The world around us is made up of 94 elements, but only 21 of these, including mainly hydrogen, oxygen, carbon, and nitrogen, are found in the human body. Among the less abundant elements, the metal iron plays a crucial role. Most of the body’s iron is found in hemoglobin, the red protein that gives blood its color and is essential for transporting oxygen from the lungs to all tissues. In addition to red blood cells, all other cells also contain iron, which is vital for their function.
We lose small amounts of iron daily through the shedding of skin and intestinal cells, but much greater iron loss can occur through bleeding. Normally, the lost iron is balanced by the iron we absorb from our diet. Despite the abundance of iron on the Earth, the soluble form that can be taken up from the diet is scarce and so iron is conserved by the body. Most of the iron needed for new red blood cells comes from recycling the iron from old red cells. However, when iron loss, usually caused by bleeding, exceeds dietary iron intake, iron deficiency develops. During iron deficiency there isn’t enough iron to meet the body’s needs.
Iron deficiency first affects red blood cells, leading to the production of fewer cells with less hemoglobin. This results in a lower hemoglobin level in the blood, a condition known as anemia. Iron deficiency anemia is one of the most common causes of disability worldwide, affecting about a quarter of the global population, particularly women and children. It often results from a diet low in iron combined with excessive blood loss from intestinal infections and frequent pregnancies. Prominent symptoms include fatigue, exertional intolerance and rapid heart rate. More severe iron deficiency can cause changes in skin, nails, hair, tongue and digestive tract as well as restless legs and cravings for non-nutrient substances like clay or ice.
To prevent iron deficiency, it is important to consume iron-rich foods such as meats, seafood, seeds, and nuts. Public health measures include the provision of iron supplements and fortification of staple foods. In people with iron deficiency anemia, the reason for iron loss should be found and treated, and medicinal iron should be provided as pills or intravenous preparations to restore adequate iron levels.
Distinguished Professor of Medicine and Pathology at UCLA. He received his PhD from the California Institute of Technology in Applied Physics and MD and advanced medical training from UCLA. He discovered and characterized hepcidin and erythroferrone, the principal hormones of iron homeostasis, authoring more than 400 publications and more than 30 book chapters, with current H-index of 174 (Google Scholar). Dr. Ganz has served as an Associate Editor of Blood and American Journal of Hematology, President of the International Bioiron Society and a member of the hematology-focused study sections of the National Institutes of Health. He has helped start three biotechnology enterprises, focused on the diagnostic and therapeutic applications of hepcidin and erythroferrone, and has advised leading pharmaceutical and biotechnology companies. He received the Marcel Simon Award of the International Bioiron Society in 2005, for the discovery of hepcidin and the American Society of Hematology E. Donnall Thomas Award in 2014 for “groundbreaking research in iron homeostasis, including the discovery of the iron-regulatory hormone hepcidin and investigation of its roles in iron metabolism”. He has trained more than thirty graduate students, postdoctoral fellows and junior faculty in his research laboratory. His current research interests include systemic iron metabolism and its regulation, the role of iron in innate immunity and infection, the interaction between erythropoiesis and iron homeostasis, and the pathogenesis of b-thalassemia and other iron-loading anemias.