Iron Metabolism and Gastrointestinal Health
Summary
Iron is an essential micronutrient that underpins oxygen transport, cellular respiration and DNA synthesis. Dietary iron exists in two principal forms: haem iron, derived from animal tissues, and non-haem iron, found in plant sources. Absorption occurs primarily in the duodenum and proximal jejunum, where enterocytes acquire iron via divalent metal transporter 1. Once inside the enterocyte, iron may be stored in ferritin or exported to plasma through ferroportin; this export is tightly regulated by the hepatic hormone hepcidin, which responds to iron status, inflammation and erythropoietic demand. Gastrointestinal health influences and is influenced by iron metabolism. Adequate mucosal integrity promotes efficient absorption, whereas excessive luminal iron can generate free radicals and perturb the microbiota, contributing to mucosal injury. Conversely, conditions such as inflammatory bowel disease and chronic infection elevate local inflammatory mediators that stimulate hepcidin synthesis, reducing iron export and predisposing to anaemia of inflammation. Iron deficiency impairs epithelial proliferation and barrier function, increasing susceptibility to enteric pathogens. At the same time, iron overload may exacerbate oxidative stress in the gastric and intestinal mucosa, manifesting in gastritis or ulceration. Understanding the bidirectional relationship between iron homeostasis and gastrointestinal health is vital for developing targeted therapies that balance iron repletion with mucosal protection.
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Iron Metabolism and Gastrointestinal Health publication trend
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Technical terms
Enterocyte: Intestinal epithelial cell responsible for nutrient and mineral absorption.
Ferroportin: Cellular iron exporter located on enterocytes and macrophages, regulated by hepcidin.
Ferritin: Intracellular protein complex that stores iron in a non-toxic, bioavailable form.
Hepcidin: Liver-derived peptide hormone that binds ferroportin to reduce iron export and absorption.
Iron pill gastritis: Gastric mucosal injury characterised by iron deposition and inflammation following oral iron tablet intake.
References
- Challenges in the Diagnosis of Iron Deficiency in Children Exposed to High Prevalence of Infections. PLOS ONE (2012).
- Iron Pill‐Induced Gastritis in the Paediatric Population. Case Reports in Pediatrics (2019).
- Case report: Rapid onset, ischemic-type gastritis after initiating oral iron supplementation. Frontiers in Medicine (2022).
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