Iron Studies - Iron Absorption - Ferrous (Fe2+), Ferric (Fe3+), TIBC, Ferritin, Transferrin - Part 1

0:00 hey guys what's up so we are talking about anemia so please go ahead and watch previous videos in the playlist first today we'll talk about iron studies but first to understand iron studies we need to understand iron absorption by iron studies I mean things like serum iron cibc ferritin first in saturation iron studies is one of the most confusing topics I'd like to make it easy you have to know that except for epithelial shedding and ministration the body has no method to

0:46 get rid of iron okay so iron absorption is heavily regulated now let's get to the nitty-gritty iron absorption this is heavy stuff I'll do my best to make it simple but let's get the short story first iron has two sources either you eat it and diet or you destroy your elderly or senescent RBC's RBC's hemoglobin heme and globin him has iron and protoporphyrin so I have iron but for now let's talk about

1:32 the one we get in diet iron in the stomach that's a big deal let's zoom in in the stomach we have hydrochloric acid that will transform iron from the ferric to that for us okay to Paula Faris instead of Furyk thanks to hydrochloric acid and also vitamin C okay so we end up with the ferrous iron that's fine so what will happen to this first iron it will go into the duodenum pass through the interosseous the cells

2:20 that line the duodenum from inside to the bloodstream and in the bloodstream it will bind to transferring the carrier protein for iron that's the short story there is a very long story that we'll discuss now but first I'd like you to know something there are two types of iron the ferrous two-plus is called the heme iron the ferric 3 plus is the non heme iron remember when we have talked about that red blood cells they have hemoglobin and the hemoglobin carries what oxygen this hemoglobin hemoglobin

3:10 has iron Fe 2 plus this is the fair Russ okay there is a mnemonic to remember that fe2 carries o2 fe2 carry so to the ferrous state the him in the hemoglobin carries the oxygen fe2 carries o2 and we have said that in the small bowel the duodenum which one is absorbed to the small bowel it's the ferry's fe2 there is a mnemonic for that fe2 goes into the enter outside

3:57 so mnemonic number one fe2 binds o2 and 1x number two fe2 goes into the duodenum to get absorbed this is so cool now let's focus on the duodenum then we'll focus on the blood vessel then we'll see the fate of iron on the transparent now let's talk about the enterocytes so we have the fair Russ only the FE two can go into the duodenum the enter side so iron the first state can go inside the inter side by two channels either the heme carrier protein one or the

4:46 divalent metal transporter one or DMT one okay no matter which channel the fate is kind of the same the iron the first are can choose to get stored as mucosal ferritin in the cytoplasm of the enter outside and then get shed okay with that normal epithelial regenerative shedding okay to this tool iron will be lost to this tool and this method okay by the way that's why cancer of the small Bell is rare because unconsciously regenerating them the cell will not be staying still for a long time so there

5:33 is less risk of mutation because when the cell stays for a long time there is increased risk of mutation but that's a completely different subject let's go back to iron so first method to be stored as mucosal Fersen and get shed in the stool the other method is to go through the door the Porta porta means door ferro iron porta door i and protein the protein that acts as a door for i ferroportin this for us get outside of the enterocyte gets converted to the ferric by some compounds okay then we

6:18 have ended up with the ferric the spheric will goes in the blood vessel okay and iron cannot be left free it's dangerous why do the Fenton reaction the Fenton reaction so it has to be bound to something what's that a plasma protein called transferrin I n means protein fer iron transport transportation a protein for transportation of iron that makes sense this ferric on the transferrin has to face either to go to the bone marrow to the erythroid precursors to help form new RBC's as we have said before in our

7:06 video about Hamato police's or it can go to the liver as ferric stimulate a protein called hepcidin this is a regulator an inhibitor when it senses that there is a lot of iron coming in so let's decrease the absorption of iron hip cider is a regulator an inhibitor and it does that by two mechanisms either to go to the door the ferroportin till this gate to shut closed please I don't want more iron or go to the macrophage that's tore iron until please macrophage dear macrophage do not release iron that's so cool

7:53 so in brief what's happening here I have iron in the which state the ferrous state and this are in the first state will go inside the intro sides by two channels when it comes in has two options either to be stored at mucosal furs in get shed in the store or go through the door called ferroportin when goes to the fair Porton get converted to the ferric bound to transfer ren and then goes either to the bone marrow or through precursors for new RBC's hematopoiesis or go to the lever stimulate the hip side in which will inhibit further absorption iron either

8:40 by shutting the door or inhibiting the macrophage from releasing iron that is cool but what is the Fenton reaction the Fenton reaction chemistry when iron is left free it's dangerous it generates free radicals which damages tissue so the mnemonic is if F E is left free by the Fenton reaction give this hydroxyl free radical it's called the Fenton reaction and the hydroxyl free radicals are freakin bad I call this the F mnemonic let's focus more about the hepcidin and the regulation of iron absorption so we have said that when we have a lot of iron coming in on the

9:27 transferrin hepcidin gets stimulated and up regulated ie the level for more Epps item to stop are an absorption in the random and to stop on relays from the macrophage that makes sense okay the opposite is also true when iron and the transferring is less hepcidin is down regulated lesseps islands form so there is increased on absorption increase on the lace because there is no inhibitor I'm afraid to absorb and release more iron to the iron serum increase in the serum iron increases that's it we have said before that iron okay gets absorbed were in the duodenum

10:13 enterocyte it has a sensor sensor why because the absorption of new iron depends on the total previous iron storage in the body it's heavily regulated it has a sensor to sense the transferring carrying iron the HFE gene helps this enter site gets activated and absorb iron in the ferrous state remember when hepcidin prevents more iron from getting absorbed there is only one way for iron to get shed with the enter oside in the stool because iron remember as we said has two fates either to go at mucosal ferritin or to go up in through the pharaoh

10:59 Gordon and simulate hip siren if hip sigh and shut the gate I have only one option to be stored at ferritin and get [ __ ] in the stool that's it for our next time we'll get some details about the our studies but for now you have to subscribe to get new videos as they come thank you very much for your support and see you in the next video