Advertisement

Iron, Copper, and Zinc

  • T. S. Dharmarajan
  • T. S. Dharmarajan
  • T. S. Dharmarajan
  • T. S. Dharmarajan
  • Srinivas Guptha Gunturu
  • C. S. Pitchumoni
  • C. S. Pitchumoni
  • C. S. Pitchumoni
Chapter

Abstract

Iron, copper, and zinc are essential micronutrients responsible for various physiological functions. In this chapter, we are going to discuss epidemiology of iron deficiency, physiology of iron absorption, role of hepcidin, iron content in food, bioavailability of iron, symptoms and signs of iron deficiency, and its treatment with oral and parenteral formulations. Later, we are discussing copper and zinc functions, daily requirements, absorption, factors affecting bioavailability, iron–copper–zinc interactions, and symptoms and signs of their deficiencies.

Keywords

Celiac Disease Iron Deficiency Copper Deficiency Oral Iron Iron Sucrose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Muñoz M. An update on iron physiology. World J Gastroenterol. 2009;15(37):4617.PubMedCrossRefGoogle Scholar
  2. 2.
    Iron deficiency—United States, 1999–2000. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5140a1.html. Accessed 7 Sep 2010.
  3. 3.
    Guralnik JM. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104(8):2263–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Munoz M, Garcia-Erce JA, Remacha AF. Disorders of iron metabolism. Part 1: molecular basis of iron homoeostasis. J Clin Pathol. 2011;64:281–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Zhu A, Kaneshiro M, Kaunitz JD. Evaluation and treatment of iron deficiency anemia: a gastroenterological perspective. Dig Dis Sci. 2010;55(3):548–59.PubMedCrossRefGoogle Scholar
  6. 6.
    Young B, Zaritsky J. Hepcidin for clinicians. Clin J Am Soc Nephrol. 2009;4(8):1384–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Babitt JL, Lin HY. Molecular mechanisms of hepcidin regulation: implications for the anemia of CKD. Am J Kidney Dis. 2010;55(4):726–41.PubMedCrossRefGoogle Scholar
  8. 8.
    Brasse-Lagnel C, Karim Z, Letteron P, et al. Intestinal DMT1 cotransporter is down-regulated by hepcidin via proteasome internalization and degradation. Gastroenterology. 2011;140(4):1261–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Ganz T. Hepcidin and iron regulation, 10 years later. Blood. 2011;117(17):4425–33.PubMedCrossRefGoogle Scholar
  10. 10.
    Dietary supplement fact sheet: iron. http://ods.od.nih.gov/factsheets/Iron_pf.asp. Accessed 20 Sep 2010.
  11. 11.
    USDA National Nutrient Database for Standard Reference, Release 17. http://www.nal.usda.gov/fnic/foodcomp/Data/SR17/wtrank/sr17a303.pdf. Accessed 4 Oct 2010.
  12. 12.
    Amato A, Santoro N, Calabrò P, et al. Effect of body mass index reduction on serum hepcidin levels and iron status in obese children. Int J Obes. 2010;34(12):1772–4.CrossRefGoogle Scholar
  13. 13.
    Faich G, Strobos J. Sodium ferric gluconate complex in sucrose: safer intravenous iron therapy than iron dextrans. Am J Kidney Dis. 1999;33(3):464–70.PubMedCrossRefGoogle Scholar
  14. 14.
    Katsanos K, Cavalier E, Ferrante M, et al. Intravenous iron therapy restores functional iron deficiency induced by infliximab. J Crohns Colitis. 2007;1(2):97–105.PubMedCrossRefGoogle Scholar
  15. 15.
    Dharmarajan TS, Widjaja D. Erythropoiesis-stimulating agents in anemia: use and misuse. J Am Med Dir Assoc. 2009;10(9):607–16.PubMedCrossRefGoogle Scholar
  16. 16.
    Dharmarajan TS, Pais W, Norkus EP. Does anemia matter? Anemia, morbidity, and mortality in older adults: need for greater recognition. Geriatrics. 2005;60(12):22–7, 29.Google Scholar
  17. 17.
    Quinn C, Uzbeck M, Saleem I, et al. Iron status and chronic kidney disease predict restless legs syndrome in an older hospital population. Sleep Med. 2011;12(3):295–301.PubMedCrossRefGoogle Scholar
  18. 18.
