Acute and chronic effects of alcohol on iron absorption.

Abstract

The absorption of nonheme59ferric chloride from a test meal was measured, using a whole-body counter, in 34 alcoholics with liver disease of varying severity, 30 of whom had normal hemoglobin values and four of whom were anemic. The results were compared with those obtained in five patients with iron-deficient anemia and nine healthy control subjects. There were no significant differences in mean percentage iron absorption (±sem) in the nonanemic alcoholic patients with fatty liver (14.6±3.7), alcoholic hepatitis (18.6±5.7), or cirrhosis (21.1±3.5) when compared with control subjects (22.0±2.5). Significantly increased mean percentage iron absorptions were seen, however, in the patients with iron-deficient anemia (64.8±5.6;P<0.0001) and the alcoholics with anemia (60.7±7.8;P<0.0001). There was an inverse relationship between iron absorption and serum ferritin concentration in the nonanemic alcoholics (r=−0.37;P<0.025) but no correlation between iron absorption and liver iron concentration. The addition of absolute alcohol (0.5 g/kg body weight) to the test meal resulted in an increase in mean percentage iron absorption in eight control subjects (21.6±1.6 to 29.0±6.1) and in ten nonanemic alcoholics (15.8±3.2 to 20.0±3.8), although these differences did not achieve significance. Similarly when intravenous alcohol was given to four control subjects at the time of the test meal, iron absorption increased in all four so that the mean percentage iron absorption increased, although not significantly, from 17.6±2.7 to 39.3±9.5. Iron absorption in alcoholics does not differ significantly from normal. While the increased liver iron concentrations seen in approximately one third of alcoholics cannot be attributed to an increase in iron absorption as a result of chronic alcohol ingestion, further studies are needed to elucidate the acute effects of alcohol on iron absorption.