Does drinking too much alcohol increase iron levels?

Answer 1

Alcohol in the form of whiskey or brandy markedly increases the absorption of ferric chloride in normal subjects, but had no effect upon the absorption of ferrous ascorbate or haemoglobin iron. Some evidence was obtained to suggest that this action was due to the stimulation of hydrochloric acid production in the stomach. These findings may have some relevance to the well established association between excessive consumption of alcohol and the development of iron overload. Hydrochloric acid was found to enhance markedly the absorption of ferric iron and to cause a modest increase in the absorption of ferrous iron. In contrast, haemoglobin iron absorption is not increased by acid. Although the reasons for these differences were not established, it seems likely that hydrochloric acid acts by maintaining ferric iron in solution until it reaches the absorbing area of the duodenum. It is known that ferrous ions remain in solution at a much higher pH than do ferric ions. The fact that the absorption of haemoglobin iron is not increased by acid adds further weight to evidence obtained by other workers which suggests that this organic iron complex is absorbed in a manner different from simple iron salts

It has been pointed out that many wines from different parts of the world contain significant amounts of iron, and it has been suggested that the high incidence of iron overload in alcoholic subjects is a result of the excessive iron intake. It should, however, be noted that wines contain 10-20 % alcohol, and the absorption of iron taken in this way may thus be enhanced.

These considerations do not exclude the possibility that other factors may contribute to the association between iron overload and the excessive consumption of alcohol. Pancreatitis is common in alcoholics, and there is now good evidence that deficiency of the exocrine secretions of the pancreas is associated with excessive absorption of iron. This has been shown in animals after pancreatectomy, ligation of the pancreatic duct, and ethionine-induced pancreatic damage, and in patients with chronic pancreatitis.

The fact that cirrhosis is common in alcoholics may also be of relevance, since it has been shown that some cirrhotic subjects absorb excessive amounts of iron even when the body stores are normal or increased . It is, however, still not clear whether these effects are secondary to the cirrhosis itself or to associated pancreatic damage.

Lastly, alcoholics as a group eat suboptimal diets, and there are several experimental studies showing increased absorption of iron when the diet is low in certain nutrients but high in iron. These diets have included low phosphate, low protein, high fat, and cholinedeficient regimes.

Ref 1-5: R. W. CHARLTON, P. JACOBS, H. SEFTEL .Effect of Alcohol on Iron Absorption. Brit. med. J., 1964, 2, 1427-1429

· The consumption of excessive amounts of alcohol affects human iron homeostasis and an association of iron overload and heavy alcohol consumption has been recognized for many years. Both major proteins of iron metabolism, ferritin and transferrin, are affected by alcohol. Increased hepatic iron levels are seen in a high proportion of alcoholic subjects, sometimes causing confusion in diagnosis between alcoholic liver disease and iron-overload disease. The pattern of deposition of this iron in alcoholics, however, differs from that seen in the iron-overload disease haemochromatosis. Excessive alcohol consumption causes transferrin to become carbohydrate deficient, which allows it to be used as an efficient biochemical marker of alcohol abuse. It is concluded that. Moderate alcohol consumption is unlikely to pose a problem with iron absorption, but excessive amounts of alcohol is associated with iron overload, particularly in adult males.

· Since nonheme iron absorption efficiency decreases with increasing dosage, iron toxicity from consumption of food sources is rare. However, consumption of large amounts of alcohol increases mucosal iron uptake, particularly among individuals with hemochromatosis or who are carriers of this recessive trait which is characterized by failure to regulate iron absorption. Symptoms of this genetic disorder include chronic fatigue, weight loss, Arthritis, mouth pain, heart palpitations and depression.

Answer 2

In addition to what has already been mentioned there is also considerable evidence that our bodies compete with bacteria in our gut for iron. It may be that high alcohol consumption kills off some of these bacteria, leading to higher iron absorption.