Heme iron is by far the best form for supplementation to combat iron deficiency. Efficacy and tolerance are clearly better than for any other form..

1. HEMOGLOBIN AS IRON FOOD
SUPPLEMENTATION
- History and Future

2. Only two kinds of iron.
Iron is an important part of the red blood cells that carry oxygen to all the cells of the
body. If we don´t have enough we easily run short of breath, get Ored and have problems
concentraOng. Our bodies contain 4-5 grammes of iron. It may be difficult to get enough
of this important nutrient unless meat courses are part of the diet. Fruit, cereals and
vegetables contain relaOvely liSle of useful iron. If you’re suffering from low iron, no
amount of vitamins or any other supplement is going to change it.
Low iron levels are very common, especially for ferOle females. There are also many
chronics that need conOnual supplementaOon for different reasons.
There are only two kinds of iron that we can use; heme iron from meat, poultry or fish
and non- heme iron from vegetables, dairy products or chemically bonded iron in
synthtetcic supplements. Heme iron is taken up along the whole gastro- intesOnal tract
(not only the first part) and, unlike non-heme iron, absorpOon is not affected by other
chelaOng components of the diet such as phytates, tannates and phosphate.

3. Non-heme iron in supplements
Different iron salts and other synthtecic/chemical iron compounds have tradiOonally been
used with mixed results. The uptake is only 2-4 % and there are o]en tolerance problems.
However, since iron is essenOal for life the alternaOves are blood transfusions or
intravenously given iron. Both, however have negaOve sides except being very costly and
uncomfortable for the paOent.
The clinical use of blood transfusion is associated with risks that can cause morbidity and
mortality. Intravenous iron injecOons cause periods of exacerbaOon of oxidaOve stress in
the circulaOon.
Many oral iron supplementaOon treatments fail because syntethic iron compounds
produce painful and uncomfortable gastro-intesOnal side-effects sooner or later.
Non-heme supplements at 100 mg Fe++ per dose regularly have an incidence of side-
effects leading to terminaOon of the therapy of around 30 %.

4. Heme iron
Heme iron is found mainly in meat in the diet, which historically has always been the
main source for iron. It is very efficiently absorbed as a whole unit as opposed to non-
heme iron, which has to dissolve before iron ions can be taken up in the intesOnal cells.
The uptake remains high in all clinical situaOons, such as for example a]er stomach
surgery. Heme iron does not have to be disconOnued when using intravenous treatment.
This can help prolong intervals between painful and uncomfortable injecOons. It also
makes for easy self-medicaOon and freedom to travel.
Heme iron uptake is not affected by simultaneously ingested food, drink or medicaOon.
It will also not block the uptake of zinc as non-heme iron in doses over 60 mg will.
The uptake of iron is constant, also a]er surgery and blood donaOon. This is not the case
for non-heme iron.
Heme iron uptake is not affected by Omeprazole/Losec.

5. Heme iron supplementaOon
Pure hemolyzed hemoglobin powder of bovine or porcine origin derived from the food
industry as raw material for iron subsOtuOon has been of interest in Sweden since the
early sevenOes, as this is by far the best-tolerated and efficient form of iron.
This gave birth to heme iron supplementaOon by the creaOon of a pharma-grade
hemoglobin powder raw material for tablets. Heme iron tablet supplements have been
in use in Scandinavia for more than 30 years. There have been no cases of serious side-
effects or poisonings reported a]er use by literally millions.

6. Heme iron advantages
Tolerance for heme iron is equal or close to placebo. There is no change in tolerance
or efficacy over Ome. The absorpOon of heme iron is several Omes higher and the
side-effects rate significantly lower than for non-heme oral iron.
Heme iron is absorbed through a separate pathway and does not have to be
disconOnued when intravenous treatment is started. This can for instance allow for
longer intervals between resource-heavy, inconvenient and painful injecOons.
Heme absorpOon is not affected by other simultaneously ingested food, drink or
medicaOon.
Because the hemoglobin molecule is absorbed as a whole unit it will not leave free
toxic iron ions in the stomach. This is believed to be the main cause of gastro-
intesOnal side-effects from non-heme iron. Free iron ions do not exist in nature and
are highly reacOve in the stomach.

7. Low natural percentage of iron in
bovine hemoglobin.
The natural percentage of iron in bovine hemoglobin is only between 1 and 3 %. To
make oral products reach recommended daily allowance dosage the next step was to
develop a procedure where the hemoglobin molecules could be made to carry more
iron.
This was eventually made and today the OpOFer® line of products contain all iron as
heme iron. They are opOmised for recommended daily allowance as iron supplements
and could even be made to contain allowances for registered medical products. The
iron added is totally integrated with the hemoglobin and will not dissolve before
uptake. DisintegraOon happens only within the gastric cells, just as with natural
hemoglobin, giving opOmal efficacy and tolerance.
There are important arguments to be made for heme iron except for nearly perfect
tolerance and the highest efficacy of any oral therapy. These are for instance that the
raw material is organic and not synthethic, that efficay and tolerance will remain the
same over Ome. This, plus the fact that it is possible to receive easy, safe and effecOve
oral therapy without clinical appointments, is good news for chronics.

8. Micronutrients
Natural bovine hemoglobin is not only well-tolerated and an efficient source of iron. It
means also a wealth of micronutrients and for example amino acids and signal substances
that together make the formaOon of blood naturally more efficient.
Called micronutrients because they are needed only in small amounts, these substances
are the “magic wands” that enable the body to produce enzymes, hormones and other
substances essenOal for proper growth and development. As Ony as the amounts are,
however, the consequences of their absence are severe. Iodine, vitamin A and iron are
most important in global public health terms; their lack represent a major threat to the
health and development of populaOons the world over, parOcularly children and pregnant
women in low-income countries. (WHO)
Micronutrients are nutrients required by humans and other organisms throughout life in
small quanOOes to orchestrate a range of physiological funcOons. Dietary trace minerals are
required in amounts generally less than 100 milligrams/day -as opposed to macrominerals
which are required in larger quanOOes
Trace elements include at iron, cobalt, chromium, copper, manganese, selenium, and zinc
.

9. How can 18 mgs of heme iron
compete with a 100 mg non-heme
iron supplement?
30 days of supplementaOon with 100 mg Fe++ non-heme iron at a bio-availablity of 2 %
theoreOcally gives 60 mg absorbed iron. At 5 %, which is unusually high the amount is
150 mg.
SupplementaOon with 18 mg of heme iron for thirty days with a bio-availability of 20 %
gives 108 mg of absorbed iron. Heme iron is very well tolerated and is known to have a
side-effects raOo as placebo. This also means a higher therapy success rate.
This is why heme iron tablets with a dose of 18 mg Fe++ can compete with non-heme
preparaOons of 100 mg Fe++ or more.
.