LOW TRANSFERRIN: WHAT IT IS, CAUSES AND TREATMENT - MEDICINE - 2025

The term low transferrin refers to the decrease in transferrin glycoprotein in the bloodstream. Transferrin is a protein responsible for taking the iron consumed daily after being absorbed by the intestine. This iron is transported by transferrin, and is then stored in the liver, spleen, and bone marrow.

After being stored in the form of ferritin, iron can be used in different processes, such as in the synthesis of hemoglobin and in the hematopoietic process. Transferrin is synthesized in the reticulum endothelial system (SRE), although it does so especially in the liver. Its half-life lasts between 8 and 10 days.

Transferrin molecule

Because its half-life is short compared to other proteins synthesized in the liver such as albumin, its measurement in plasma is a reliable indicator of the liver's ability to synthesize. However, serum transferrin levels should not be confused with transferrin saturation.

Serum transferrin levels refer to the amount of protein present in blood plasma, while transferrin saturation refers to the percentage of that transferrin in plasma that is busy transporting iron.

Normal transferrin saturation values ​​range from 25% to 35%.

Main causes of low transferrin

Malnutrition

Some literatures describe low iron diet as a direct cause of low plasma transferrin levels. However, iron has been shown not to assist in the synthesis of transferrin in the liver.

This relationship may be due to the fact that the body is always looking to maintain balance and prevent the deficit or excess of any of its molecules and proteins.

Therefore, the body perceives a decrease in the amount of iron available for body processes and translates it as a need for transferrin; it then sends the signal to the liver to increase its synthesis and transport more iron for use.

On the contrary, if the body perceives an excessive increase in iron available for hematopoietic processes -or the synthesis of hemoglobin-, it translates it as an excess of transferrin transporting iron and, consequently, sends the signal to the liver to reduce its production.

Alcoholism

Since transferrin is synthesized mainly in the liver, the causes of its decrease in plasma are mainly those that can affect liver function.

It has been shown that the consumption of more than 80 grams of alcohol daily can inhibit the glycosylation of some glycoproteins, among them transferrin. As a consequence, low levels are found in plasma.

Glomerulonephritis

Glomerulonephritis is a condition in which the kidney's filtering capacity has been lost.

Therefore, it allows the passage of large molecules that would not normally pass through the glomerulus, such as albumin proteins, gamma globulins and transferrins.

This loss of protein through the kidney has multiple causes and usually triggers a nephrotic syndrome and low plasma transferrin.

Hemochromatosis

Transferrin saturation levels are taken into consideration for the diagnosis of hemochromatosis.

When there is the pathology, they are usually above 50%, 20% more than the expected normal value.

This means that there is little transferrin in the bloodstream and, therefore, a greater percentage of it must transport iron to meet the body's needs.

Two transferrin saturation readings above 50% is already considered diagnostic of the disease.

Inflammatory processes

Transferrin belongs to the group of serum proteins known as "negative acute phase proteins", which means that its normal serum values ​​decrease by at least 25% when inflammatory processes occur.

This can occur in surgeries, neoplasms, infections, post-traumatic inflammation, and any process that triggers acute phase reactants.

Treatment

Treatment for low levels of transferrin in the bloodstream depends mainly on the cause that produces it.

More than treatment, in some cases it is about corrective measures in eating and alcoholic habits.

In the event that low levels of transferrin in the blood are due to an excess of iron in the body, the treatment will be aimed at reducing iron.

Deferoxamine binds to free iron in excess (it respects iron in hemoglobin and iron bound to transferrin), and forms chelates that the kidneys can filter and are excreted in the urine.

Accompanied by a diet low in iron, it is recommended to avoid food supplements with iron and vitamin C, which favors intestinal iron absorption.

References

1. Mary D. Litchford, in Levin and O'Neal's The Diabetic Foot (Seventh Edition), 2008. Nutritional issues in the patient with Diabetes and foot ulcers. Recovered from: com
2. Medical Definition os Transferrin. 05/13/2016. Recovered from: com
3. Alison U Kelly, Stephen T McSorley, Prinesh Patel BMJ 2017; 357: j2513. net. General medicine. How to interpret iron studies? Recovered from: intramed.net
4. Emanuela Tolosano. US National Library of Medicine National Institute of Health. Hematological. 2015 May; 100 (5): 565–566. doi: 3324 / haematol.2015.124966 Increasing serum transferrin to reduce tissue iron overload due to ineffective erythropoiesis. Recovered from: ncbi.nlm.nih.gov
5. Aisen P, Leibman A, Zweier J (Mar 1978). "Stoichiometric and site characteristics of the binding of iron to human transferrin". The Journal of Biological Chemistry. 253 (6): 1930–7. PMID 204636 Recovered from: jbc.org