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Iron Metabolism in an Iron Supplement‐Dependent Young Male
Author(s) -
Vanness Arlyce F,
Krebs Nancy F,
Hambidge K Michael
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a191-a
Subject(s) - hepcidin , irritability , medicine , gastroenterology , ferritin , transferrin saturation , iron deficiency anemia , anemia , physiology , endocrinology , iron deficiency , menopause
Iron deficiency can be manifested by a multitude of neurologic symptoms, including restless legs syndrome, without anemia. We investigated a 7 yr boy with recurrent Fe deficiency manifest as fatigue, muscle “tightness”, irritability, emotional lability, and cold intolerance. Screening labs showed low serum Fe and percent Fe saturation. Treatment with Fe (65 mg elemental Fe/day) resulted in symptomatic and biochemical improvement, but symptoms recurred when the supplement was stopped. After obtaining baseline biomarkers, 2 mg oral stable Fe isotope (58Fe) was administered fasting to measure Fe absorption by RBC enrichment and fecal monitoring after seven months off Fe supplement. Polysomnography was obtained both off and on supplement. Results Habitual dietary Fe intake was 9.8mg/d. Biomarkers of Fe status and metabolism showed normal CBC, serum Fe, TIBC, and urine hepcidin. Percent Fe saturation was low and ferritin was low normal. Fe absorption by RBC enrichment and fecal monitoring were both 0.53. Polysomnography off Fe showed periodic limb movement index of 19.7 compared to 5.3 after Fe supplementation. Conclusion Fe absorption was normal in this child whose symptoms improve with supplemental Fe. Although additional absorption studies are warranted, these data do not suggest a defect in intestinal absorption as the etiology of the apparent Fe dependency. Supported by Pediatric GCRC, NIH # M01 RR00069.