Iron Metabolism and Hemoglobin: A Complete Guide for Students & Practitioners

1. Hemoglobin (Hb):

Definition:

Hemoglobin is an iron-containing red pigment present in RBCs that carries oxygen and carbon dioxide.


Structure of Hemoglobin:

  • It is a conjugated protein.
  • Made of:
    • 4 Globin chains (2 alpha, 2 beta)
    • 4 Heme groups (each has 1 iron molecule)

Mnemonic: “4G + 4H = 1 Hb”


Normal Hemoglobin Levels:

Group

Hb Level

Men

13–18 g/dL

Women

12–16 g/dL

Newborns

14–20 g/dL

Types of Hemoglobin:

Type

Notes

HbA

Adult Hb (α2β2) – Most common type

HbF

Fetal Hb (α2γ2) – Higher O₂ affinity

HbA2

Minor adult Hb (α2δ2)

Mnemonic:
“A-F-A2” = Adult, Fetal, Adult Minor
A → α2β2
F → α2γ2
A2 → α2δ2


Functions of Hemoglobin:

Function

Description

O₂ Transport

From lungs to tissues (as oxyhemoglobin)

CO₂ Transport

From tissues to lungs (as carbaminohemoglobin)

Buffering Action

Maintains blood pH

Mnemonic: "HBO" = Hemoglobin Buffers & carries O₂


2. Iron Metabolism

Daily Requirement of Iron:

Group

Requirement

Men

~10 mg/day

Women

~18 mg/day

Pregnant

~30 mg/day


Sources of Iron:

  • Animal source: Liver, red meat (heme iron – well absorbed)
  • Plant source: Green leafy vegetables (non-heme – less absorbed)

Mnemonic: “HeMaL” – Heme from Meat and Liver


Iron Absorption:

  • Site: Duodenum & upper jejunum
  • Enhanced by: Vitamin C, acidic pH
  • Inhibited by: Tea, phytates, calcium

Mnemonic:
“C helps C (Citrus helps Conversion)”
→ Vitamin C ↑ absorption


Transport of Iron:

  • Iron is transported in blood as Fe³⁺ bound to transferrin

Storage of Iron:

  • Stored in liver, spleen, bone marrow as:
    • Ferritin (soluble, major storage form)
    • Hemosiderin (insoluble, stored in overload)

Mnemonic: “Ferritin is Friendly, Hemosiderin is Hoarded”


Iron Cycle:

  1. Absorption in duodenum
  2. Transport by transferrin
  3. Uptake by bone marrow → Hb synthesis
  4. Aging RBCs destroyed → iron recycled
  5. Storage in liver/spleen

Mnemonic: "ATUSS" → Absorb, Transport, Use, Store, Scrap


3. Disorders Related to Hemoglobin/Iron

Disorder

Cause

Anemia

↓ Hb or ↓ iron

Iron Deficiency

Poor diet, blood loss

Hemochromatosis

Iron overload → organ damage

Thalassemia

Genetic defect in globin chain

Sickle Cell Anemia

Abnormal Hb → sickle-shaped RBCs

Quick Comparison Table:

Feature

Hemoglobin

Iron Metabolism

Main role

O₂ transport

Required for Hb synthesis

Location

Inside RBC

Absorbed in gut, stored in liver

Transport protein

N/A

Transferrin

Storage form

N/A

Ferritin & Hemosiderin

Daily requirement

N/A

10–30 mg depending on person

FAQs – Frequently Asked Questions

Q1. What is the normal level of hemoglobin?

Ans:
Men: 13–18 g/dL
Women: 12–16 g/dL

Q2. Where is iron absorbed in the body?

Ans: Duodenum and upper jejunum

Q3. What enhances or inhibits iron absorption?

Ans:

  • Enhancers: Vitamin C, acidic pH
  • Inhibitors: Tea, calcium, phytates

Q4. What is ferritin?

Ans: Ferritin is the main storage form of iron in the body.

Q5. What is the role of transferrin?

Ans: Transferrin transports iron in the blood.

Q6. What happens to iron when RBCs are destroyed?

Ans: Iron is recycled and reused for new RBC formation. 


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