6 ms·

The War for Iron

137 points by etiam 4y ago

emiliobumachar 4y ago
Interesting. The infected human body stops absorbing some metals because the infecting bacteria will miss it more.
letharion 4y ago
This seems to go hand in hand with the idea, suggested by Jason Fung and others, that one should fast when sick. If we stop eating, then there's less nutrients available for invaders, who have a large need to grow and replicate so they can spread to the next host. The human body doesn't need to rapidly grow though, so it can go without much food for a few days.
- hutzlibu 4y ago
  And the body can focus on fighting the disease and not digestion, which is work, too. I am currently sick and I just don't want to eat (much), so I won't. That's why we have fat reserves.
  - nradov 4y ago
    Anecdotally, several people have told that they lost a few pounds of fat while suffering from mild COVID-19 symptoms despite still eating during the course of the disease. And this was real fat loss, not just dehydration. Fighting the infection seems to burn a lot of calories.
- joshmarinacci 4y ago
  Interesting. I’ve been sick for the past 48hours and have zero appetite, but very thirsty for plain water.
  - nabla9 4y ago
    Do you have fever? Digestive proteins don't work well when you get fever. It becomes harder to absorb nutrition from food.
    - unglaublich 4y ago
      So you would expect that you need _more_ food to absorb the same amount of nutrients.
      - LarryMullins 4y ago
        The presumed point is to have fewer nutrients. Reduced appetite accomplishes this, as do less efficient digestive processes. Both together should compliment each other.
      - nabla9 4y ago
        Yes, but it stresses metabolism even more. When your immune system is using energy, stressing it with food if you are not suffering from malnutrition may not help. Instead of eating, try resting and laying still. Don't even watch movies. Maybe listen only music or listen podcasts if you must. This is just anecdotal and personal, but if I just have patience to stay still and lay down, I usually get better faster.
  - letharion 4y ago
    I tried finding the articles I learned this from originally, but he appears to have migrated to a new blog and I can no longer find the sources, but IIRC Fung claims that this is the bodies way of solving precisely the "no-nutrients-for-the-invader" problem. Just dial down hunger as low as possible, to avoid eating.
- TheSpiceIsLife 4y ago
  The centruries old saying is starve a fever, feed a cold. But probably the best thing to do is: eat (but not too much) if you're hungry, don't if you're not (but probably don't go too many days without food).
jtbayly 4y ago
Hmm. I wonder what the impact is on those that are already anemic and get an infection that causes this reaction. I also wonder whether there is any impact on length of illness by taking things like iron and magnesium. Aren’t zinc and magnesium a couple of the things they say to take during sickness?
- pacaro 4y ago
  It can be bad. My partner has fairly severe chronic iron deficiency anemia, an infection landed them in an ICU followed by a month of hospitalization
cperciva 4y ago
See also "anaemia of chronic disease" -- people with chronic infections or inflammation often end up suffering from what is effectively iron-deficiency anaemia, because their bodies sequester iron to keep it away from pathogens.
- jtbayly 4y ago
  That answers one of my questions in another comment. Thanks. It did seem like an obvious point of concern, since our bodies need iron.
- sph 4y ago
  That's my running theory why my IBS, especially after eating gluten-rich foods for multiple days, gives me terrible restless legs syndrome that keeps me up at night: malabsorption and systemic inflammation causes iron deficiency, which in my case is resolved after a week of zero carb diet. A myriad of vegetables likewise give me IBS-like symptoms, whereas meat causes zero discomfort and has a ton of bioavailable minerals. I've also found cod liver (such an underrated delicacy) and iron supplements sometimes give me a tremendous amount of energy a couple hours after ingestion, possibly due to chronic mineral deficiencies. I am not anaemic btw, and male, so I'm not losing iron every month. I should try and take iron pills more often, but one needs to be careful not to go overboard with metals. EDIT: well, apparently iron therapy for IBD is a thing. Somehow I had never heard of it: https://en.wikipedia.org/wiki/Iron_supplement#By_injection https://en.wikipedia.org/wiki/Iron_supplement#By_injection
  - cperciva 4y ago
    Not my field, but I'd be surprised if this was an iron issue; the timescales don't match up. I wouldn't be surprised if magnesium was an issue though.
  - justinator 4y ago
    "a myriad of vegetables" - are we talking nightshades?
    - 4y ago
dbcooper 4y ago
This is also a problem with iron salt supplements. As someone with Crohn's disease, I am interested in developing superior alternatives.
- trashface 4y ago
  Do you know if iron supplementation increase the risk of harmful gut infection in susceptible people, for instance those with diverticulosis? I've recently started supplementing iron myself (i'm mostly vegetarian and have had low iron levels on blood tests before) and have noticed some unpleasant intestinal changes, which could be related. I do have diverticula but not crohn's.
  - User23 4y ago
    I can't answer your question, but I can say you really need to talk to a medical professional or nutritionist who knows your circumstances and not get the answer from the Internet. It's well and good to generalize and I do that myself[1], but if you know you have some atypical condition please just talk to a pro who really understands your situation. [1] For example I mentioned in another comment not too long ago that under normal circumstances dietary cholesterol isn't a big deal and it's not. But there are people with certain conditions for whom it is a very big deal.
    - trashface 4y ago
      Like many people, I have to figure stuff out for myself because the US medical industry is borderline useless. I've talked to plenty of primary care docs, gastroenterologists. They have no clue, they don't care. They just shrug off your questions and see you out the door after the allotted 6 minutes of office visit time for which I pay $75 a pop. All they want to do is procedures like colonoscopies, which I've had and which have showed nothing of note.
      - User23 4y ago
