The Regulation of Iron Absorption

Oral iron tolerance

The tolerance of volunteer patients to various ferrous salt preparations, administered orally in equivalent doses of elemental iron, has been compared. The palatability of ferrous sulphate tablets, BP, given before meals was not improved by administration after meals, by sustained release formulation, or by substituting other ferrous salts. Intolerance was related to the number of tablets rather than to the dose of iron in a course. The liquid iron preparation was the least acceptable.

Ferrous sulphate tablets, BP, given before meals, approximate most closely to the hypothetical ideal iron preparation for therapeutic oral administration.

Histochemical studies of the myocardium and conduction system in acquired iron-storage disease

The myocardium, all parts of the conduction system, and the S-A node contained iron in six patients with acquired iron-storage disease. The nerve fibers and ganglia contained negligible amounts. No correlation was demonstrated between the amount of histochemically demonstrated iron in the myocardium and conduction system, or the amount of transfused iron, or the amount of quantitatively analyzed myocardial iron and the presence of antemortem arrhythmias and conduction disturbances. The degree of scarring in the S-A node, A-V node, and bundle of His did not parallel the density of iron deposits in these structures.

These observations support the theory that factors other than iron alone are responsible for the cardiac rhythm and conduction abnormalities associated with iron-storage disease.