The role of oral iron in the treatment of adults with iron deficiency.

Autor: Lo JO; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA., Benson AE; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA., Martens KL; Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA., Hedges MA; Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA., McMurry HS; Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA., DeLoughery T; Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA., Aslan JE; Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA., Shatzel JJ; Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.; Department of Biomedical Engineering, Oregon Health & Science University, Oregon, USA.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2023 Feb; Vol. 110 (2), pp. 123-130. Date of Electronic Publication: 2022 Nov 20.
DOI: 10.1111/ejh.13892
Abstrakt: Iron deficiency is the most common nutrient deficiency in the world, affecting over 20% of premenopausal women worldwide. Oral iron supplementation is often the first-line treatment for the acute and chronic management of iron deficiency due to its ease and accessibility. However, there is no consensus on the optimal formulation or dosing strategy, or which patients should be preferentially treated with intravenous iron. Management of iron deficiency is complicated by the hepcidin-ferroportin iron regulatory pathway, which has evolved to prevent iron overload and thereby creates an inherent limit on gastrointestinal iron uptake and efficacy of oral iron. Unabsorbed iron propagates many of the side effects that complicate oral iron use including dyspepsia and constipation, all of which can thus be exacerbated by excessive oral iron doses. Daily low dose and every other day dosing protocols have attempted to bypass this physiologic bottleneck to allow for effective absorption and limit side effects; however, this approach has still resulted in low fractional iron absorption. In the following manuscript, we review the pathophysiology of iron absorption and current evidence for various preparations of oral iron. Lastly, we highlight opportunities for further study to advance the care of individuals affected by iron deficiency.
(© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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