Adequate iron stores and the 'Nil nocere' principle

Area of Science:

• Human physiology
• Nutritional science
• Medical policy

Background:

• Iron metabolism is precisely regulated by sophisticated physiological adaptations.
• Unselective iron supplementation policies may interfere with these natural regulatory mechanisms.
• Adequate iron store levels during infancy and pregnancy require further definition.

Purpose of the Study:

• To question the policy of unselective iron supplementation during periods of increased cell proliferation.
• To highlight the importance of physiological iron regulation and its role in host-pathogen interactions.
• To discuss the adverse effects of excess iron and the potential benefits of iron chelation therapies.

Main Methods:

• Review of recent data on iron metabolism and regulation.
• Analysis of the role of the iron-regulating factor (IRF) in cellular iron homeostasis.
• Examination of clinical evidence regarding iron supplementation and its effects.

Main Results:

• Iron metabolism is tightly controlled by factors like IRF, TfR, and ferritin.
• Excess iron is linked to increased risks of infection, malignancy, and oxidative stress.
• Physiological hypoferremia in pregnancy appears to be an adaptive mechanism.

Conclusions:

• Interference with physiological iron regulation through unselective supplementation is not justified.
• Iron levels during pregnancy and infancy are adaptive and should not be routinely treated.
• Any policy changes regarding iron supplementation require careful monitoring of health effects.