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Inhibition of iron absorption by cholestyramine

Demonstration of diminished iron stores following prolonged administration

Abstract

Recent studies have demonstrated that cholestyramine, an anionic exchange resin, binds inorganic and hemoglobin ironin vitro and inhibits the absorption of these compounds from the rat small intestine. However, these studies did not answer the question: Will prolonged cholestyramine administration cause depletion of iron stores and development of iron deficiency anemia? Accordingly, rats were fed diets of standard rat chow or standard rat chow containing either 2 or 5% cholestyramine for 6 months. In the 5% cholestyramine group the hematocrit and hemoglobin values were significantly lower as compared to controls (37.5 vs 43.6%;P<0.001) and (11.4 vs 14.2 g%;P<0.001). Serum iron values in the 5% cholestyramine groups were significantly less than the control group (158±23 vs 205±15 µg%;P<0.001). In the control group nonheme iron in the liver, spleen and duodenum was 206±31, 1482±212 and 12.5±1.1 µg/g tissue, respectively. In the 2% cholestyramine-treated group, liver nonheme iron was reduced to 172±33 µg/g, spleen nonheme iron to 1266±447 µg/g and duodenal iron to 11.7±1.0 µg/g. In the 5% cholestyramine-treated group liver nonheme iron was significantly reduced to 143±35 µg/g, spleen nonheme iron to 1030±3.4 µg/g and duodenal nonheme iron to 10.2±1.4 µg/g respectively. In addition, a significant decrease in serum vitamin B12 levels was noted in cholestyramine-fed rats compared to controls (256±83 vs 404±118 µµg/ml). These data indicate that prolonged administration of cholestyramine to rats results in significantly decreased serum iron, tissue nonheme iron stores and serum vitamin B12 levels associated with decreased hematocrit and hemoglobin levels.

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References

  1. Gallo DG, Bailey KR, Sheffner AJ: The interaction between cholestyramine and drugs. Proc Soc Exp Biol Med 120:60–65, 1965

    PubMed  Google Scholar 

  2. Thomas FB, McCullough FM, Greenberger NJ: Inhibition of the intestinal absorption of inorganic and hemoglobin iron by cholestyramine. J Lab Clin Med 78:70–80, 1971

    PubMed  Google Scholar 

  3. Wheby MS, Suttle GE, Ford KT: Intestinal absorption of hemoglobin iron. Gastroenterology 58:647–654, 1970

    PubMed  Google Scholar 

  4. Wintrobe, M: Clinical Hematology. Sixth edition. New York, Lea and Febiger, 1967, pp 433–441

    Google Scholar 

  5. Young DS, Hicks JM: Method for the automatic determination of serum iron. J Clin Pathol 18:98–102, 1964

    Google Scholar 

  6. Lau KS, Gottlieb C, Wasserman LR, et al: Measurement of serum vitamin B12 level using radioisotope dilution and coated charcoal. Blood 26:202–214, 1965

    PubMed  Google Scholar 

  7. Herbert V: Aseptic addition method forLactobacillus casei assay of folate activity in human serum. J Clin Pathol 19:12–16, 1966

    PubMed  Google Scholar 

  8. Foy A, Williams H, Cortell S, et al: Determination of nonheme iron in tissue. Anal Biochem 18:559–563, 1967

    Google Scholar 

  9. MacDermott RP, Greenberger NJ: Evidence for a humoral factor influencing iron absorption. Gastroenterology 57:117–125, 1969

    PubMed  Google Scholar 

  10. Snedecor GW: Statistical Methods. Fifth edition. Ames, Iowa, The Iowa State College Press, 1956

    Google Scholar 

  11. Kniffen JC, Noyes WD, Porter FS: Iron and cholestyramine in erythropoietic protoporphyria. Clin Res 18:38, 1970

    Google Scholar 

  12. Harris, JW: The Red Cell. Cambridge, Harvard University Press, 1965, pp 31–64

    Google Scholar 

  13. Beutler E: The red cell indices in the diagnosis of iron deficiency anemia. Ann Intern Med 50:313–322, 1959

    PubMed  Google Scholar 

  14. Caldwell JH, Greenberger NJ: Cholestyramine enhances digitalis excretion and protects against lethal intoxication. J Clin Invest 49:16a, 1970

    Google Scholar 

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The authors wish to thank Dr. Stanley Balcerzak for performing determinations of the serum vitamin B12 and folate levels.

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Thomas, F.B., Salsburey, D. & Greenberger, N.J. Inhibition of iron absorption by cholestyramine. Digest Dis Sci 17, 263–269 (1972). https://doi.org/10.1007/BF02232300

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Keywords

  • Iron Deficiency
  • Iron Deficiency Anemia
  • Serum Iron
  • Deficiency Anemia
  • Iron Store