Do you suffer from an iron deficiency, and are taking the regular prescribed high dose iron from your GP, which is most likely making you constipated?
Then you need to read the below!

Hepcidin is an enzyme released by the liver which was initially thought to have antimicrobial properties. In addition to this, hepcidin regulates ferroportin, an iron transporter that exports elemental iron from cells, and is essential for the distribution of iron between tissues.

Hepcidin regulates the entry of iron into plasma, and increased levels of iron increase hepcidin production; regulating the degradation and inernalisation of ferroportin.

In lamens terms, increased hepcidin concentration reduces iron absorption and transfer into tissues.

Therefore, when taking an iron supplement, it is important to take it in the morning, and not every day; that way the more iron is absorbed, without Hepcidin blocking it's bioavailability.


IRON DEFICIENCY AND YOUR GP'S RANGES:

Typically, Ferritin (storage form of iron and most sensitive to assess iron deficiency) reference ranged for a GP is anywhere from 30-300 or 30-200 ng/mL, whereas functional pathology references ranges are much more specific.
Generally GP references ranges are much larger to allow for the vast majority of the population.
However, why would you want to me 'normal', or 'the same as the majority?' Don't you want to be OPTIMAL?!

Functional Ferritin ranges are 90-250 ng/mL.

I see clients EVERY DAY where their Ferritin levels are 30 or just over, and the doctors send them on their merry way telling them everything is ok.
THIS IS NOT THE CASE.
In my eyes, that is a clear iron deficiency, and can often be paired with smaller red blood cells; which most certainly is not ideal for one's optimal health.

SIGNS OF AN IRON DEFICIENCY:

An iron deficiency can result in symptoms such as fatigue, brittle nails, breathing difficulties, a sensitivity to the cold, constipation, poor cognitive function, digestive disturbances, dizziness, headaches, mitochondrial DNA damage, poor appetite, poor immune system function, spoon shaped distortion of the fingernails, general weakness, as well as pale sclera, pale palms and pale gums/ inside your lips.


IRON, HEPCIDIN, INFECTIONS AND INFLAMMATION.

The release of Hepcidin is also increased by higher concentrations of pro-inflammatory metaboliytes and cytokines; acting as a guard to reduce pathogenic microorganisms taking the iron out of cells. If pathogenic infection is present, some pathogens have evolved to have the ability to extract iron from heme by lysing erythrocytes (red blood cells). However if infection is present, neutrophils and macrophages also have the ability to synthesize hepcidin, which reduces the availability of free plasma iron. In the presence of TNFa, IL-1, IL-6 and INFy further strengthen iron withholding defenses.


As the body’s defense mechanism against pathogenic microorganisms, excess iron is bound to transferrin (which is a transporter protein that carries iron around the body) as well as other plasma molecules such as amino acids, citrate and albumin. With a reduced concentration of free plasma iron, the pathogen(s) have a reduced ability to sequest iron from the host.

So why alter/cease iron supplementation, and what do we do if infection is present?

Excess iron, and free iron throughout the body (resulting from high dose supplementation) not only increases oxidative stress (and increased free radicals in the body) and causes high amounts of constipation, but also acts as fuel to enhance pathogenic growth and colonisation.

Iron supplementation in the immuno-compromised results in higher rates of infections. Although there is little clinical evidence, iron supplementation should cease when signs of pathogenic infection is present, such as diarrhoea, stomach upset, fatigue, body tenderness, fever, or infection of any body system.

Cessation of supplementation during bouts of infection will not significantly reduce stores in a small amount of time; and stores can be repleted as soon as the infection has subsided; thus supplementation may restart as soon as infection has subsided and fever is no longer present.

Long term chronic infections that take longer to subside would need to be monitored concurrently with the clients Doctor, and ongoing iron studies should be performed to ensure they do not get dangerously low.


If you're concerned about your iron levels, I urge you to get in contact with a functional practitioner as soon as possible.
Even more so if you're wanting to conceive as it is essential your iron stores ( as well as other vitamin and mineral stores) are at their optimal level as soon as possible.

E   x.

The Oral Contraceptive Pill - A blessing or a curse?
 
