Fortifer FA Mechanism of Action

Pharmacology: Pharmacodynamics: Iron (as Ferrous Fumarate): Iron is essential in the formation of healthy red blood cells. It is a component of two heme proteins: hemoglobin and myoglobin. Hemoglobin in red blood cells transport oxygen in the blood. Myoglobin in muscles facilitates the movement of oxygen in the muscle cells. Iron also acts as a cofactor of enzymes involved in energy metabolism. Cytochromes, for example, are heme containing compounds critical to the electron transport chain. Iron also has immune-enhancing and cognition-enhancing properties.
Thiamine Mononitrate (Vitamin B₁): Thiamine plays an essential role as a cofactor in the key reactions in carbohydrate metabolism. It acts in two types of reactions upon conversion into the coenzyme thiamine pyrophosphate (TPP): oxidative decarboxylation and transketolation. These reactions are vital in carbohydrate metabolism, specifically in the citric acid cycle (Krebs cycle) and the pentose pathway. Thiamine assists in blood formation and nerve transmission. It is also involved in the conversion of the amino acid tryptophan to the vitamin niacin and the metabolism of the branched-chain amino acids leucine, isoleucine and valine.
Pyridoxine Hydrochloride (Vitamin B₆): Pyridoxine is converted to its active forms, pyridoxal phosphate (PLP) and pyridoxamine phosphate (PMP). PLP facilitates more than 100 different enzymatic reactions that support protein metabolism, blood synthesis, carbohydrate metabolism, and neurotransmitter synthesis. It helps produce a number of neurotransmitters including serotonin, gamma amino butyric acid (GABA), dopamine, and epinephrine. Pyridoxine supports the synthesis of white blood cells of the immune system and is crucial for the synthesis of the hemoglobin rings of red blood cells, which carry oxygen to hemoglobin. Inadequate vitamin B₆ disturbs the binding of oxygen to hemoglobin, causing microcyctic hypochromic anemia. In this type of anemia, red blood cells are smaller than normal and also lack sufficient hemoglobin to carry oxygen.
Cyanocobalamin (Vitamin B₁₂): Cyanocobalamin plays a key role in folate metabolism by transferring a methyl group from the folate coenzyme tetrahydrofolic acid (THFA), which is important in many metabolic pathways. Cyanocobalamin is required in the synthesis of myelin, the white sheath of lipoprotein that surrounds many nerve fibers. During cyanocobalamin deficiency, progressive demyelination of nerve fibers occurs, leading to a variety of neurological symptoms.
Cyanocobalamin is involved in biochemical processes essential for DNA synthesis. A cellular deficiency of vitamin B₁₂ can impair DNA synthesis for growth and division of cells. The lack of DNA affects red blood cells which rapidly turn over every 120 days. When red blood cell precursors in the bone marrow are not able to form new DNA, they cannot divide normally to become red blood cells. As these precursor cells continue to synthesize protein and other cell components, the grow into large, fragile, immature cells which displace red blood cells and cause megaloblastic anemia.
Folic acid: Folic acid participates in several important metabolic processes in the body. It is essential for the normal growth and maintenance of all cells because it acts as a coenzyme required for normal DNA and RNA synthesis. Folic acid is vital for the reproduction of fetal cells; a deficiency affects normal cell division and protein synthesis, impairing growth. Folic acid, together with vitamin B₁₂, converts homocysteine to methionine thereby reducing blood levels of homocysteine and may help lower the risk of heart disease. Elevated plasma homocysteine or hyperhomocysteinemia may be a risk factor in the development of heart and blood vessel disease. Folic acid maintains nervous system integrity and intestinal tract functions. It is involved in the production of neurotransmitters such as serotonin, which regulate mood, sleep and appetite.
Pharmacokinetics: Iron (as Ferrous Fumarate): Iron is irregularly and incompletely absorbed from the gastrointestinal tract, the main sites of absorption being the duodenum and jejunum. Absorption is aided by the acid secretion of the stomach and by some dietary acids. Absorption is also increased in conditions of iron deficiency or in the fasting state but is decreased if the body stores are overloaded. Only 5 to 15% of the iron ingested in food is usually absorbed. About 33% of iron is absorbed from every 100 mg of iron from ferrous fumarate. After absorption, the majority of iron is bound to transferrin and transported to the bone marrow where it is incorporated to hemoglobin. In the absence of bleeding (including menstruation), only a small amount of iron is lost daily. The majority of losses occur through the desquamation of the cells of the gastrointestinal tract and smaller amounts are lost through the skin and the urine.
Thiamine Mononitrate (Vitamin B₁): Thiamine is readily absorbed in the jejunum by active transport and passive diffusion mechanisms. It is transported by the portal and systemic circulations to the liver and to the various tissues in the body. Thiamine is metabolized in the liver and excreted in the urine.
Pyridoxine Hydrochloride (Vitamin B₆): Pyridoxine is readily absorbed from the jejunum after oral administration. It is stored mainly in the liver and lesser amounts, in the muscle and brain. Pyridoxine is converted to the active forms pyridoxal phosphate and pyridoxamine phosphate. In the liver, pyridoxal is oxidized to 4-pyridoxic acid which is excreted in the urine.
Cyanocobalamin (Vitamin B₁₂): Cyanocobalamin bind to the intrinsic factor, a glycoprotein produced by the gastric mucosa, and is then actively absorbed from the gastrointestinal tract. Absorption from the gastrointestinal tract can also occur by passive diffusion; little of the vitamin present is absorbed in this manner although the process becomes increasingly important with larger amounts such as those used therapeutically. Cyanocobalamin is extensively bound to transcobalamin which is involved in the rapid transport of the cobalamins to tissues. Cyanocobalamin is stored in the liver, excreted in the bile, and undergoes extensive enterohepatic recycling; part of the administered dose is excreted in urine.
Folic acid: Folic acid is absorbed rapidly from the gastrointestinal tract after oral administration; the nutrient is absorbed mainly from the proximal portion of the small intestine. Folic acid is distributed in the plasma and extracellular fluid. Folic acid is bound weakly to albumin in plasma. Folic acid enters breast milk which may be beneficial to the infant. Folic acid is excreted in the urine as folic acid cleavage products. Intact folic acid enters the glomerulus and is reabsorbed into the proximal renal tubule. Very little intact folic acid is excreted in the urine. Folic acid is excreted in the bile and much of it is reabsorbed via the enterohepatic circulation.