Researchers in Norway have discovered that iron—a common contaminant in drinking water—may contribute to distressing and difficult-to-treat digestive problems that fall into the “inflammatory bowel disease” (IBD) category, such as ulcerative colitis and Crohn’s disease.
Scientists believe that genetic predisposition, disrupted balance of bowel bacteria, and immune system problems may cause IBD, but no one knows for sure. Effective treatments remain as elusive as the source of the problem, so identifying any factors that may be controlled is valuable information.
What you can’t see may matter
A study published in the American Journal of Epidemiology looked at 843 people with IBD and analyzed drinking water samples for iron, aluminum, pH (acidity), bacteria, color, and turbidity (muddiness) from the regions where they live.
Iron concentration was the only characteristic found to be strongly associated with IBD risk. For every 0.10 mg/liter increase in iron concentration, a 26% rise in IBD incidence was observed, with a similar increase for ulcerative colitis and Crohn’s disease.
“Our results show a relation between iron content in drinking water and incidence rates of inflammatory bowel disease,” the study’s authors said. “We suggest that these findings are explained by increased oxidative stress or increased bacterial growth that increases the likelihood of adverse immune responses in genetically predisposed individuals.”
The downside of iron
Iron plays a critical role in hemoglobin, the red blood cell complex that carries oxygen to tissues throughout the body. However, iron can also trigger chemical reactions that result in oxygen free-radical formation, making it a potent pro-oxidant that could contribute to inflammation.
Further, some bowel bacteria thrive when iron levels increase, crowding out other healthy bacteria and disrupting the bacterial balance. These iron-loving bacteria often become stronger and more poisonous in the presence of excess iron. This can also change the way the body’s immune system responds to harmful bacteria, possibly triggering the autoimmune process believed to occur in people with IBD.
Protect your drinking water purity
Iron can get into the water supply from two sources: soil and bedrock, and corroding water pipes. Check with your municipality to see if they can provide you with information about the iron content of your drinking water. If you have a well or other private system, many commercial laboratories provide an inexpensive iron-concentration test. The US Environmental Protection Agency recommends using a state certified laboratory to test your drinking water.
While healthy people should check with a doctor before supplementing with iron, trace amounts in water are not a health risk for most people. However, IBD sufferers who find their drinking water contains iron would be well advised to address the issue by:
• Buying drinking water: If hiring a water company to deliver water to your door is out of your budget, many grocers offer bulk water programs with refillable, reusable containers in addition to widely available bottled water.
• Trying a filtration system: “A small reverse osmosis system that can be installed under the kitchen is likely to be sufficient for removing iron from drinking water,” advised a representative from EcoPure Water Systems in British Columbia, Canada. However, reverse osmosis also removes beneficial trace minerals from the water that are hard to get from other sources. “A single cartridge system with an iron-removing cartridge is another possible option, depending on the circumstances,” he added.
Note that simple carbon filters, popular for their ability to remove chlorine and disagreeable tastes and odors, are generally not effective for iron removal. Consult a water filtration specialist to find out what type of system may work best for your water and to help you decide which solution is best.
(Am J Epidemiol 2008;168:1065–72)
Maureen Williams, ND
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