Numerous women around the world rely on Oral Contraceptive Pills (OCP), whether it be for hormonal regulation or contraception. But what many women don't know, or aren't advised of are the detrimental effects it can have on their health.
This is especially evident for women who are thinking of coming off the pill prior to trying for a baby - it's extremely important that you understand what vitamin and mineral deficiencies can be caused by the OCP, as these stores will need to be replenished before conceiving.

ILL-HEALTH effects of the OCP:

• Increased risk of venous thromboembolism (blood clot in vein), which is the leading cardiovascular diagnosis after strokes and heart attacks (American Heart association, 2017). This increased risk is caused by the OCP increasing fibrinolysis and vitamin K dependent coagulation (Weisberg, 2002).
• Combined contraceptive pills have been associated with an increased risk of heart attacks and strokes, with rates of around 2-20 per million women (Stewart & Black, 2015). This risk increases significantly if they’re obese or a smoker (Shufelt & Noel Bairey Merz, 2009). Furthermore, women who have or have a history of increased blood pressure or uncontrolled hypertension, diabetes or vascular complications should not use any form of hormonal therapy, whether it’s the ocp or hormone replacement therapy (Stewart & Black, 2015).
• Oral contraceptive pill use is also associated with an increased risk of  Beast and Ovarian cancer (Cancer Council Australia, 2015).

 
 
NUTRITIONAL DEFICIENCIES
Key nutritional deficiencies associated with oral contraceptive use include:

• Zinc
• Selenium
• Magnesium
• Vitamin E
• Vitamin C
• Vitamin B12
• Vitamin B6
• Vitamin B2
• Folate

(Palmery, Saraceno, Vaiarelli, Carlomagno, 2013)
 

WHY ARE THESE NUTRIENTS IMPORTANT IF WE WANT TO CONCEIVE?
 
 
ZINC: Zinc is an essential metal that is a cofactor for over 300 enzymes in the human body, as well as the proteins that defend us against oxidative stress (Osiecki, 2010, p210). It’s also essential for the proper development of the brain and sexual organs, maintains immune function, has a structural role in the development of respiration and helps the body absorb the B group vitamins (just to name a few important things) (Osiecki, 2010, p210).
 
SELENIUM: Involved in the maintenance of cellular membranes, protects against chromosomal damage, reduces sepsis in neonates, synergises with sex hormones, stimulates DNA repair, and is essential for healthy thyroid hormones (Osiecki, 2010, p198). A selenium deficiency can result in damage of the foetus’s immune and nervous system, and is associated with low birth weight (Pieczynska & Grajeta, 2015).
 
MAGNESIUM: Required for DNA stabilization and promotes DNA transcription and replication, and is a cofactor to many enzymes in the body including the production of energy and is essential for bone structure (Osiecki, 2010, p182).
 
VITAMIN E: vitamin E is a potent antioxidant that is also essential for immune modulation, to maintain the integrity of lipid membranes, regulates the synthesis of sex hormones, stabilizes normal growth maintenance (Osiecki, 2010, p78), and deficiencies have been associated with preterm births (Institute of Medicine, 1990).
 
VITAMIN C: Required for the formation of blood cells, the growth of bones and teeth, collagen synthesis, essential for the integrity of connective tissue and the maintenance of cell membranes (Osiecki, 2010, p65).
 
VITAMIN B12 (COBALAMIN): Essential for the normal growth and development of the peripheral and central nervous system, bone marrow, skin, bones, mucous membranes and blood vessels; it’s also required for the biosynthesis of DNA and protein and blood cells (Osiecki, 2010, p49).
 
VITAMIN B6 (Pyridoxine): B6 is essential for the development of the nervous system and neurotransmitter synthesis, thus making it an essential nutrient during pregnancy (Osiecki, 2010, p45).
 
VITAMIN B2 (RIBOFLAVIN): Required for the growth and development of the foetus, the maintenance of epithelial and eye tissues, as well as the maintenance of mucosa and myelin sheath (Osiecki, 2010, p33).
 
FOLATE: Required for the differentiation of embryonic tissue including nervous tissue, required for healthy formation of the neural tube, DNA growth, reduces the expression of chromosomal mutations and is required for the synthesis of neurotransmitters such as serotonin, choline and noradrenaline (Osiecki, 2010, p89).

If you're thinking of coming off the pill for various reasons, check in with a Naturopath, Nutritionist or GP/healthcare practitioner to discuss the important steps you can take to help support your body during this process, as well as prepare you for pregnancy.

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