Patient/caregiver was educated on contraindications for using Ferrocite as follows:
- Ferrocite must be avoided or administered with extreme caution in individuals with history of hemochromatosis, an inherited condition that results in the body absorbing dietary iron in significantly large amounts than normal. Excess of dietary iron absorbed results in iron overload and accumulation in various vital organs, such as, nervous tissues, liver, skin, pancreas, and heart, leading to the symptoms of tissue iron toxicity. This results in compromised organ function and debility. Toxic iron overload and accumulation in the liver can result in long-term changes like chronic abdominal pain, hepatitis, cirrhosis, liver failure, and even hepatocellular carcinoma. Iron overload and accumulation in the heart can result in arrhythmias and congestive heart failure. Deposition of iron in the pancreas can lead to inflammation of pancreas, deficient secretion of digestive pancreatic enzymes with compromised digestion and overall metabolism, and reduced insulin secretion, leading to diabetes. Accumulation of iron in nervous tissues can result in neuropathy with pain, altered sensation, and tingling and numbness in the extremities. Individuals with iron accumulation in the nervous tissues can also present with altered cognition, reduced memory, episodes of confusion and loss of consciousness, and in severe cases can result in seizures. Administering Ferrocite in these individuals can worsen the toxicity with iron overload.
- Ferrocite intake must be avoided in individuals with history of porphyria. Porphyria is a condition resulting from accumulation of porphyrins, which are natural chemicals in the body. Porphyrins bind to iron forming the heme. Heme in association with globin forms the hemoglobin of red blood cells, which binds and carries the oxygen to tissues. The association of porphyrins with iron and synthesis of heme is a multi-step process, mediated by many enzymes. Deficiency of these enzymes can be inherited, which results in poor association of porphyrins and iron, leading to compromised synthesis of heme. Deficient heme synthesis leads to poor hemoglobin and red blood cell synthesis and individuals present with findings of anemia. The deficiency in individuals with history of porphyria is with the enzymes needed for synthesis of heme, but not iron, as it manifests to be. As heme synthesis is compromised, unused porphyrins and iron in these individuals accumulate in the body in various vital organs, leading to the symptoms of porphyria and tissue iron toxicity. Administering Ferrocite in these individuals, to offset anemic symptoms, can worsen the toxicity with iron overload and so, must be avoided.
