What do we really know about heme iron? some published medical studies

In the literature mechanisms for both organic (heme) and inorganic (non-heme) iron uptake are well documented. The regular iron supplements are artificial/synthetic non-heme iron compunds. Today the OptiFer® series of heme iron supplements are available. Find out more at www.optifer.international and www.hemeiron.com.

The special pathway through which heme iron is absorbed has great benefits, mainly because the uptake is substantially higher.

Since the hemoglobin molecule is absorbed as a whole unit no free iron ions are released in the intestine to trigger disturbances. This happens with artificial/synthetic non-heme, as it must disintegrate in the gut before any uptake can happen. Since uptake for non-heme is low, reactive free irons remain in the gut.

Hemoglobin, containing heme iron is absorbed by human duodenal mucosal cells as a whole unit in a specific uptake process which is not influenced by extrinsic factors like phytates, calcium or oxalates. The two different absorption pathways are complimentary and additive. Heme iron will not desensitize mucosa cells like non-heme iron. It will be absorbed for instance during proton pump inhibitor/antacid treatment as opposed to non-heme.

Heme iron tablets typically have a tolerance close to placebo level. Compared to this, non-heme oral iron has a therapy failure rate due to side-effects of around 30 %

Heme iron products have the potential to complement anaemia therapy. This would mean substantial savings for the community and a much improved quality of life for the patients.

The following material presents and comment some of the published scientific studies on heme iron.

Conclusions:

  • Heme iron is better taken up than all other forms of palatable iron.
  • There are significantly fewer therapy-destroying side-effects.
  • It is safe and works well as supplement for chronics, pregnants and so on.
  • Safe and natural in all forms of iron deficiency.
  • It can successfully replace current medications.
Heme iron supplements are more efficient and better tolerated than the synthetic supplements

Comparative Absorption of Ferrous and Heme-Iron with Meals in Normal and Iron Deficient Subjects.

Zeitschrift für Ernährungswissenschaft 1993 Mar; 32 (1): 67-70 Ekman M, Reizenstein P. Hematology Laboratory, Karolinska Hospital and Institute, Stockholm, Sweden.

“For targeted prophylaxis of iron deficiency with small, side-effect-free doses, heme-iron is thus a valuable component which increases the absorption by about 40%. Heme-iron does not cause high concentrations in the intestinal lumen of free radical inducing, possibly harmful ferric iron.”

Heme iron tablets typically have a tolerance close to placebo level, whereas non-heme oral iron has a therapy failure rate due to side- effects of around 30 % Heme iron products have the potential to complement anaemia therapy. This would mean substantial savings for the community and a much improved quality of life for the patients.

Blood donation

Side Effects of Iron Supplements in Blood Donors

Side Effects of Iron Supplements in Blood Donors: Superior Tolerance of Heme Iron. Laboratory Clinical Medicine 1994 April; 123(4): 561-4.

“The study demonstrates that a low-dose iron supplement containing both heme iron and non-heme iron has fewer side effects when compared with an equipotent, traditional non-heme iron supplement.”

In the literature mechanisms for both organic (heme) and inorganic (non-heme) iron uptake are well documented. The special pathway through which heme iron is absorbed has great benefits, mainly because the uptake is substantially higher. Since the hemoglobin molecule is absorbed as a whole and no free iron ions are released in the intestine to trigger disturbances.

Pregnancy

Iron Supplementation in Pregnancy

Iron Supplementation in Pregnancy: Is less enough? A randomised, placebo Controlled Trial of Low Dose Iron Supplementation with and without Heme Iron. Eskeland B. Acta Obstet Gynecol Scandinavia 1997 Oct 76(9);822-828.

“A daily dose of 27 mg elemental iron, containing a heme component, given in the second half of pregnancy, prevents depiction of iron stores after birth in most women. An equivalent dose of pure inorganic iron seems less effective, but the sample size in this study was too small to demonstrate significant differences between the two treatment groups.”

Heme iron is better taken up than all other forms of artificial/synthetic non- heme) palatable iron. There are significantly fewer therapy-destroying side-effects. It is safe and works well as supplement for chronics, pregnants etc. Safe and natural in all forms of iron deficiency. It can successfully replace current medications.

Absorption

Seminars in Hematology 1998 Jan; 35 (1): 27-34. Absorption of heme iron. Uzel C, Conrad ME. USA Cancer Center, University of South Alabama, Mobile 36688, USA.

