Iron deficiency: Underestimated risk factor for thrombosis tendency
Austrian scientists have researched the connection between iron deficiency and blood clot. Because iron deficiency can also occur in young, healthy people and thromboses are potentially life-threatening, this risk factor is of increasing importance.
About eight percent of all Germans suffer from iron deficiency. According to health experts, it is the most widespread deficiency disease worldwide. Researchers at the Medical University (MedUni) Vienna have now identified a further risk in addition to classic complications such as visual problems, drowsiness or shortness of breath: people with iron deficiency apparently have an increased risk of thrombosis.
Accompanying iron therapy for bowel diseases
As explained in a contribution by "scilog", the magazine of the Austrian Science Fund FWF (Fund for the Promotion of Scientific Research), for gastroenterologist Christoph Gasche everything started with the blood pictures of a risk group: patients with inflammatory bowel diseases such as Crohn's disease or ulcerative colitis.
Due to illness, they lose blood via the intestine and with it the oxygen transporter hemoglobin, the central element of which is iron. According to the information, the exact analysis of the blood values showed as a side effect thrombocytosis, i.e. an abnormally increased amount of platelets (platelets) in the blood. In a first study, evidence was found that iron deficiency boosts platelet production and iron infusions improve the well-being of patients with the intestinal diseases. The accompanying iron therapy is a standard of treatment these days.
“The fact that the platelets increase when there is a lack of iron was surprising in that all other cell systems are shut down. Every cell needs iron, so if there is a deficiency, they stop growing, ”project manager Christoph Gasche explained the initial situation for a research project on iron deficiency and thrombosis tendency supported by the Science Fund FWF.
Platelets play a key role in blood clotting
Because platelets play a key role in blood coagulation, the team at MedUni Vienna concluded that iron deficiency and clot formation were linked. Thromboses, i.e. the formation of blood clots in venous or arterial vessels, are known from clinical practice as a feared side effect of inflammatory bowel diseases.
“Thrombosis has various causes, but iron deficiency is relatively common. So we are on the trail of a previously unnoticed but important teammate in mortality that goes far beyond the condition of intestinal inflammation. "
Blood usually flows during operations, and every month for women of childbearing age. Thrombosis is a high risk postoperatively and 20 percent of women under 50 lack iron - their risk of thrombosis is therefore significantly higher than that of men. It is possible to include iron in the diet, but it is difficult or strictly limited.
“Meat is a good source of iron. Meat also contains red blood pigment (hemoglobin). The body can absorb the iron bound in it particularly well. Iron from plant-based foods is generally harder to use, ”writes the Institute for Quality and Efficiency in Health Care (IQWiG) on the portal“ gesundheitsinformation.de ”.
Too many platelets make sense in the short term
According to the “scilog”, the hypothesis was obvious that the production of platelets for more blood clotting makes systemic sense to stop bleeding. Too many platelets in the blood make sense in the short term, but thrombocytosis permanently increases the risk of clot formation. In the FWF project, the influence of iron deficiency on venous and arterial blood clotting was examined in the rat model.
PhD student Kristine Jimenez compared three groups of healthy rats. The first group was malnourished for iron, the second also, but with accompanying iron infusion and the control group received normal feed. In order to examine the venous system, the inferior vena cava was tied off in all three groups in order to narrow the cross-section, and the development of the thrombosis was observed using ultrasound. The thrombi were then examined histopathologically. All groups formed thrombi, but larger plugs with a high platelet count were formed in the anemic rats in a shorter time.
The control group and the iron-substituted rats behaved the same in terms of clot formation. For the arterial system, the carotid artery was prepared in all three groups and the vessel was stimulated, which reliably activated the blood clotting inside. Although the blood pressure is much higher than in the vena cava, an occlusion also formed there.
In turn, the malnourished rats are faster and bigger. At the same time, Kristina Jimenez searched for biological activation markers on the megakaryocytes, i.e. the cells that form platelets, but was unable to find any. Such tests could quickly identify less obvious risk groups.
Any clot formation is potentially life threatening
“We were able to show that arterial and venous thrombi have similar pathways in which iron deficiency is an important factor. From the outside, a heart attack and swollen legs have little to do with each other, but the iron deficiency-induced thrombosis is relevant for both and is important due to the widespread use of iron deficiency, ”summarizes the internist Christoph Gasche.
The doctor at the MedUni Vienna would like to have the level of iron checked every time the operation is released in order to minimize the risk of thrombocytosis and not just rely on blood reserves - because any clot formation is potentially life-threatening.
The research team next plans to investigate inflammatory bowel diseases in mice. It is important to find out whether the iron deficiency-related changes in the platelets have an influence on thrombosis and intestinal inflammation and whether it is possible to treat the inflammation by administering iron. (ad)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Science Fund FWF (Fund for the Promotion of Scientific Research): Underestimated risk factor for thrombosis tendency, (accessed: August 27, 2019), scilog
- Institute for Quality and Efficiency in Health Care (IQWiG): How can I cover my iron needs ?, (accessed: August 27, 2019), gesundheitsinformation.de