        That really sucks, I'm sorry to hear that. I guess I've been lucky and have just had really good caregivers so far. In the circumstances you describe though it sounds like you need to do your best to read and evaluate the source material and make the best decisions you can. I wish you the best. One thing that's worked out for me is nerding out with my doctors though. If they can't then I find a new one. So far for me this has just been with respect to lifting weights and the various consequences thereof, but I imagine the principle generalizes. I'm getting to the age where my body is going to start climbing the s-curve of decay so I hope I'm right. And I do have reason to hope. Someone very important to me has a rare genetic disorder. It took over a decade, but that person found a doctor who actually cared and nerded out over it and followed the research. Those caregivers are out there, so don't give up looking for them. If you happen to be fortunate enough to live in California your odds of finding such a person within driving distance are quite good.
jbandela1 4y ago
If you look the author is Derek Lowe. He is also the author of the hilarious series: Things I won’t Work With. (If you have not read that series you should definitely do so) I am really impressed by and grateful for people who are deep subject matter experts and can also write in a very engaging style that regular people can follow along with and learn from.
- denton-scratch 4y ago
  Ah, thanks. I recognized the face, but not the name. Things I won't Work With is hilarious. Old joke: "Nice to see you. I recognize your name, but I'm damned if I can remember your face."
rcme 4y ago
The iron-plankton connection was used in attempt to boost salmon yields [0]. Iron was dumped off the side of a boat to cause a plankton bloom, with the goal of ultimately producing more salmon. It seems to have kind of worked? 0: https://archive.nytimes.com/dotearth.blogs.nytimes.com/2014/07/18/a-fresh-look-at-iron-plankton-carbon-salmon-and-ocean-engineering/ https://archive.nytimes.com/dotearth.blogs.nytimes.com/2014/...
- unglaublich 4y ago
  Ah, as usual: a short term profit optimization strategy with unknown, but potentially disastrous long term cost.
  - hutzlibu 4y ago
    "but potentially disastrous long term cost." I think scale matters. If done in big quantities, it surely would change the maritime ecology, but do you have any reason to believe there are hidden dangers?
photochemsyn 4y ago
Another article that emphasizes just how ridiculously complicated the immune system can be. Here's the source report that this article discusses: https://www.nature.com/articles/s42255-022-00723-5 https://www.nature.com/articles/s42255-022-00723-5 Note that they were studying a mouse model of sepsis, which is a full-blown blood-borne bacterial infection that is certainly fatal in humans as often as not. Today this is treated by antibiotic injection and is rarely fatal if caught early, but likely this process is something like a last-ditch defense against the invading bacteria. Sequesting iron after blood cell lysis might inhibit bacterial growth but probably also means it's harder for the remaining blood cells to deliver oxygen to and pick up CO2 from important cells like those in the heart and brain, and it might mess up other basic metabolic processes. Hence this probably isn't something that gets triggered too easily, or which plays much of a role in mild illnesses. It might also be a counter-productive response in some viral illnesses. Anyone who thinks they might be in the early stages of sepsis should seek immediate medical attention in an emergency room. This happened to me once, after foolishly swimming in the ocean after getting a deep cut on my leg - which swelled up to half again its normal size with long red streaks shooting up the whole length of the leg. Two big shots of rifampicin in each buttock and a week spent in bed with a course of some other oral antibiotics and I was fine, but in the pre-antibiotic era that might not have been the case! > "Early sepsis is characterized by the systemic inflammatory response syndrome (SIRS) - tachycardia, tachypnea, fever (over 100.4 F or 38oC) or hypothermia (below 96.8 F or 36oC), and leukopenia or leukocytosis." https://www.news-medical.net/health/Everything-You-Need-To-Know-About-Sepsis.aspx https://www.news-medical.net/health/Everything-You-Need-To-K...
- kldavis4 4y ago
  Just curious, but which beach were you swimming at when you were infected?
fwungy 4y ago
We accumulate iron as we age, and the accumulation correlates with mortality. Women's mortality starts to match men's as they progress on menopause. The theory on that is that their iron markers go up when they stop menstruation. This is also probably why blood donors have better health and longer lifespans, even when you account for the better starting health of the blood donor cohort.
- pacaro 4y ago
  One of my siblings has hereditary hemochromatosis, so their body retains far more iron than it should. This is not fun. Careful diet helps slow the buildup, but the only effective treatment is blood letting
  - clsec 4y ago
    Since you said one of your siblings has it, I assume you are half siblings? I have hereditary hemochromatosis, and since my sisters and I have different mothers, I am the only one in my family to have it. It takes two parents who carry the gene. Anyway, yes, bloodletting (properly called phlebotomy) is really the only way to deal with it. The first 3 years after my diagnosis my hematologist and I tried out quite a few things to help control it, including diet modifications and different time intervals between phlebotomies. We ended up settling on phlebo every 6 weeks and eat whatever I want.
    - pacaro 4y ago
      The variant in question is autosomal recessive, so my sibling has two copies of the genes and I got lucky and have one
    - dennis_jeeves1 4y ago
      Regarding diet: a carnivore diet helps. This is counter intuitive because red meat is supposed to contain a lot of iron. I will leave it at that and I will let you research. Tip look at: Shawn Baker's videos
  - bolangi 4y ago
v8xi 4y ago
Siderophores are some of the craziest things in biology, in my opinion. Short peptides (often <10 amino acids) with affinities to metal irons that are just incomprehensibly low with binding so tight you can actually deplete metals from water - 0 atoms per liter. An excellent technology for future e.g. heavy metal/nuclear contamination remediation
lymph 4y ago
A fine addition to my rss feeds - In The Pipeline Derek Lowe’s commentary on drug discovery and the pharma industry. https://blogs.sciencemag.org/pipeline/feed https://blogs.sciencemag.org/pipeline/feed

