The body is constantly trying to maintain an equilibrium of iron content through absorption and loss. The normal amount of iron in a "70 kg man is about 4 g" but "the body only absorbs 1 mg of iron daily to maintain equilibrium," although the internal requirement is about 20-25 mg because of the turnover of red blood cells, which have a life cycle lasting around 120 days (Harper). The table below shows the flow maintaining the balance of iron in the blood.
(Harper)
The concentration of iron in the body "is regulated carefully by absorptive cells in the small intestine, which alter iron absorption to match body losses of iron" (Harper). These cells are shown in the picture below:
These cells have a 2-3 day life cycle, and are sloughed off into the intestinal lumen when they die (Harper).
Iron is absorbed through three different pathways, heme, ferrous, and ferric acid, that are shown in the picture below:
(Harper).
Dietary iron contains both heme and nonheme elements, which are absorbed "noncompetitively into duodenal and jejunal mucosal cells" (Harper). However, many different factors can cause these pathways to malfunction, as shown in the picture below:
(Harper).
"Either diminished absorbable dietary iron or excessive loss of body iron can cause iron deficiency" (Harper). Diminished absorbable iron is usually a result of a lack of iron consumption, and hemorrhages are the main cause for a loss of body iron. When a hemorrhage occurs, "the bone marrow is stimulated to increase production of hemoglobin, thereby depleting iron in body stores. Once they are depleted, hemoglobin synthesis is impaired and microcytic hypochromic erythrocytes are produced" (Harper).
Some other blood loss diseases include hemosiderinuria, hemoglobinuria, and pulmonary hemosiderosis. These are blood loss through the urine, through heart surgery, and through renal disorders (Harper).
Iron deficiency anemia resulting from poor absorption can be caused by either a genetic disorder, having a major surgery performed on the small intestine, or having a DI tract disease (like celiac disease) which may cause absorption problems (Harper).
Works Cited:
Harper, J. (n.d.). Iron Deficiency Anemia. Retrieved September 14, 2015.
http://emedicine.medscape.com/article/202333-overview#a7
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