Iron Fortification: Health Risks Of Excessive Iron Intake


Although necessary for several body processes, including the production of haemoglobin, iron can be detrimental if consumed in excess. Food fortification with iron is one of the indicated treatments for iron-deficient anaemia.

Points to Ponder:

  • Iron is added to common foods including wheat, rice, and salt as part of an effort to treat iron-deficient anaemia.
  • Up to two-thirds (10 mg/day) of an adult woman’s daily requirement of iron and nearly all of a man’s daily requirement of iron are the goals of the fortification.
  • When people regularly consume a healthy, balanced diet or consume more fortified foods than is recommended, they may consume too much iron.
  • The “tolerable upper limit” of iron intake is 40 mg per day, above which the risk of adverse consequences increases.
  • Those who have iron overload conditions, such as thalassemia sufferers, are especially vulnerable to the negative effects of excessive iron intake.
  • The body controls how much iron is absorbed, excreting only in small, constant amounts other than when there is bleeding (such as during menstruation).
  • Increased iron excretion in children receiving fortification has been shown in recent research; this is probably due to intestinal or urinary exfoliation.
  • Due to the body’s regulatory processes and unabsorbed iron, fortification may not have the overall impact on haemoglobin synthesis that was anticipated.
  • Normally, only 5-10% of the iron that is consumed is absorbed; the remainder is excreted.
  • Unabsorbed iron can promote intestinal lining irritation, alter colonic flora, result in gastrointestinal bleeding, and hinder the absorption of other minerals.
  • Due to its potential to harm DNA, proteins, and cells through prolonged oxidative stress, excess iron has been strongly associated with diabetes.
  • Chronic excess iron-induced oxidative stress can disrupt long-chain fatty acid beta-oxidation in the mitochondria, resulting in aberrant fat oxidation, high serum triglyceridemia, and triglyceride buildup in muscle and liver tissues.
  • Higher serum ferritin levels (iron storage state) were linked to higher risks of high fasting serum glucose, total cholesterol, triglycerides, and hypertension in Indian teenage children, according to data analysis.
  • According to scenario analysis, fortification with an additional 10 mg of iron per day could raise the prevalence of elevated fasting blood glucose by 2-14% among various socioeconomic categories.
  • Iron can activate hepatic stellate cells and cause an excessive buildup of extracellular matrix in the liver in very high doses, which can result in liver fibrosis and the development of cirrhosis.
  • Individualised iron fortification techniques must be created, and careful monitoring must be maintained to identify any negative effects as soon as possible.
  • To reduce the risk of iron overload and associated chronic long-term disorders, public health must be precise.
  • Finding a middle ground between mandated fortification and complete elimination would be preferable, taking into account both individual needs and the hazards of excessive iron intake.