Iron Overload Related to Excessive Vitamin C Intake
Authors: Mark A. Mallory, Chalengpoj Sthapanachai, Kris V. Kowdley
Journal: Annals of Internal Medicine (2003)

Letters16 September 2003Iron Overload Related to Excessive Vitamin C IntakeMark A. Mallory, MD, Chalengpoj Sthapanachai, MD, and Kris V. Kowdley, MDMark A. Mallory, MDFrom University of Washington School of Medicine; Seattle, WA 98144., Chalengpoj Sthapanachai, MDFrom University of Washington School of Medicine; Seattle, WA 98144., and Kris V. Kowdley, MDFrom University of Washington School of Medicine; Seattle, WA 98144.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-6-200309160-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 61-year-old woman was referred to the University of Washington iron overload clinic after presenting with fatigue. She reported a 27-year history of oral iron supplementation with 325 mg of ferrous sulfate twice per day, along with 15 000 mg of oral vitamin C per day as self-initiated prophylaxis against recurrent upper respiratory tract infections. Her medical, medication, family, and social history were otherwise unremarkable. She did not report alcohol use.Physical examination demonstrated a normal-sized liver, no bronzing of the skin, and no signs of chronic liver disease. On laboratory evaluation, her hematocrit was 0.44, serum ...References1. Britton RS, Fleming RE, Parkkila S, Waheed A, Sly WS, Bacon BR. Pathogenesis of hereditary hemochromatosis: genetics and beyond. Semin Gastrointest Dis. 2002;13:68-79. [PMID: 12064862] MedlineGoogle Scholar2. Cook JD, Watson SS, Simpson KM, Lipschitz DA, Skikne BS. The effect of high ascorbic acid supplementation on body iron stores. Blood. 1984;64:721-6. [PMID: 6466873] CrossrefMedlineGoogle Scholar3. Hunt JR, Gallagher SK, Johnson LK. Effect of ascorbic acid on apparent iron absorption by women with low iron stores. Am J Clin Nutr. 1994;59:1381-5. [PMID: 8198064] CrossrefMedlineGoogle Scholar4. Hoffman KE, Yanelli K, Bridges KR. Ascorbic acid and iron metabolism: alterations in lysosomal function. Am J Clin Nutr. 1991;54:1188S-1192S. [PMID: 1962568] CrossrefMedlineGoogle Scholar5. Toth I, Rogers JT, McPhee JA, Elliott SM, Abramson SL, Bridges KR. Ascorbic acid enhances iron-induced ferritin translation in human leukemia and hepatoma cells. J Biol Chem. 1995;270:2846-52. [PMID: 7852359] CrossrefMedlineGoogle Scholar6. Pointon JJ, Wallace D, Merryweather-Clarke AT, Robson KJ. Uncommon mutations and polymorphisms in the hemochromatosis gene. Genet Test. 2000;4:151-61. [PMID: 10953955] CrossrefMedlineGoogle Scholar7. Roetto A, Totaro A, Piperno A, Piga A, Longo F, Garozzo G, . New mutations inactivating transferrin receptor 2 in hemochromatosis type 3. Blood. 2001;97:2555-60. [PMID: 11313241] CrossrefMedlineGoogle Scholar8. Montosi G, Donovan A, Totaro A, Garuti C, Pignatti E, Cassanelli S, . Autosomal-dominant hemochromatosis is associated with a mutation in the ferroportin (SLC11A3) gene. J Clin Invest. 2001;108:619-23. [PMID: 11518736] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Washington School of Medicine; Seattle, WA 98144. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHigh-Dose Vitamin C and Iron Overload Bill Sardi High-Dose Vitamin C and Iron Overload Kris V. Kowdley Metrics Cited ByAscorbic Acid Promotes Functional Restoration after Spinal Cord Injury Partly by Epigenetic ModulationClinical Effect of Intravenous Vitamin C on Viral Myocarditis in Children: A Systematic Review and Meta-AnalysisIron, Human Growth, and the Global Epidemic of ObesitySubconjunctival Hemorrhages: Presenting Sign for Hereditary HemochromatosisVitamin use among children attending a Canadian pediatric emergency departmentNeogenin inhibits HJV secretion and regulates BMP-induced hepcidin expression and iron homeostasisSafety Considerations and Potential Interactions of Vitamins: Should Vitamins Be Considered Drugs?Possible adverse effect of high δ-alpha-tocopherol intake on hepatic iron overload: Enhanced production of vitamin C and the genotoxin, 8-hydroxy-2′- deoxyguanosinePotential Vitamin-Drug Interactions in ChildrenPrevalence and characteristics of vitamin or dietary supplement users in Lausanne, Switzerland: the CoLaus studyPotential Interactions of Drug–Natural Health Products and Natural Health Products–Natural Health Products among ChildrenIron supplement use and iron status among US adults: results from the third National Health and Nutrition Examination SurveyHigh-Dose Vitamin C and Iron OverloadBill Sardi 16 September 2003Volume 139, Issue 6Page: 532-533KeywordsAttentionCellsFatigueFerritinHemochromatosisLiverMutationPhlebotomySerum ferritin levelsVitamin C ePublished: 16 September 2003 Issue Published: 16 September 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...