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Iron metabolism and iron deficiency anemia
Iron deficiency anemia develops slowly over weeks and months. The daily iron requirement (iron metabolism) is 1 – 2 mg per day. The body has a storage of about 2.5 – 3.5 g in liver, bone marrow and the monocyte-macrophage system.
About 10 – 20 mg per day are taken in through a normal diet, of which less than 10% are absorbed in the intestines. However, our body is able to increase the absorption 3 – 4 times if necessary. This is done by the hormone hepcidin, which is produced in the liver and controls the demand.
Bivalent iron is absorbed in the upper small intestine and then bound to transferrin for transport. However, trivalent iron is usually absorbed through food. In the stomach, trivalent iron can be converted into bivalent iron by the environment there.
Therefore, after removal of the stomach (gastrectomy), iron deficiency anemia can occur due to disturbed absorption. The iron bound to transferrin docks to a transferrin receptor in the cell body of the precursors of the red blood cells in the bone marrow and is incorporated. This receptor can be measured in peripheral blood. Ferritin