137 points by etiam 4y ago

Interesting. The infected human body stops absorbing some metals because the infecting bacteria will miss it more.

This seems to go hand in hand with the idea, suggested by Jason Fung and others, that one should fast when sick. If we stop eating, then there's less nutrients available for invaders, who have a large need to grow and replicate so they can spread to the next host. The human body doesn't need to rapidly grow though, so it can go without much food for a few days.

hutzlibu 4y ago
And the body can focus on fighting the disease and not digestion, which is work, too. I am currently sick and I just don't want to eat (much), so I won't. That's why we have fat reserves.
- nradov 4y ago
  Anecdotally, several people have told that they lost a few pounds of fat while suffering from mild COVID-19 symptoms despite still eating during the course of the disease. And this was real fat loss, not just dehydration. Fighting the infection seems to burn a lot of calories.
joshmarinacci 4y ago
Interesting. I’ve been sick for the past 48hours and have zero appetite, but very thirsty for plain water.
- nabla9 4y ago
  Do you have fever? Digestive proteins don't work well when you get fever. It becomes harder to absorb nutrition from food.
  - unglaublich 4y ago
    So you would expect that you need _more_ food to absorb the same amount of nutrients.
    - LarryMullins 4y ago
      The presumed point is to have fewer nutrients. Reduced appetite accomplishes this, as do less efficient digestive processes. Both together should compliment each other.
    - nabla9 4y ago
      Yes, but it stresses metabolism even more. When your immune system is using energy, stressing it with food if you are not suffering from malnutrition may not help. Instead of eating, try resting and laying still. Don't even watch movies. Maybe listen only music or listen podcasts if you must. This is just anecdotal and personal, but if I just have patience to stay still and lay down, I usually get better faster.
- letharion 4y ago
  I tried finding the articles I learned this from originally, but he appears to have migrated to a new blog and I can no longer find the sources, but IIRC Fung claims that this is the bodies way of solving precisely the "no-nutrients-for-the-invader" problem. Just dial down hunger as low as possible, to avoid eating.
TheSpiceIsLife 4y ago
The centruries old saying is starve a fever, feed a cold. But probably the best thing to do is: eat (but not too much) if you're hungry, don't if you're not (but probably don't go too many days without food).

