AMA #58: Iron: its role in health, testing methods, and strategies for preventing and managing iron deficiency

**Peter Attia** (0:10)
Hey, everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created.
Or you can learn more now by going to peterattiamd.com forward slash subscribe.
So without further delay, here's today's sneak peek of the Ask Me Anything episode.

**SPEAKER_1** (0:39)
Peter, welcome to another AMA, how are you doing?

**Peter Attia** (0:41)
I'm doing well. I noticed you're in a new environment today.

**SPEAKER_1** (0:45)
Yeah, just always keeping you on your toes. Always got to switch it up.
You would be happy that there's still a race car theme, even in this new environment.

**Peter Attia** (0:53)
I noticed that right away.

**SPEAKER_1** (0:56)
I'm sure you did.
So today's AMA, we're going to focus on something that we haven't really covered before, but we see a lot of questions come through, which is related to iron deficiency, ferritin. This is something that people see on blood tests, and they're kind of curious of like what this means, why does it matter, all of that. So we gathered all these questions, and the hope is we'll cover why is iron necessary in the body? What happens if you're deficient? What are those symptoms? How prevalent is it? Who is most susceptible? And then ultimately really lean into what can someone do about this?
And is there even any concern if you have too much iron? So I think it will be really interesting for a lot of people, but before we get started, anything on that you wanna say?

**Peter Attia** (1:43)
No, I think this is kind of one of those weird topics where I just didn't learn this in med school or I didn't pay attention to it.
And in residency, I don't know, I just didn't know much about what was going on. So this has been something that I have learned about only in the last few years, I would say. And I think it's a far more complicated topic than we're going to cover today. And that's by design. The way we prepare for these AMAs is obviously very involved. Just in case people think I'm not just sitting up here talking off the top of my head, there's a lot of prep that goes into this.
But as we got down the rabbit hole of iron biology, it was like the most overwhelming thing I've ever encountered, at least for me. And I realized that we needed to bring it way back to make it more actionable.
And I think we've struck that balance here today. So there might be some people who say, oh my God, you didn't get into this carrier protein and that carrier protein. And I think what we really wanna do is make sure that after the end of listening to this, you can look at your blood test.
First of all, you know what blood tests you should get, and you can ask for them if you're not getting them. You know how to look at it and interpret it, and you know what to do about it. That's basically what we're trying to accomplish here, and I guess people will be the judge if we can accomplish that.

**SPEAKER_1** (2:59)
Before we get into iron too, I think what we also did for this AMA was snag a few questions that we've seen come through in really high volume based on previous content. This will look at, do you take creatine? Do you worry about the sodium in your venison sticks? A few other questions that we've seen come through a lot that we'll also tack on at the end of this. But before we get to those, when we look at iron, I think it'd be really helpful to start with helping people understand why is iron so necessary in the body, and why is this something that people should think about?

**Peter Attia** (3:35)
Yeah, I was a little bit surprised to kind of learn the ubiquity of iron in the human body. So basically 2% of the human genome encodes for iron related proteins.
That's a staggering amount of our human genome.
And of these, nearly half are heme-binding proteins. So as we get into this and you start to understand, okay, well, what is it about iron that's important in the body? Well, a big part of it comes down to all things related to hemoglobin and oxygen binding and oxygen transport.
Another big part of it is basically every enzyme in the body. In fact, 6.5% of all enzymes in the human body are iron dependent. And again, let's remind people what an enzyme is. An enzyme is a substance that facilitates a chemical reaction. So if you think about the literally trillions of chemical reactions that are going on inside of our body, imagine how many of them are facilitated by enzymes that depend on iron. So we could get into more detail, but I think that's the high level of it. I mean, we could literally spend the entire AMA just talking about what's going on in the mitochondria in the endoplasmic reticulum with respect to iron and how it feeds into aerobic metabolism. But I think honestly, for the sake of getting to what's more actionable, I'll let people refer to the show notes where they can maybe get a little bit more detail on what's happening with iron. But if you forget everything else about iron's importance, just remember this, you're not gonna be able to move oxygen around your body without it. And when it comes to your mitochondria and other very important places in the body where cellular respiration takes place, some of the most important enzymes depend on iron.