Oral iron absorption test: should it be performed before starting treatment with ferrous preparations?

The oral iron absorption test is sometimes used in the assessment of ferrous preparation efficacy before therapeutic use in the treatment of patients with anemia. Overdoses of Fe can cause the production of free radicals that are dangerous because of chemical modifications and damage of proteins, lipids, carbohydrates, and nucleotides. We suggest that this test should not be performed with the recommended dose of iron because of the potential threat to the patients. We assessed the serum concentration of iron and total iron-binding capacity during the test. Before and after the test, the concentration of malonyldialdehyde, an end product of lipid peroxidation, was determined in serum. In most patients, we found an increase in malonyldialdehyde concentration, suggesting the enhanced production of free radicals. This increase was particularly marked in patients with an overabsorption of iron. The administration of iron in the dose recommended for the oral iron absorption test causes increase in serum malonyldialdehyde concentration, proving an overproduction of free radicals. This test should not be performed because of the evidence proving detrimental effects of free-radical overproduction on the human body.