jtbayly 4y ago

Hmm. I wonder what the impact is on those that are already anemic and get an infection that causes this reaction. I also wonder whether there is any impact on length of illness by taking things like iron and magnesium. Aren’t zinc and magnesium a couple of the things they say to take during sickness?

pacaro 4y ago
It can be bad. My partner has fairly severe chronic iron deficiency anemia, an infection landed them in an ICU followed by a month of hospitalization

cperciva 4y ago

See also "anaemia of chronic disease" -- people with chronic infections or inflammation often end up suffering from what is effectively iron-deficiency anaemia, because their bodies sequester iron to keep it away from pathogens.

jtbayly 4y ago
That answers one of my questions in another comment. Thanks. It did seem like an obvious point of concern, since our bodies need iron.
sph 4y ago
That's my running theory why my IBS, especially after eating gluten-rich foods for multiple days, gives me terrible restless legs syndrome that keeps me up at night: malabsorption and systemic inflammation causes iron deficiency, which in my case is resolved after a week of zero carb diet. A myriad of vegetables likewise give me IBS-like symptoms, whereas meat causes zero discomfort and has a ton of bioavailable minerals. I've also found cod liver (such an underrated delicacy) and iron supplements sometimes give me a tremendous amount of energy a couple hours after ingestion, possibly due to chronic mineral deficiencies. I am not anaemic btw, and male, so I'm not losing iron every month. I should try and take iron pills more often, but one needs to be careful not to go overboard with metals. EDIT: well, apparently iron therapy for IBD is a thing. Somehow I had never heard of it: https://en.wikipedia.org/wiki/Iron_supplement#By_injection https://en.wikipedia.org/wiki/Iron_supplement#By_injection
- cperciva 4y ago
  Not my field, but I'd be surprised if this was an iron issue; the timescales don't match up. I wouldn't be surprised if magnesium was an issue though.
- justinator 4y ago
  "a myriad of vegetables" - are we talking nightshades?
  - 4y ago

dbcooper 4y ago

This is also a problem with iron salt supplements. As someone with Crohn's disease, I am interested in developing superior alternatives.

trashface 4y ago
Do you know if iron supplementation increase the risk of harmful gut infection in susceptible people, for instance those with diverticulosis? I've recently started supplementing iron myself (i'm mostly vegetarian and have had low iron levels on blood tests before) and have noticed some unpleasant intestinal changes, which could be related. I do have diverticula but not crohn's.
- User23 4y ago
  I can't answer your question, but I can say you really need to talk to a medical professional or nutritionist who knows your circumstances and not get the answer from the Internet. It's well and good to generalize and I do that myself[1], but if you know you have some atypical condition please just talk to a pro who really understands your situation. [1] For example I mentioned in another comment not too long ago that under normal circumstances dietary cholesterol isn't a big deal and it's not. But there are people with certain conditions for whom it is a very big deal.
  - trashface 4y ago
    Like many people, I have to figure stuff out for myself because the US medical industry is borderline useless. I've talked to plenty of primary care docs, gastroenterologists. They have no clue, they don't care. They just shrug off your questions and see you out the door after the allotted 6 minutes of office visit time for which I pay $75 a pop. All they want to do is procedures like colonoscopies, which I've had and which have showed nothing of note.
    - User23 4y ago
      That really sucks, I'm sorry to hear that. I guess I've been lucky and have just had really good caregivers so far. In the circumstances you describe though it sounds like you need to do your best to read and evaluate the source material and make the best decisions you can. I wish you the best. One thing that's worked out for me is nerding out with my doctors though. If they can't then I find a new one. So far for me this has just been with respect to lifting weights and the various consequences thereof, but I imagine the principle generalizes. I'm getting to the age where my body is going to start climbing the s-curve of decay so I hope I'm right. And I do have reason to hope. Someone very important to me has a rare genetic disorder. It took over a decade, but that person found a doctor who actually cared and nerded out over it and followed the research. Those caregivers are out there, so don't give up looking for them. If you happen to be fortunate enough to live in California your odds of finding such a person within driving distance are quite good.

jbandela1 4y ago

If you look the author is Derek Lowe. He is also the author of the hilarious series: Things I won’t Work With. (If you have not read that series you should definitely do so) I am really impressed by and grateful for people who are deep subject matter experts and can also write in a very engaging style that regular people can follow along with and learn from.

denton-scratch 4y ago
Ah, thanks. I recognized the face, but not the name. Things I won't Work With is hilarious. Old joke: "Nice to see you. I recognize your name, but I'm damned if I can remember your face."

