Writing in the journal Medicine, researchers at Nanjing Medical University in China used data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020 to explore the possible link between dietary iron consumption and PID and whether the mineral could lead to therapeutic techniques to fight the disease.
Notably, participants with the highest iron use experienced a 30% reduction in PID risk.
“Our analysis revealed a significant inverse association between iron intake and PID development,” the researchers wrote. “These findings emphasize the crucial role of trace minerals in enhancing gynecological health and propose that augmenting dietary iron could be a strategic approach to prevent PID.”
Trace minerals
There are several common gynecologic inflammatory disorders that fall under the category of pelvic inflammatory disease (PID) including endometritis, tubo-ovarian abscess and pelvic peritonitis. PID typically impacts sexually active women who can experience infection and inflammation in the upper genital tract, often a result of pathogens such as Neisseria gonorrhoeae and Chlamydia trachomatis.
Delaying treatment for these treatable infections can lead to heightened risks of ectopic pregnancy, secondary infertility, chronic pelvic pain and poor pregnancy outcomes. It is estimated that annually 500,000 to 1,000,000 women in the United States have PID, posing significant strain to the U.S. health system.
The NHANES study sought to explore a possible link between PID and dietary iron intake that could lead to strategies for prevention and therapy.
Dietary trace minerals like copper, iron, selenium and zinc play key roles in metabolic functions.
“Iron is especially critical for health, contributing to protein synthesis, oxygen transport and immune function,” the researchers explained. “Deficiencies in iron can lead to various health issues, including iron-deficiency anemia, atrophic ligamentitis and restless leg syndrome, whereas excess iron intake has been linked to biotoxic effects such as oxidative DNA damage.”
Study details
The study surveyed 5,034 women between 20 to 59 years old of whom 294 responded to the questionnaire stating they had received treatment for an infection in the fallopian tubes, uterus or ovaries.
Participants were asked to recall their dietary supplement use after a 24-hour dietary recall. This information included vitamins, minerals, herbs, and other dietary supplements consumed.
The researchers found that higher dietary iron intake is associated with a lower probability of developing PID. The study showed that each one-unit increase in dietary iron intake below 27 mg/day led to a 3% decrease in PID.
”Innate immunity is the body’s primary defense against pathogens, functioning as a first line of defense through a natural mechanical barrier,” the researchers wrote. “When pathogens invade, adaptive immunity is rapidly activated. Iron acts as an initiator of adaptive immunity in the clonal expansion of lymphocyte subpopulations.”
In contrast, iron overload can be a risk factor for infection, increasing morbidity and mortality for people with high iron levels.
“Iron acts both as a modulator of immune responses and a nutrient for pathogens in infectious diseases, including PID…when infection occurs, the host can drive iron withdrawal (sequestering iron in storage compartments, including macrophages) to inhibit pathogen growth,” the researchers noted. “However, as the infection continues to develop and chronic immunity is activated, it can lead to the isolation of iron from infectious agents; autoreactive lymphocytes; and also from erythroid progenitor cells, which is one of the key mechanisms that lead to anemia in chronic inflammation.”
Source: Medicine. doi: 10.1097/MD.0000000000048490. “Association between dietary iron intake and pelvic inflammatory disease in women from the US: Findings from the 2013 to 2020 NHANES dataset. Authors: Xiaoshi Wang et al.
