Exp Clin Endocrinol Diabetes 2020; 128(04): 270-277
DOI: 10.1055/a-0885-1677
Review
© Georg Thieme Verlag KG Stuttgart · New York

The Case for an Estrogen-iron Axis in Health and Disease

Mawieh Hamad
1   Sharjah Institute for Medical Research, University of Sharjah, United Arab Emirates
2   Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, UAE
,
Khuloud Bajbouj
1   Sharjah Institute for Medical Research, University of Sharjah, United Arab Emirates
3   Department of Basic Medical Sciences, College of Medicine, University of Sharjah, UAE
,
Jalal Taneera
1   Sharjah Institute for Medical Research, University of Sharjah, United Arab Emirates
3   Department of Basic Medical Sciences, College of Medicine, University of Sharjah, UAE
› Author Affiliations
Funding This work was supported by research grants 15010501005-P and 1701050126-P, University of Sharjah, UAE and grant AJF201664, Al-Jalila Foundation, Dubai, UAE.
Further Information

Publication History

received 17 October 2018
revised 24 March 2019

accepted 27 March 2019

Publication Date:
12 April 2019 (online)

Abstract

Clinical and experimental evidence suggest that estrogen manipulates intracellular iron metabolism and that elevated levels of estrogen associate with increased systemic iron availability. This has been attributed to the ability of estrogen to suppress hepcidin synthesis, maintain ferroportin integrity and enhance iron release from iron-absorbing duodenal enterocytes and iron-storing macrophages and hepatocytes. These observations speak of a potential “estrogen-iron” axis that manipulates iron metabolism in response to hematologic (erythropoiesis) and non-hematologic (uterine growth, pregnancy, lactation) needs for iron. Such an axis could contribute to minimizing iron deficiency in premenopausal women and iron overload in postmenopausal women. It could also exacerbate iron overload and related clinical consequences including cancer, osteoporosis, cardiovascular complications and neurodegenerative symptoms, especially in postmenopausal women on hormonal replacement therapy. Understanding the role of estrogen in iron metabolism may shed some light on the pleotropic, but often paradoxical, roles of estrogen in human health and disease.

 
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