rcme 4y ago

The iron-plankton connection was used in attempt to boost salmon yields [0]. Iron was dumped off the side of a boat to cause a plankton bloom, with the goal of ultimately producing more salmon. It seems to have kind of worked? 0: https://archive.nytimes.com/dotearth.blogs.nytimes.com/2014/07/18/a-fresh-look-at-iron-plankton-carbon-salmon-and-ocean-engineering/ https://archive.nytimes.com/dotearth.blogs.nytimes.com/2014/...

unglaublich 4y ago
Ah, as usual: a short term profit optimization strategy with unknown, but potentially disastrous long term cost.
- hutzlibu 4y ago
  "but potentially disastrous long term cost." I think scale matters. If done in big quantities, it surely would change the maritime ecology, but do you have any reason to believe there are hidden dangers?

photochemsyn 4y ago

Another article that emphasizes just how ridiculously complicated the immune system can be. Here's the source report that this article discusses: https://www.nature.com/articles/s42255-022-00723-5 https://www.nature.com/articles/s42255-022-00723-5 Note that they were studying a mouse model of sepsis, which is a full-blown blood-borne bacterial infection that is certainly fatal in humans as often as not. Today this is treated by antibiotic injection and is rarely fatal if caught early, but likely this process is something like a last-ditch defense against the invading bacteria. Sequesting iron after blood cell lysis might inhibit bacterial growth but probably also means it's harder for the remaining blood cells to deliver oxygen to and pick up CO2 from important cells like those in the heart and brain, and it might mess up other basic metabolic processes. Hence this probably isn't something that gets triggered too easily, or which plays much of a role in mild illnesses. It might also be a counter-productive response in some viral illnesses. Anyone who thinks they might be in the early stages of sepsis should seek immediate medical attention in an emergency room. This happened to me once, after foolishly swimming in the ocean after getting a deep cut on my leg - which swelled up to half again its normal size with long red streaks shooting up the whole length of the leg. Two big shots of rifampicin in each buttock and a week spent in bed with a course of some other oral antibiotics and I was fine, but in the pre-antibiotic era that might not have been the case! > "Early sepsis is characterized by the systemic inflammatory response syndrome (SIRS) - tachycardia, tachypnea, fever (over 100.4 F or 38oC) or hypothermia (below 96.8 F or 36oC), and leukopenia or leukocytosis." https://www.news-medical.net/health/Everything-You-Need-To-Know-About-Sepsis.aspx https://www.news-medical.net/health/Everything-You-Need-To-K...

kldavis4 4y ago
Just curious, but which beach were you swimming at when you were infected?

fwungy 4y ago

We accumulate iron as we age, and the accumulation correlates with mortality. Women's mortality starts to match men's as they progress on menopause. The theory on that is that their iron markers go up when they stop menstruation. This is also probably why blood donors have better health and longer lifespans, even when you account for the better starting health of the blood donor cohort.

pacaro 4y ago
One of my siblings has hereditary hemochromatosis, so their body retains far more iron than it should. This is not fun. Careful diet helps slow the buildup, but the only effective treatment is blood letting
- clsec 4y ago
  Since you said one of your siblings has it, I assume you are half siblings? I have hereditary hemochromatosis, and since my sisters and I have different mothers, I am the only one in my family to have it. It takes two parents who carry the gene. Anyway, yes, bloodletting (properly called phlebotomy) is really the only way to deal with it. The first 3 years after my diagnosis my hematologist and I tried out quite a few things to help control it, including diet modifications and different time intervals between phlebotomies. We ended up settling on phlebo every 6 weeks and eat whatever I want.
  - pacaro 4y ago
    The variant in question is autosomal recessive, so my sibling has two copies of the genes and I got lucky and have one
  - dennis_jeeves1 4y ago
    Regarding diet: a carnivore diet helps. This is counter intuitive because red meat is supposed to contain a lot of iron. I will leave it at that and I will let you research. Tip look at: Shawn Baker's videos
- bolangi 4y ago

v8xi 4y ago

Siderophores are some of the craziest things in biology, in my opinion. Short peptides (often <10 amino acids) with affinities to metal irons that are just incomprehensibly low with binding so tight you can actually deplete metals from water - 0 atoms per liter. An excellent technology for future e.g. heavy metal/nuclear contamination remediation

lymph 4y ago

A fine addition to my rss feeds - In The Pipeline Derek Lowe’s commentary on drug discovery and the pharma industry. https://blogs.sciencemag.org/pipeline/feed https://blogs.sciencemag.org/pipeline/feed