Iron deficiency in Coeliac disease and obesity

Numerous gastrointestinal diseases result in sideropenia (iron deficiency), which, when untreated, can lead to iron deficiency anemia. Sideropenia is observed in a wide range (36–76%) of individuals with inflammatory bowel diseases (IBD), whereas iron deficiency is found in 10–15% of celiac disease patients and escalates to 50% of patients after bariatric surgery.

Iron deficiency in celiac disease and obesity

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According to the World Health Organization (WHO), the physiological range of hemoglobin (Hb) differs according to gender and age. The physiological hemoglobin (Hb) ranges for men is 14–18 g/dL, 12–16 g/dL for women, and 10.5–13.5 g/dL for children.

Iron deficiency in celiac disease and obesity

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A lower Hb level than the above values indicates iron deficiency anemia. Other important parameters were also measured for the confirmation of anemia.

  • Sideremia refers to the amount of iron in the bloodstream bound to a particular protein called transferrin (physiological range: 50–180 mcg/dL)
  • Saturation of transferrin (%TSAT) is a protein that transports iron in the tissues and districts responsible for its use (physiological value: >20%)
  • Ferritin is a storage protein that can hold up to 4500 iron atoms (physiological range: 30–300 ng/mL)

Hematological alterations are not always apparent with iron deficiency, though; hemoglobin levels may be normal despite ferritin and transferrin saturation being low.

Gastrointestinal diseases can end up causing chronic inflammation, restricting the body’s absorption and utilization of iron.

In fact, these patients have functional sideropenia (Transferrin Saturation (TSAT) 20% Ferritin >30 ng/mL), and regular oral iron supplementation is usually ineffective in resolving this problem. This is because, in these chronic conditions, the body makes high levels of hepcidin, a peptide hormone produced by the liver that works by lowering the serum concentration of iron.

Celiac disease

The small intestine is affected by an autoimmune and digestive condition known as celiac disease. The condition is brought on by eating foods that contain gluten. The illness can impair the body’s ability to absorb all of the nutrients it needs and lead to long-term digestive problems.1

An allergy to the grain protein gliadin, which makes up the majority of gluten, results in celiac disease. In these individuals, gliadin acts as a foreign substance that, because the intestinal mucosa is unable to detect it, encourages lymphocyte aggregation. This harms the intestinal mucosa, which eventually deteriorates until the intestinal villi disappear.

The symptoms vary, but the most prevalent include abdominal pain, bleeding, weight loss, joint pain, skin rashes, headaches, tiredness, and iron deficiency anemia.

Iron deficiency in celiac disease and obesity

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Obesity

Obesity is a huge public health concern around the world. Obese patients who are unable to lose weight are increasingly turning to bariatric surgery.  All bariatric surgery techniques lead to a significant reduction in nutrient absorption. Iron, vitamin D, and vitamin B12 are the most important nutrients that are deficient after bariatric surgery.

Sideral®

PharmaNutra spa has come up with Sucrosomial® Iron (Sideral®) to counter states of iron deficiency.

Iron deficiency in celiac disease and obesity

Image Credit: PharmaNutra Spa

This novel technology is an innovative iron-containing oral formulation in which iron pyrophosphate is encased (covered) in a matrix of phospholipids and sucrose esters of fatty acids (Sucrosome®).

This method results in increased gastrointestinal tolerability and greater iron absorption in the intestine. Numerous pieces of scientific evidence (both preclinical and clinical) have been published in international scientific publications in recent years, confirming the efficacy of Sucrosomial® technology.

Gastroresistance is provided by the sucrester matrix, which shields iron from the acidity of the pH of the stomach, as established in dedicated studies. This permits the Sucrosome® to reach the intestinal mucosa intact, where it is absorbed as a vesicular structure by enterocytes via paracellular and transcellular pathways.

Iron deficiency in celiac disease and obesity

Image Credit: PharmaNutra Spa

In the intestinal mucosa, in addition to enterocytes, there are membranous cells (M cells) belonging to Peyer’s plaques. Preclinical research studies have shown that these cells are also able to absorb the Sucrosome® by endocytosis.

Numerous clinical studies using Sideral® in the field of gastroenterology have shown how this technology may restore normal hematochemical values and guarantee proper red blood cell and hemoglobin function.

Conclusion

The innovation of the Sucrosomial® technology is characterized by excellent tolerability, allowing iron intake at any time of day (with or without meals), for extended periods of time, and preventing any discomfort generally associated with iron intake, like an unappealing metallic aftertaste, irritation of the gastric mucosa, nausea, or constipation.

By addressing the drawbacks of conventional iron supplements, Sideral® increases iron absorption in all situations of iron deficiency or rising iron demands.

Bibliography

  1. www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease
  2. https://www.sideral.it
  3. https://www.humanitas.it/malattie/obesita/
  4. https://www.mici360.it/anemia-e-carenza-di-ferro-nella-malattia-di-Crohn
  5. https://www.ecco-ibd.eu/publications/ecco-guidelines-science.html
  6. S. Gómez-Ramírez, E. Brilli, G. Tarantino, M. Muñoz. Sucrosomial® Iron: A New Generation Iron for Improving Oral Supplementation.  Pharmaceuticals (Basel).2018 Oct 4;11(4):97.
  7. https://www.who.int/health-topics/anaemia#tab=tab_1
  8. Bertani L. et al; Oral Sucrosomial Iron Is as Effective as Intravenous Ferric Carboxy-Maltose in Treating Anemia in Patients with Ulcerative Colitis; Nutrients 2021 Feb 12;13(2):608.  doi:10.3390
  9. S. Mahadev, et al.; Prevalence of Celiac Disease in Patients with Iron Deficiency Anemia – a Systematic Review with Meta-analysis. Gastroenterology. 2018 Aug; 155(2): 374–382.e1:

About PharmaNutra Spa

Founded and led by the President Andrea Lacorte and Vice President Roberto Lacorte, PharmaNutra was established in 2003.

It develops unique nutritional supplements and innovative medical devices, handling the entire production process, from proprietary raw materials to the finished product.

The effectiveness of its products is documented by considerable scientific proof, including 112 publications.

The Group distributes and sells its products in Italy and abroad. In Italy, products are sold through a network of 150 Pharmaceutical Representatives serving doctors and also exclusively selling PharmaNutra products to pharmacies throughout Italy. Products are sold in over 50 countries abroad, through 39 partners selected from among the finest pharmaceutical companies. PharmaNutra leads the market in the production of iron-based nutritional supplements under the SiderAL® brand, where it boasts a number of important patents on Sucrosomial® technology.

Over the years, the Group has developed a precise strategy for the management and production of intellectual property, founded on the integrated management of all the various elements: proprietary raw materials, patents, brands and clinical evidence.


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Last updated: Sep 28, 2022 at 6:55 AM

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