Oral Iron Supplements Increase Hepcidin and Decrease Iron Absorption from Daily or Twice-Daily Doses in Iron-Depleted Young Women
Open accessAbstract
Key Points: Iron supplements at doses of 60 mg Fe as FeSO4 or higher increase hepcidin for up to 24 hours and are associated with lower iron absorption on the following day. The soluble transferrin receptor/ferritin ratio and hepcidin are equivalent predictors of iron absorption from supplements.
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Other groups have confirmed enhanced iron absorption with single dosing once daily or alternate day dosing.
“Other groups have also confirmed enhanced iron absorption with single dosing once daily or alternate day dosing [33,34,36].”
From Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota (2021) · cites this paper as [33]
The Results report lower absorption after twice-daily dosing than after a single morning dose, supporting the once-daily comparison in iron-depleted young women. The Discussion (page not available in our copy) says alternate-day dosing may improve fractional absorption, but presents this as a hypothesis requiring longer-term study, not a confirmed finding. (LLM, conf=0.87)
Experimental — accuracy not yet measuredHigh doses of oral iron supplements cause an increase in hepcidin, which inhibits iron absorption for up to 24 h.
“Moretti et al. 2015 [33] found that high doses of oral iron supplements cause an increase in hepcidin, which inhibits iron absorption for up to 24 h.”
From Oral Iron Supplementation—Gastrointestinal Side Effects and the Impact on the Gut Microbiota (2021) · cites this paper as [33]
The dynamics of the increase in hepcidin levels after oral iron therapy have suggested that alternate-day administration of iron salts is an alternative to daily refracted doses, with the former being a protocol that increases both efficacy and tolerability, at least in women with iron deficiency without or with mild anemia.
“The dynamics of the increase in hepcidin levels after oral iron therapy have suggested that alternate-day administration of iron salts is an alternative to daily refracted doses, with the former being a protocol that increases both efficacy and tolerability, at least in women with iron deficiency without or with mild anemia.116,118,119”
From Iron metabolism and iron disorders revisited in the hepcidin era (2020) · cites this paper as [118]
An increase in plasma iron stimulates hepcidin secretion which dampens macrophage iron egress and to a lesser extent duodenal iron absorption following its interaction with Fpn1.
“An increase in plasma iron stimulates hepcidin secretion which dampens macrophage iron egress and to a lesser extent duodenal iron absorption following its interaction with Fpn1.”
From “Pumping iron”—how macrophages handle iron at the systemic, microenvironmental, and cellular levels (2017) · cites this paper as [158]
By changing iron dosing schedules to reflect the negative feedback mechanisms intrinsic to mammalian iron homeostasis, fractional iron uptake can be maximized.
“By changing iron dosing schedules to reflect the negative feedback mechanisms intrinsic to mammalian iron homeostasis, fractional iron uptake can be maximized. 185 , 186”
From The battle for iron in enteric infections (2020) · cites this paper as [186]
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“Moretti et al. 2015 [33] found that high doses of oral iron supplements cause an increase in hepcidin, which inhibits iron absorption for up to 24 h.”
BackgroundIron deficiency anemia in pregnancy
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BackgroundSelf-citation
- Authors
- Moretti, D., Goede, J. S., Zeder, C., Jiskra, M., Chatzinakou, V., Tjalsma, H., Melse-Boonstra, A., Brittenham, G., Swinkels, D. W., & Zimmermann, M. B.
- Affiliations
- ETH Zurich (CH)
- University of Zurich (CH)
- Radboud University Medical Center (NL)
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands;
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2015-10-22
- Volume
- 126
- Issue
- 17
- Pages
- 1981-1989
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W1805394574
- Cited by
- 547
- References
- 37
- Citations by year
- 2026: 45 · 2025: 49 · 2024: 52 · 2023: 55 · 2022: 46 · 2021: 49 · 2020: 74 · 2019: 53 · 2018: 50 · 2017: 44 · 2016: 27 · 2015: 1 · 2014: 1
- FWCI
- 31.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (141044)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Plant Micronutrient Interactions and Effects
- Keywords
- oral iron supplementation, hepcidin, iron absorption, iron deficiency, dose dependence, twice-daily dosing, alternate-day dosing, iron sulfate, young women, plasma ferritin
- MeSH terms
- Administration, Oral, Adolescent, Adult, Biological Availability, Drug Administration Schedule, Female, Ferritins, Follow-Up Studies, Humans, Intestinal Absorption, Iron, Male, Middle Aged, Prognosis, Biomarkers, Case-Control Studies, Cross-Over Studies, Iron, Dietary, Dietary Supplements, Young Adult, Hepcidins
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