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Gut. 2007 Sep;56(9):1291-5. Epub 2007 Mar 7.

Proton pump inhibitors suppress absorption of dietary non-haem iron in hereditary haemochromatosis.

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  • 1The Iron Metabolism Interdisciplinary Research Group, King's College London, London, UK.

Abstract

BACKGROUND AND AIMS:

During the long-term treatment of patients with hereditary haemochromatosis (HH) the authors observed that proton pump inhibitors (PPI) reduced the requirement for maintenance phlebotomy. Gastric acid plays a crucial role in non-haem iron absorption and the authors performed a case review and intervention study to investigate if PPI-induced suppression of gastric acid would reduce dietary iron absorption in C282Y homozygous patients.

METHODS:

Phlebotomy requirements to keep serum ferritin approximately 50 microg/l before (mean 6.1 (SE 0.6) years) and during (3.8 (0.9) years) administration of a PPI were evaluated in seven patients and a post-prandial study was performed to determine whether PPIs reduce absorption of non-haem iron (14.5 mg) from a test meal in a further 14 phlebotomised patients with normal iron stores.

RESULTS:

There was a significant reduction (p<0.001) in the volume of blood removed annually before (2.5 (0.25) l) and while taking (0.5 (0.25) l) a PPI. Administration of a PPI for 7d suppressed absorption of non-haem iron from the meal as shown by a significant reduction (all p<0.01) in: area under the serum curve (2145 (374) versus 1059 (219)), % recovery of administered iron at peak serum iron (20.5 (3.2) versus 11.0 (2.0)%) and peak serum iron (13.6 (2.4) vs 6.1 (1.2) micromol/l) (all values are before vs during PPI).

CONCLUSIONS:

Administration of a PPI to patients with HH can inhibit the absorption of non-haem iron from a test meal and the habitual diet.

PMID:
17344278
[PubMed - indexed for MEDLINE]
PMCID:
PMC1954964
Free PMC Article

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