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Could suspected low-grade inflammation in ME cause iron deficiency?

Discussion in 'Vitamin B12, D and other deficiencies' started by DokaGirl, Jun 5, 2021.

  1. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    Could suspected low-grade inflammation in ME cause iron deficiency?

    The following are: an article on iron deficiency from the Royal College of Physicians, an article on the role of low-grade inflammation in ME, and lastly, an article on activin family proteins as serum biomarkers for ME/cfs.

    This third article reports:

    "Interestingly, activin B is involved in inflammatory-induced anaemia via regulation of hepcidin expression [10], a function distinct from activin A."

    Speculative wondering. Your comments are very much appreciated.

    Thank you.

    Here are the articles:


    This article is from the Royal College of Physicians:

    Iron deficiency without anaemia: a diagnosis that matters
    Abdulrahman Al-Naseem, Abdelrahman Sallam, Shamim Choudhury and Jecko Thachil
    DOWNLOAD PDF
    DOI: https://doi.org/10.7861/clinmed.2020-0582
    Clin Med March 2021

    "Causes of iron deficiency
    Iron has both a storage pool and a functional pool. The storage pool is the reticuloendothelial system which consists of the liver, spleen and lymph nodes. The functional pool consists of red blood cells, bone marrow and cardiac and skeletal muscle. Iron is absorbed in the duodenum via specific transporters and is carried by transferrin molecules to the storage and functional pools. Iron deficiency can be absolute or functional. AID is when the storage pool is iron-deficient due to reduced intake, increased needs, reduced absorption or excessive loss. AID also causes low iron levels within the functional pool. In FID the burden is the chronic inflammation, causing cytokine and hepcidin release. Hepcidin causes iron deficiency via the blockage of an iron exporter known as ferroportin. There are two ways in which this blockage causes ID. First, it reduces iron absorption in the duodenum; second, it causes iron retention within the storage pools. This means that despite normal iron levels within the storage pools, functional pools are iron deficient and cannot utilise the stored iron for vital body processes."2,10,12 (my bolding)

    https://www.rcpjournals.org/content/clinmedicine/21/2/107



    The role of low-grade inflammation in ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) - associations with symptoms
    https://pubmed.ncbi.nlm.nih.gov/31901625/



    Activin B is a novel biomarker for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) diagnosis: a cross sectional study

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353946/#!po=4.26829

    "Interestingly, activin B is involved in inflammatory-induced anaemia via regulation of hepcidin expression [10], a function distinct from activin A."

    ETA: added quotation marks

    ETA #2: added title
     
    Last edited: Jun 5, 2021
  2. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Could suspected low-grade inflammation in ME cause iron deficiency?

    I think inflammation could cause low iron in anyone, with or without ME - but I'm making a distinction between serum iron and ferritin (iron stores).

    Ferritin is an "Acute Phase Protein". This means it rises in the presence of infection or inflammation.

    It increases because the body moves iron into ferritin to reduce the ability of pathogens to reproduce. Iron is locked up very tightly in ferritin and pathogens can't access the iron, whereas serum iron can be "stolen" by pathogens.

    You might find this link of interest :

    https://irondisorders.org/anemia-of-chronic-disease-2/
     
  3. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I think the problem is that these studies did not find low grade inflammation in ME. The second study sounds as if it did but it actually had no controls so tells us nothing about ME having low grade inflammation. It talks about correlations with symptoms but although it picks out the few instances where there was some correlation it seems that is a whole there were no correlations - at least with fatigue. So hidden behind the text it says - we more or less did not find any inflammation that related to ME symptoms.

    The third study is even clearer. Despite the raised Activin B, everything else was normal - so no inflammation. So it is a bit difficult to know what to make of the Activin - certainly not a relation to inflammation.

    The first paper claims that iron deficiency without anaemia is very important but there is precious little support for this in the actual paper. It admits that symptoms are too vague to now whether they are due to iron deficiency or the disease causing the iron deficiency.

    I cannot get excited about this I am afraid.
     
    merylg, FMMM1, Wyva and 8 others like this.
  4. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    merylg and FMMM1 like this.
  5. DokaGirl

    DokaGirl Senior Member (Voting Rights)

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    Thank you @Arnie Pye for your comments and the link.
     
    merylg and Arnie Pye like this.
  6. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    People might like this video, which just came out today, on "Blood Tests For Iron Status".

    The speaker is not the most compelling speaker I've ever heard, but his information was interesting. He discusses iron studies and ferritin in a general way, then starts to discuss results you might see in sickness, including inflammation. Towards the end of his talk he discusses haemochromatosis.

     
    alktipping, DokaGirl and merylg like this.

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