCL. Chlorophyll, blue green algae, and spirulina also mysteriously help in building blood and absorbing iron.

Oral iron treatment may fail in patients with low stomach acid, other forms of malabsorption syndrome, chronic diarrhea, continued blood loss, or those who have had part or all of the stomach removed. I have also seen it fail in others for as yet unclear reasons. They will require shots or intravenous iron, as will those who cannot tolerate oral iron treatment.

Iron and overdose

Accidental overdose of iron containing products is a leading cause of fatal poisoning in children under 6. So do not be careless in properly sealing and storing containers.

Iron and thyroid

Recent studies have shown that under experimental conditions ferrous sulfate (iron) may reduce the gastrointestinal absorption of orally administered levothyroxine sodium in patients with primary hypothyroidism. A patient became hypothyroid while taking ferrous sulfate. The hypothyroid status was corrected by increasing the dose of levothyroxine. Subsequently, when ferrous sulfate was discontinued, the patient became hyperthyroid while taking the higher dose of thyroid hormone preparation. Since both hypothyroidism and iron deficiency anemia may coexist, additional thyroid function testing is recommended in patients treated concurrently with ferrous sulfate and L-thyroxine.

Iron and copper

Low iron which is not corrected by giving iron is a common clinical signs of copper deficiency and may be corrected by adding copper supplementation. The low iron results from defective iron mobilization. Copper deficiency may also result in abnormally low numbers of white blood cells, which can make you susceptible to infections and unable to combat them when they occur. We need copper for proteins involved in growth, nerve function and energy release. It is vital for the formation of some important proteins. It is a critical functional component of a number of essential enzymes, known as cuproenzymes. Two copper-containing enzymes, ceruloplasmin ferroxidase I and ferroxidase II are involved in iron metabolism. Copper is stored in appreciable amounts in the liver. It also has anti-oxidant properties and involved in the regulation of gene expression.

CAN YOU GET TOO MUCH IRON?

EXCESS IRON OR IRON OVERLOAD PROBLEMS/ HEMOCHROMATOSIS

The body normally absorbs less iron if its stores are full, but some individuals are poorly defended against iron toxicity. Once considered rare, iron overload has emerged as an important disorder of iron metabolism

Hereditary hemochromatosis (HH) is an iron overload genetic disease caused by a gene which enhances the absorption of iron. It is the most common inherited metabolic disease among the white population worldwide. The body absorbs excess iron and stores it in the major organs (heart, pancreas, liver, etc.). If untreated, this can eventually cause cirrhosis of the liver, diabetes mellitus, and cardiac complications HH is treated by phlebotomy--blood-letting until the serum ferritin normalizes.

The frequency of those with 2 copies of the gene and therefore the disease is about 1%. Those having 1 copy of the gene and therefore a tendency to abnormal iron metabolism are 4-19% depending upon the study. They may have some form of iron overload or hemosiderosis, characterized by large deposits of the iron storage protein, hemosiderin, in the liver and other tissues.

Transferrin saturation is the recommended screening test for hemochromatosis; a repeated high value indicates hemochromatosis . Also the ferritin level will be greater than 300.

Other causes of Excess iron include many blood transfusions and iron therapy given in excessive amounts or for too long. Excess iron consumed all at once causes vomiting, diarrhea, and damage to the intestine. Excess iron consumed over a period of time may damage coronary arteries. Treatment often consists of the drug deferoxamine, which binds with iron and carries it out of the body in urine.

Iron overload is most often diagnosed when tissue damage occurs, especially in iron-storing organs, such as the liver. Ironically, some of the signs of iron overload are analogous to those of iron deficiency: fatigue, dizziness, nausea, vomiting, headache, weight loss, shortness of breath, irritability, lowered work performance, and possibly a grayish skin color. Other common symptoms of iron overload include enlarged liver, skin pigmentation, joint diseases, loss of body hair, loss of menstrual periods, and impotence.


Until next time, many blessings

Priscilla Slagle M.D.

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sixgoofykids
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quote:
Originally posted by Hambone:


My hemoglobin was fine but my Ferritin was ZERO. I could barely lift my arms and was so weak I couldn't wash my hair or stand more than a minute. Started taking iron and the weakness got waaaaaay better.

My ferritin with taking double doses of iron for years was 22. I was terribly fatigued from it (and it wasn't zero!!). I feel so much better with it up in the 60's. My gyno would like to see it higher than that, even.

I can tell you with certainty that in my case, low ferritin caused fatigue. My hemoglobin would test fine (around 13) because of the supplementation.

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seekhelp
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Wow Hambone, that is so enlightening. I am just perplexed so many physicians say what they do. How is this acceptable in medicine? I swear no matter what is wrong with me and comes back abnormal, they have zero concern. I'm told everything does not cause any symptoms. It's pretty absurd really. They say it with a straight face.

I think all hematologists care about is cancer honestly.

The whole go see another specialist routine is a joke now. They should NOT get paid when they pull that. It's not fair to not be accountable for your patients.

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Catgirl
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THANK you Hambone! I think I've been getting too much zinc.

I didn't know much of this:

"Certain foods and drinks reduce your body's ability to absorb iron, including:

Soy proteins can reduce absorption from plant sources.
Tannins from tea, coffee and wine reduce iron absorption by binding to the iron and carrying it out of the body.
The stored phosphorus in bran, called phytate or phytic acid, reduces iron absorption.
High fiber diets can reduce the absorption of iron and other minerals, because food is moved very quickly through the digestive system. A common cause of low iron is a high cereal/grain, low animal protein diet.
Low Vitamin A can lead to iron deficiency because Vitamin A helps to release stored iron.
Calcium, phosphorus, Manganese, Chromium, Magnesium, Zinc, Nickel, and Cadmium reduce the absorption of plant-sourced iron. Zinc is a major antagonist of iron.
Antacid use
Egg Yolk inhibits iron absorption

Iron deficiency is more likely on a dairy rich diet."

--------------------
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glm1111
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This statement seems to be an oxymoron. Egg yolks are listed as high in iron, then it says egg yolks inhibits iron absorption.

REALLY??

Gael

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Hambone
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quote:
Originally posted by glm1111:
This statement seems to be an oxymoron. Egg yolks are listed as high in iron, then it says egg yolks inhibits iron absorption.

REALLY??

Gael

I just did a quick Google about that and found this:

"Eggs contain a compound that impairs absorption of iron. Phosphoprotein called phosvitin is a protein with a iron binding capacity that may be responsible for the low bioavailability of iron from eggs. This iron inhibiting characteristic of eggs is called the egg factor. The egg factor has been observed in several separate studies. One boiled egg can reduce absorption of iron in a meal by as much as 28% "


Apparently eggs have iron, but because they also have phosvitin, that iron isn't absorbed and any other iron you eat with an egg is reduced because of it.

I guess eggs are iron rich, but it's unusable. Learn something new everyday.

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glm1111
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Hambone,

Thanks for researching the egg yolk dilemma. I guess it's the eggs themselves that are the oxymoron. [Cool]

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