Anemia is a disease which can affect around 1/3 of the world’s human population, and the most common is iron deficiency anemia. Iron plays a crucial role in the human metabolic process with respect to oxygen transport, electron transfer, oxidation-reduction reactions and hormone synthesis. Iron can be taken from food, such as meat or vegetables, medications or transfusions, but the source of iron is crucial, as well as the type of iron. Several mechanisms that help to maintain adequate iron absorption is related to symbiotic bacteria in the gut. The most common and well-recognized is fermentation, which improves the absorption of iron element.

In clinical research, many probiotic bacteria, such as Lactobacillus acidophilus or Bifidobacterium longum have anti-inflammatory properties. One of the most important known actions of probiotics is to play a dominant role over pathogenic microorganisms. In addition, they help in the production of short-chain fatty acids (SCFA), vitamins, bactericidins, and the metabolism of bile acid salts. Some of these bacteria and their metabolites are important in iron absorption and influence the course of anemia. A lot of studies have showed a correlation between gut microbiota and iron deficiency. Additionally, some studies recording positive effects on iron absorption due to probiotic bacteria were published. Vonderheid et al. (2019) showed a positive effect of Lactiplantibacillus plantarum299v on the prevention of iron deficiency anemia. This strain improves the absorption of non-heme iron in Caucasian Europeans. Korcok et al., describe the additive effect of using L. plantarum 299v together with sucrosomal iron and vitamin C in the prevention and treatment of iron deficiency. In this research, control group received only vitamin C and iron, and the case group was given additional L. plantarum. At the end of the study, the iron blood levels were higher in the case group because of increased iron absorption. Iron deficiency studies focused also on other potentially beneficial types of probiotics as lactobacillus fermentum or Lactobacillus acidophilus. Garces et al proved that L. fermentum into enterocytes delivering iron-oxide particles by which adequate levels of iron are obtained. In addition, Lactobacillus acidophilus use in iron deficiency anemia according to study of Khodaii et al results in an increase in ferritin formation in the intestinal cell.

Vonderheid et al. (2019) analyzed the possible mechanism of probiotic strains on iron status and its prevention of iron deficiency. This process is possible due to immunomodulation, anti-inflammatory response, the formation of bioavailable ferrous form by reduction of ferric iron, and enhancing iron uptake by enterocytes. Currently, L. plantarum 299 can significantly improve the absorption of iron in the body, and the possible mechanism is explored. Future studies should include evaluating the effect of L. plantarum 299 on iron absorption and iron status in high-risk groups of iron-deficiency anemia, including pregnant women. More research is needed to prove the positive effects of other probiotics on iron absorption.

  1. Zuzanna Zakrzewska, Aleksandra Zawartka, Magdalena Schab, Adrian Martyniak, Szymon Skocze ´n , Przemysław J. Tomasik , and Andrzej W˛edrychowicz. Prebiotics, Probiotics, and Postbiotics in the Prevention and Treatment of Anemia.Microorganisms 2022, 10, 1330. https://doi.org/10.3390/microorganisms10071330
  2. Susan C. Vonderheid , Lisa Tussing-Humphreys , Chang Park , Heather Pauls , Nefertiti OjiNjideka Hemphill , Bazil LaBomascus , Andrew McLeod and Mary Dawn Koenig.A Systematic Review and Meta-Analysis on the Effects of Probiotic Species on Iron Absorption and Iron Status. Nutrients 2019, 11, 2938; doi:10.3390/nu11122938