Serum iron, rise

Based on USDA estimates of per capita consumption of wheat flour, one-third of the adult woman s Recommended Dietary Allowance (RDA) for iron could be obtained if we consumed whole wheat products Q). The iron in wheat, however, is thought to be poorly bioavailable to humans, primarily attributable to the effect of phytate. British investigators found that the iron balance of individuals was lower when they ate largely whole meal bread than when they ate bread made with white flour (2). When the test bread made with white flour contained either sodium or ferric phytate, postprandial serum iron rise was depressed ( ). They theorized that the phytate present in the brown bread formed an insoluble iron salt and rendered the iron unabsorbable. That theory was supported by the work of Moore et al. (4) at Washington University, who tested the response of anemic individuals administered therapuetic doses of ferric... 

Several laboratory abnormalities can occur after the administration of GCCA, the most common being pseudohypocalcemia [202]. Other abnormalities include reduction of angiotensin converting enzyme levels, alteration of serum iron (a rise or a reduction), increased total iron-binding capacity, and reduction of serum zinc levels [202, 214]. These abnormalities particularly occur with the use of specific measurement assays, indicating that they may be artifacts, but their exact mechanisms are unclear. 

Transferrin Liver M.W. 77,000 8.8 days N 225-400 mg/dl Mild 150-200 mg/dl Moderate 100-150 mg/dl Severe <100 mg/dl Transports iron in the ferric state serum levels rise proportional to iron deficiency, a better marker than albumin however, not suitable in the short-term hospital setting. 

They have demonstrated that a rise in serum ferroxidase activity precedes a rise in serum iron following copper injection. Serum iron does not rise until the serum Cp reaches about 1% of normal. However, any hypoferremia can be corrected immediately in vivo by the administration of Cp. An empirical equation relating serum iron to Cp was derived AFe (/Ag/min) =4 + 1.2 log Cp. 

Normally, most iron is stored as ferritin but with increasing iron overload hemosiderin increases. Hemosiderin is found in the parenchymal cells of the liver and this may result in hemosiderosis and even cirrhosis. Treatment is with the iron chelator desferrioxamine and small amounts of ascorbic acid. The effect of ascorbic acid upon iron transport has been reported for dietary iron overload and P-thalassemia. As a result of ascorbic acid administration, serum iron rapidly rises and its careful use in conjunction with the iron chelator desferrioxamine increases urinary iron excretion (O Brien, 1974 Nienuis et ai, 1976 Nienhuis, 1981 Murray, 1982). 

Most of the transition elements can form complexes with transferrin and other proteins in serum, and can be stored in ferritin. This accounts for the effect of iron metabolism when the concentrations of these metals rise. Limited information which shows the presence of specific transport and storage systems is available on some metals. 

In one other instance, plasma ferritin levels may be elevated even when the body s iron stores are low. Plasma ferritin may be elevated in the first few days of iron therapy in anemia, particularly where the doses of iron are high. Anemia in infants, for example, can be treated with 6 mg of iron/kg body weight per day. The iron can be supplied as oral ferrous sulfate. Iron deficiency anernia in adults can be treated with 50 mg of iron three times a day. The iron can be supplied as ferrous sulfate. Early rises in serum ferritin may not occur at these doses, but can occur at higher doses. With the use of standard doses, scrum ferritin may rise into the ronraJ range only after the anemia has been corrected. 

Succimer is the meso isomer of 2,3-dimethylmercapto-succinic acid (DMSA). It is used as a lead chelator for oral administration (1). Nausea, vomiting, diarrhea, and anorexia are common. Rashes, sometimes necessitating withdrawal, have been reported in up to 10% of adults and 5% of children, and mild transient rises in serum transaminase activity in 6-10% (mostly adults) (2,3). Life-threatening hyperthermia occurred on two occasions in one subject, but no details were given. Iron can be safely and effectively given to patients taking succimer, which (unlike dimercaprol) does not appear to deplete iron stores or to form a toxic chelate that would preclude the parenteral administration of iron (3). 

Results published from 1938 to 1953 can be viewed as having clearly demonstrated that patients with RA had a higher mean serum copper concentration than do normal healthy individuals. Small sex-related differences in normal individuals were obscured by marked increases found for both male and female patients. The increase in serum copper associated with the onset and persistence of active disease returned to normal with disease remission. It is now known from animal studies [46, 47] that the rise in serum copper is accompanied by a fall in total serum zinc and iron. This fall in total serum zinc and iron is partially accounted for by their requirement for the synthesis of copper-containing components in the liver. 

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