ID/IDA can be treated with oral or IV iron replacement. However, current oral treatments are not well tolerated and negatively impact the gut microbiome of patients.
Many conventional oral iron supplements are based on ferrous iron or ferric iron forms, which which have been associated with quite a number of gastrointestinal side effects, including disrupting the gut microbiome.1,2 In fact, most supplements provide large amounts of iron of which only a small fraction is absorbed and reaches the blood circulation, while the majority stays in the gut, where it can be redox-reactive and facilitates microbiome imbalance.
In contrast, dietary ferritin, the natural ferric iron [Fe(III)] storage protein in plants and animals, is well absorbed within the enterocytes by endocytosis. It does not release free iron on the intestinal lining and as such, does not exert negative impact on the gut microbiome.