    Clark SF. Iron deficiency anemia: diagnosis and management. Curr Opin Gastroenterol. 2009;25(2):122–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Macdougall IC. Strategies for iron supplementation: oral versus intravenous. Kidney Int Suppl. 1999;55 Suppl 69:S61–6.CrossRefGoogle Scholar
  20. 20.
    Hunt JR. Bioavailability of iron, zinc and other trace minerals from vegetarian diets. Am J Clin Nutr. 2003;78(Suppl):633S–9.PubMedGoogle Scholar
  21. 21.
    Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults results of a US consensus panel of experts. Arch Intern Med. 2003;163(22):2716–24.PubMedCrossRefGoogle Scholar
  22. 22.
    Rimon E, Kagansky N, Kagansky M, et al. Are we giving too much iron? Low-dose iron therapy is effective in octogenarians. Am J Med. 2005;118(10):1142–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Lyseng-Williamson KA, Keating GM. Ferric carboxymaltose: a review of its use in iron-deficiency anaemia. Drugs. 2009;69(6):739–56.PubMedCrossRefGoogle Scholar
  24. 24.
    Bager P, Dahlerup JF. The health care cost of intravenous iron treatment in IBD patients depends on the economic evaluation perspective. J Crohns Colitis. 2010;4(4):427–30.PubMedCrossRefGoogle Scholar
  25. 25.
    Luan DC, Zhao Z, Li H, Li X, Li SJ, Liu ZM. Body iron stores and dietary iron intake in relation to diabetes in adults in North China. Diabetes Care. 2008;31:285–6.CrossRefGoogle Scholar
  26. 26.
    Tzonou A, Lagiou P, Trichopoulou A, Tsoutsos V, Trichopoulos D. Dietary iron and coronary heart disease risk: a study from Greece. Am J Epidemiol. 1998;147(2):161–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Neven E, De Schutter TM, Behets GJ, Gupta A, D’Haese PC. Iron and vascular calcification. Is there a link? Nephrol Dial Transplant. 2011;26(4):1137–45.PubMedCrossRefGoogle Scholar
  28. 28.
    Mascitelli L, Goldstein MR. Inhibition of iron absorption by polyphenols as an anti-cancer mechanism. Q J Med. 2011;104(5):459–61.CrossRefGoogle Scholar
  29. 29.
    Krupanidhi S, Sreekumar A, Sanjeevi CB. Copper and biological health. Indian J Med Res. 2008;128:448–61.PubMedGoogle Scholar
  30. 30.
    Banci L, Bertini I, Cantini F, Ciofi-Baffoni S. Cellular copper distribution: a mechanistic systems biology approach. Cell Mol Life Sci. 2010;67(15):2563–89.PubMedCrossRefGoogle Scholar
  31. 31.
    Lutsenko S. Human copper homeostasis: a network of interconnected pathways. Curr Opin Chem Biol. 2010;14(2):211–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Milne DB, Johnson PE. Assessment of copper status effect of age and gender on reference ranges in healthy adults. Clin Chem. 1993;39(5):883–7.PubMedGoogle Scholar
  33. 33.
    Dietary reference intakes for vitamin a, vitamin k, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. 2001. http://search.nap.edu/nap-cgi/skimchap.cgi?recid=10026&chap=224-257. Accessed 1 Nov 2010.
  34. 34.
    van den Berghe PVE, Klomp LWJ. New developments in the regulation of intestinal copper absorption. Nutr Rev. 2009;67(11):658–72.PubMedCrossRefGoogle Scholar
  35. 35.
    Hung YH, Bush AI, Cherny RA. Copper in the brain and Alzheimer’s disease. J Biol Inorg Chem. 2009;15(1):61–76.PubMedCrossRefGoogle Scholar
  36. 36.
    Gambling L, Andersen Henriette S, McArdle Harry J. Iron and copper, and their interactions during development. Biochem Soc Trans. 2008;36(6):1258.PubMedCrossRefGoogle Scholar
  37. 37.
    Hirota K, Hirota T. [Nutrition-related bone disease]. Nippon Rinsho. 2006;64(9):1707–11.PubMedGoogle Scholar
  38. 38.
    Knovich MA, Il’yasova D, Ivanova A, Molnar I. The association between serum copper and anaemia in the adult Second National Health and Nutrition Examination Survey (NHANES II) population. Br J Nutr. 2008;99(6):1226–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Hammond Jr BR, Johnson MA. The age-related eye disease study (AREDS). Nutr Rev. 2002;60(9):283–8.PubMedCrossRefGoogle Scholar
