Iron is vital for the proliferation of all cells including those of the immune system. Iron Iron 733

deficiency causes several defects in both humoral and cellular immunity (Bowlus

2003), including a reduction in peripheral T cells secondary to atrophy of the thymus and inhibition of thymocyte proliferation (Bowlus 2003) and a reduction in IL-2 production (Bergman et al 2004). Reduced IL-2 production may partly explain the increased susceptibility to infections and cancer in patients with iron deficiency anaemia (Bergman et al 2004). Supplementation of ferrous sulfate (60 mg Fe) once daily for 8 weeks has been shown to reduce the incidence and duration of upper-respiratory tract infections in children (de-Silva et al 2003).

However, there is also preliminary evidence that iron may be implicated in the pathogenesis of auto-immune disorders, including SLE, scleroderma, type 1 diabetes, Goodpasture syndrome, multiple sclerosis and RA (Bowlus 2003). Current evidence suggests that moderately elevated iron stores may be associated with an overall increased risk for cancer, especially colorectal cancer (McCarty 2003). Additionally, it has been proposed that iron may increase HIV replication and the rate of progression of HIV infection, although doses of 60 mg of elemental iron twice weekly for 4 months did not appear to affect HIV-1 viral load in clinical studies (Olsen et al

2004). Although maintaining adequate iron status may be important for immunity, the benefits of routine supplementation in the absence of deficiency cannot be justified.

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