ORAL IRON SUPPLEMENTS 

Oral iron supplementation is usually recommended as first-line therapy, however, there are many difficulties in all stages during the absorption and metabolisation process, depending on the iron molecule. 

IRON AND OXYGEN 

Iron has a very high and reversible affinity to oxygen and therefore, iron is essential to transport oxygen. Iron also catalyses auto-oxidation in the body which is generating reactive oxygen species (ROS), causing the oxidation of lipid membranes, proteins, enzymes, and DNA. Intestinal DNA oxidation of iron increases the risk of colon cancer. 

ABSORPTION ROUTES 

The classical routes of iron absorption are through the DMT-1 channel. The second known route is the absorption of bisglycinate ions via the Dipeptide importer. The third route is the absorption of Heme iron via the Heme importer. A new absorption pathway was discovered in 2017 via endocytosis of very small insoluble iron phosphate particles, and we can say that this is the fourth pathway. 

THE SunActive™ PATENTED NUTRIENT DELIVERY SYSTEM 

SunActive™ is a patented nutrient delivery system that delivers micronised and encapsulated ferric pyrophosphate (FeP) in a unique manner which enhances absorption and bioavailability of the iron and improves gastrointestinal tolerability. It is stable against pH and oxidation and has no iron or metallic taste. The enhanced bioavailability and improved absorption are possible due to the very small iron (micronised) average particle size of only 0.3 μm. These micronised ferric pyrophosphate particles are absorbed via endocytosis like liposomes by the intestinal microfold cells (M-cells). This is known as endosomal absorption. Endosomal absorption of iron is independent of traditional iron absorption pathways, other ions, and food, and therefore not affected by it. 

Iron deficiency (ID) and iron deficiency anaemia (IDA), remain a global disease burden, but the newer forms of iron supplementation now available will challenge the entrenched oral treatment regimens which contributed to many patients stopping their iron treatments and leaving IDA untreated. 

REFERENCES 

• The Micronutrient Initiative catalogue. 
• Kim et al, 2017. Frontiers in Microbiology. 8(749):1-14. 
• Wegmuller R, Zimmermann MB, Moretti D, et al. Particle size reduction and encapsulation affect the bioavailability of ferric pyrophosphate in rats. J. Nutr. 2004;134: 3301–3304. 
• Fidler MC, Walczyk T, Davidsson L, et al. A micronised, dispersible ferric pyrophosphate with high relative bioavailability in man. British Journal of Nutrition 2004, 91, 107–112. 

SOURCE: Medical Chronicle