  40. 40.
    Giacconi R, Muti E, Malavolta M, et al. The +838 C/G MT2A polymorphism, metals, and the inflammatory/immune response in carotid artery stenosis in elderly people. Mol Med. 2007;13(7–8):388–95.PubMedGoogle Scholar
  41. 41.
    Mocchegiani E, Malavolta M, Lattanzio F, et al. Cu to Zn ratio, physical function, disability, and mortality risk in older elderly (ilSIRENTE study). Age. 2012;34(3):539–52.Google Scholar
  42. 42.
    Stefanidou M, Maravelias C, Dona A, Spiliopoulou C. Zinc: a multipurpose trace element. Arch Toxicol. 2005;80(1):1–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Meunier N, O’Connor JM, Maiani G, et al. Importance of zinc in the elderly: the ZENITH study. Eur J Clin Nutr. 2005;59:S1–4.PubMedCrossRefGoogle Scholar
  44. 44.
    Maret W, Sandstead H. Zinc requirements and the risks and benefits of zinc supplementation. J Trace Elem Med Biol. 2006;20(1):3–18.PubMedCrossRefGoogle Scholar
  45. 45.
    Iyengar V, Pullakhandam R, Nair KM. Dietary ligands as determinants of iron-zinc interactions at the absorptive enterocyte. J Food Sci. 2010;75(8):H260–4.PubMedCrossRefGoogle Scholar
  46. 46.
    Miyata S. Zinc deficiency in the elderly. Nippon Ronen Igakkai Zasshi. 2007;44(6):677–89.PubMedGoogle Scholar
  47. 47.
    Berson EL. Nutrition and retinal degenerations. Int Ophthalmol Clin. 2000;40, Fall(4):93–111.CrossRefGoogle Scholar
  48. 48.
    Tubek S. Role of zinc in regulation of arterial blood pressure and in the etiopathogenesis of arterial hypertension. Biol Trace Elem Res. 2007;117:39–51.PubMedCrossRefGoogle Scholar
  49. 49.
    Yamaguchi M. Role of nutritional zinc in the prevention of osteoporosis. Mol Cell Biochem. 2009;338(1–2):241–54.PubMedGoogle Scholar
  50. 50.
    Lynch SR. Interaction of iron with other nutrients. Nutr Rev. 1997;55(4):102–10.PubMedCrossRefGoogle Scholar
  51. 51.
    McColl KEL. Effect of proton pump inhibitors on vitamins and iron. Am J Gastroenterol. 2009;104:S5–9.PubMedCrossRefGoogle Scholar
  52. 52.
    Muhsen K, Cohen D. Helicobacter pylori infection and iron stores a systematic review and meta-analysis. Helicobacter. 2008;13:323–40.PubMedCrossRefGoogle Scholar
  53. 53.
    Singh A, Patel T, Hertel J, Bernardo M, Kausz A, Brenner L. Safety of ferumoxytol in patients with anemia and CKD. Am J Kidney Dis. 2008;52(5):907–15.PubMedCrossRefGoogle Scholar
  54. 54.
    Chandler G, Harchowal J, Macdougall I. Intravenous iron sucrose: establishing a safe dose. Am J Kidney Dis. 2001;38(5):988–91.PubMedCrossRefGoogle Scholar
  55. 55.
    Munoz M, Garcia-Erce JA, Remacha AF. Disorders of iron metabolism. Part II: iron deficiency and iron overload. J Clin Pathol. 2011;64:287–96.PubMedCrossRefGoogle Scholar
  56. 56.
    Gozzard D. When is high-dose intravenous iron repletion needed? Assessing new treatment options. Drug Des Devel Ther. 2011;5:51–60.PubMedCrossRefGoogle Scholar
  57. 57.
    www.monofer.com/download.ashx?file…dosing+card.pdf. Accessed 9 May 2011.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • T. S. Dharmarajan
    • 1
  • T. S. Dharmarajan
    • 2
  • T. S. Dharmarajan
    • 3
  • T. S. Dharmarajan
    • 4
  • Srinivas Guptha Gunturu
    • 5
  • C. S. Pitchumoni
    • 6
  • C. S. Pitchumoni
    • 1
  • C. S. Pitchumoni
    • 7
  1. 1.New York Medical CollegeValhallaUSA
  2. 2.Department of MedicineMontefiore Medical Center (North Division)BronxUSA
  3. 3.Division of GeriatricsMontefiore Medical Center (North Division)BronxUSA
  4. 4.Geriatric Medicine Fellowship ProgramMontefiore Medical Center (North Division)BronxUSA
  5. 5.Department of MedicineMontefiore Medical Center (North Division)BronxUSA
  6. 6.Robert Wood Johnson School of Medicine, Drexel University School of MedicinePhiladelphiaUSA
  7. 7.Gastroenterology, Hepatology and NutritionSaint Peter’s University HospitalNew BrunswickUSA

Personalised recommendations