In both developed and underdeveloped countries, iron deficiency is the most common nutrient deficiency. Worldwide, at least 700 million individuals have iron deficiency anemia (Shils et al. 1999). More than just a constituent of hemoglobin and myoglobin, iron is a key component in nearly every living organism and in humans is associated with hundreds of enzymes and other protein structures. People have been supplemented with iron in order to increase treatment of iron deficiency anemia, alleviate poor cognitive function in children, increase athletic performance, and suppress restless legs syndrome (RLS).
High concentrations of iron in the blood may worsen neuronal injury secondary to cerebral ischemia (Davolos et al. 2000). Increased iron levels during pregnancy may lead to preterm delivery and neonatal asphyxia (Lao et al. 2000). These complications may occur even with normal iron intake if the patient also takes vitamin C, as high doses of the vitamin can increase iron absorption (Siegenberg et al. 1991).
Iron may inhibit absorption of many drugs including levodopa, methyldopa, carbidopa, penicillamine, thyroid hormone, captopril, and antibiotics in the quinolone and tetracycline family (Lehto et al. 1994, Campbell and Hasinoff 1991, Heinrich 1974, Osman et al. 1983, Campbell et al. 1992). Some medications may decrease iron absorption and lead to decreased therapeutic levels of the mineral. These include antacids, H2 receptor antagonists, proton pump inhibitors, and cholestyramine resin (Hendler and Rorvik 2001, Minerals 2000). Oral iron should not be given within 2 h of other pharmaceuticals to avoid alterations in drug or mineral absorption.
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