Abstract
Iron deficiency anaemia (IDA) is a worldwide healthcare problem affecting approximately 25% of the global population. The most common IDA treatment is oral iron supplementation, which has been associated with gastrointestinal (GI) side effects such as constipation and bloating. These can result in treatment non-adherence and the persistence of IDA. Intravenous iron does not cause GI side effects, which may be due to the lack of exposure to the intestinal lumen. Luminal iron can cause changes to the gut microbiota, aiding the promotion of pathogenic species and decreasing beneficial protective species. Iron is vital for methanogenic archaea, which rely on iron for growth and metabolism. Increased intestinal methane has been associated with slowing of intestinal transit, constipation, and bloating. Here we explore the literature to understand a potential link between iron and methanogenesis as a novel way to understand the mechanism of oral iron supplementation induced GI side effects.
Highlights
Iron deficiency anaemia (IDA) affects up to 25% of the worldwide population [1], or approximately 2 billion people [2]
This can be caused by oral iron supplementation and virulence limiting for many bacteria
Iron can help methanogens outcompete Sulphate-reducing bacteria (SRB) as iron can precipitate sulphides to ferrous sulphide (FeS) [74]. This assists with methanogenesis by preventing the formation of hydrogen sulphide (H2 S), which is toxic to methanogens and SRB [75]
Summary
Iron deficiency anaemia (IDA) affects up to 25% of the worldwide population [1], or approximately 2 billion people [2]. Oral iron is the most common treatment for ID and IDA due to its low cost, high bioavailability and effectiveness [5,6]. An example of this is ferric carboxymaltose, which is non-dextran and deemed to be safe and significantly better than oral iron at replenishing haemoglobin levels with a single dose of 750 mg. Up to 60% of people taking oral iron supplements report gastrointestinal side effects [10]. These GI complaints cause up to 50% of oral iron receiving patients to not follow their treatment plan, meaning their IDA persists [9]. Understanding the mechanism to improve the side effect profile could have significant benefits in terms of patient outcome and healthcare economics
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