“Heme iron is absorbed from meat more efficiently than dietary inorganic iron and in a different manner. Thus, iron deficiency is less frequent in countries where meat constitutes a significant part of the diet.“

Heme iron is absorbed by human duodenal mucosal cells in a specific uptake process which is not influenced by extrinsic factors like phytates, calcium or oxalates. The two different absorption pathways are complementary and additive. Heme iron will not desensitize mucosa cells like non-heme iron. It will be absorbed for instance during proton pump inhibitor/antacid treatment as opposed to non-heme.

Iron pathways

Pathways of iron absorption

Marcel E. Conrad and Jay N. Umbreit. Blood Cells, Molecules, and Diseases (2002) 29(3) Nov/Dec: 336–355

”Iron is vital for all living organisms but excess iron can be lethal because it facilitates free radical formation. Thus iron absorption is carefully regulated to maintain an equilibrium between absorption and body loss of iron. In countries where meat is a significant part of the diet, most body iron is derived from dietary heme because heme binds few of the dietary chelators that bind inorganic iron.

Women eat less food than men and must absorb about 2 mg of iron daily during the childbearing years in order to avoid becoming iron deficient.

Heme enters the enterocyte as an intact metalloporphyrin. Heme uptake is not competitive with non-heme iron.

Other simultaneously ingested food or drink

Effect of tea and other dietary factors on iron absorption

Zijp IM, Korver O, Tijburg LB. Crit Rev Food Sci Nutr. 2000 Sep;40(5):371-98.

"Increased heme-iron intake (this form of dietary iron present in meat fish and poultry is hardly influenced by other dietary factors with respect to its absorption.”

Heme iron absorption is not affected by other simultaneously ingested food, drink or medication.

Losec stops non-heme iron absorption

Proton pump inhibitors suppress absorption of dietary non-haem iron in hereditary haemochromatosis.

Hutchinson C, Geissler CA, Powell JJ, Bomford A. Gut. 2007 Sep;56(9):1291-5

“Low iron counts and even anemia is often found in patients using proton pump inhibitors such as Losec (omeprazole). These drugs make stomach content less acidic. A lowered gastric acid pH effectively stops non-heme iron uptake.”

Heme and non-heme taken up independently

Non-heme iron as Ferrous Sulphate does not interact with heme iron absorption in humans.

Gaitán D, Olivares M, Lönnerdal B, Brito A, Pizarro F. Biol Trace Elem Res. 2012 Dec;150(1-3):68-73

“The addition of non-heme iron as ferrous sulfate did not have any effect on heme iron absorption (P = NS). We reported evidence that heme and non-heme iron as ferrous sulfate does not compete for absorption,"

Heme- and non-heme iron will not interact or compete for uptake or efficacy. In fact they complement each other.

Few side-effects and good efficacy

Heme iron-based dietary intervention for improvement of iron status in young women.

Hoppe M, Brun B, Larsson MP, Moraeus L, Hulthen L. Nutrition. 2013 Jan;29(1):89-95.

"Conclusion: Dietary-based treatment containing heme iron has few side effects and can be used efficiently to improve the iron status of women of reproductive age.”

This means that there are few, if any, side-effects and good efficacy for heme iron when used with fertile females.

Higher absorption

Production of stable-isotope-labeled bovine heme and its use to measure heme-iron absorption in children.

Paz Etcheverry, Gordon E Carstens, Erin Brown, Keli M Hawthorne, Zhensheng Chen, and Ian J Griffin. Am J Clin Nutr 2007;85:452–9.

"The current study suggests that geometric mean heme-iron absorption from 4 mg heme iron (13–16 %) is higher, consistent with the expectation that heme-iron absorption would be greater than nonheme-iron absorption.”

Heme Iron is absorbed efficiently as a whole unit. Uptake is between 20 and 40 %. Non-heme iron uptake varies between 2 and 4 %

Bioavailability

PREDICTION OF DIETARY IRON ABSORPTION: AN ALGORITHM FOR CALCULATING ABSORPTION AND BIOAVAILABILITY OF DIETARY IRON.

Hallberg L, Hulthén L. Am J Clin Nutr. 2000 May;71(5):1147-60.

” The basis for the algorithm was the absorption of iron from a wheat roll (22.1 +/- 0.18%) containing no known inhibitors or enhancers of iron absorption and adjusted to a reference dose absorption of 40%.”

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