Understanding Iron

If you want energy to seize the day, a beautiful head of hair, joints that are free of pain, and a graceful aging into your future, you need to understand this so profoundly misunderstood mineral.

One of the most misunderstood aspects of iron is that we have no reliable blood markers of what is happening to iron inside cells, and it is common for people with signs of intracellular iron deficiency — hair falling out, low sex hormones, eczema — to look like they have markers of iron overload.

To make matters worse, they may even have a moderate predisposition to iron overload due to the presence of one of the common HFE gene polymorphisms, seeming to clinch the case that they need to use my Iron Overload Protocol, when in fact iron depletion strategies could make things considerably worse.

If that person suffers from fatigue, which can be a manifestation of both iron deficiency and iron excess, then it may be all the harder to come to the right conclusion.

Or take low dopamine as an example. Dopamine synthesis requires iron, and myelin synthesis requires iron, but iron overload causes brain damage. This has been most studied in the contexts of iron deficiency causing restless leg syndrome from low dopamine and wrecking childhood IQ from poor myelin synthesis, and in the context of iron overload being a risk factor for Parkinson’s. But at the end of the day, any kind of neurological, psychiatric, or cognitive problem could easily be a manifestation of iron that is too low or too high.

And since it is fairly easy to deplete the blood of iron rather quickly, but could take months to deplete other tissues with low turnover, it could take months to see the negative effects of iron loss, making the puzzle even more confusing to solve.

Fortunately, solving iron issues becomes much easier if we understand the nuances of iron metabolism. Therefore, this article traces the metabolism of iron from the moment you eat it through its distribution to tissues and incorporation into iron-dependent enzymes, with an aim of gaining practical insights into how to interpret lab data and make high-quality decisions to fix problems with iron metabolism.

In This Article

• Key Insights

• How Much Iron We Have, How Much We Lose, How Much We Need (and The Secret 1.8 Rule for Vegetarians Hidden in the RDA Documents)

• Redox States of Iron Are Central to Its Metabolism (and how to remember the perpetually confusing "ic" and "ous" of iron names)

• The True Complexity is Staggering

• How We Absorb Dietary Iron

• The Absorption of Non-Heme Iron

• The Absorption of Heme Iron

• How to Wreck Your Iron Absorption

• Iron Inside the Intestinal Cell

• Circulation in Transferrin (and surprising roles of oxalate)

• Import of Iron Into the Mitochondrion

• Storage of Iron in Ferritin (and why impaired release may throw a monkey wrench in your interpretation of lab work)

• The Liver and Beyond

• Cellular Regulation of Iron Metabolism

• Systemic Regulation of Iron Metabolism (and the surprising potential value of succinate and fumarate)

• Implications for Hyperbaric Oxygen Therapy (it is unfortunately less paradoxical than its advocates argue)

• Serum Vs Cellular Ferritin

• A Specific Example of Where the Divergence Could Matter

• Is There a Role for the Soluble Transferrin Receptor?