Top Tweets for #IntMed
Iron absorption in the gastrointestinal tract is deliberately inefficient and tightly regulated.
🌟 In a typical Western diet containing ~10–20 mg of iron per day, only ~5–15 % is absorbed, and in iron-replete individuals this can fall to ~1–2 mg/day, just enough to offset obligatory losses from skin desquamation, intestinal epithelial turnover and minor bleeding.
This low fractional absorption is not a flaw of physiology; it is an evolved safety mechanism.
*⃣ The first difficulty lies in iron chemistry.
Dietary iron exists in two main forms.
Non-heme iron (the majority, from plant sources) is predominantly ferric (Fe³⁺), poorly soluble at neutral pH and must be reduced to ferrous iron (Fe²⁺) at the brush border before uptake. This reduction step is rate-limiting and sensitive to luminal conditions (pH, ascorbate, phytates, polyphenols).
Heme iron (from animal sources) is absorbed more efficiently, but even here uptake is regulated and far from complete. Thus, different redox states of iron do not behave equivalently, and the intestine acts as a chemical filter as much as a transporter.
*⃣ The evolutionary rationale is clear, iron is essential but dangerous.
Its ability to cycle between Fe²⁺ and Fe³⁺ makes it indispensable for oxygen transport, electron transfer and enzymatic catalysis, but that same redox activity fuels Fenton chemistry, generating hydroxyl radicals.
Excess free iron amplifies oxidative stress, damages lipids, proteins and DNA, and creates a permissive environment for pathogens, which are often iron-hungry. From an evolutionary standpoint, iron scarcity is safer than iron excess.
*⃣ A second, crucial point is that iron homeostasis is controlled almost exclusively at the level of absorption and recycling, not excretion.
Unlike sodium, potassium, calcium or phosphate, iron has no regulated urinary excretory pathway. Once iron enters the internal milieu, the body cannot actively eliminate it. Losses are passive and minimal. Therefore, any chronic increase in absorption would inevitably lead to accumulation, with toxic consequences.
Evolution has solved this by making the intestine the gatekeeper and by linking absorption to systemic need rather than intake.
*⃣ Additionally, iron is recycled with extraordinary efficiency. Senescent erythrocytes are phagocytosed, and their iron is reused, meaning that daily requirements are driven more by recycling fidelity than by diet. This further reduces the need for high absorption efficiency.
*⃣ In summary, iron absorption is difficult because it must be. Low fractional absorption, redox-dependent handling, lack of excretory routes, pathogen pressure, and oxidative risk have collectively shaped a system in which deficiency is tolerated better than excess. Iron is not managed like an electrolyte; it is treated like a potentially toxic catalyst that must be allowed in only under strict supervision.

Update in #ARDS Management
Join us for Current Concepts in Hospital #Medicine
📅 Oct 30 | 12–1:30 PM
🎙️ Javier Perez Fernandez, MD
💻 Live webinar | 1.5 #CME credits
🔗 Register: https://t.co/eLzRrp9e1L
#MedTwitter #fyp #IntMed #ICU
#HospitalMedicine #CriticalCare #MedEd #GME

🧵 CAPS: la tormenta trombótica más temida ⚡️
Aparece en días, afecta múltiples órganos y aún mata a 1/3 de los pacientes pese a terapia intensiva.
¿Cómo reconocerla y tratarla a tiempo? 👇
#IntMed #ICU #RheumTwitter

Hi #MedTwitter! I’m Harsh Bapaye, an IMG from BJ Medical College, Pune 🇮🇳.
Excited to share that I’m going to be applying for #IntMed residency in #Match2026!
AAMC ID : 16035545
Hoping for a great match season for all applicants! @TheNRMP @ERASinfo @ECFMG_IMG

🎤🌟Honored to co-present “State of the #Nephrology Division” w/ #JohnEdwardsMD at @SSMHealthSTL #IntMed Faculty Meeting!🤝🏽🏥
🤲🏽Celebrating incredible achievements of @slunephrons — from #CKD to #Transplant to #Interventional & beyond! 💉🧬
💙“Where we find our joy &share it.”💚

🌟 Happy Internal Medicine Day! 🌟
Celebrated annually on Oct 28th to honor the contributions of #internists and their #compassion, #resilience, #dedication, #tireless commitment to #caring.
#InternalMedicineDay #IMproud #IntMed #IMphysician #PhysicianLife #AdvocatesInMedicine

https://t.co/uXXemAS4Xb…
#Join us as for an #opportunity to #learn about the #internalmedicine #residency starting in #July 2025 @FIUMedicine & @BaptistHealthSF!
@BHAcademics @AAIMOnline @FIU #GME #IntMed #IM #MedEd #DocsInTraining #FutureDocs #PineAppleProud #PantherMed

A short educational 🧵 on the basics of inherited bone marrow failure syndromes (IBMFSs). Not medical advice. Always open to feedback and corrections. I am a big admirer of Dr. Patnaik’s work on this topic. @MrinalPatnaik
#MedTwitter #Hematology #Oncology #IntMed

Spent some time in senate office building yesterday with healthcare leader of Senator Brian Schatz on issues including GPCIs, specialty pay 💰 & the hardships of #intmed #radonc #medonc @ACCCBuzz @OfficialRCCSInc @ASTRO_org @ASCO @ACRORadOnc @ARRO_org @RadiologyACR @CancerExecs

When you travel to Sault Ste Marie you find yourself in a slower pace. Time for food, good friends and an inspiring medical experience. #medicine #medstudent #medschool #medicalstudent #futuredoctor #discoveron #medlife #premed #icu #internalmedicine #obstetrics #obsgyn #intmed

mid-week #IntMed

@PeruDoctorsUS @FrancoMurilloCh @IMG_Advocate @StoriesImg @F1Doctors @ImgJourney @LatinxenMed @InternalMed_Res Hola @FrancoMurilloCh I am glad to see a future @PeruDoctorsUS from my lovely #Cusco 🇵🇪 applying to #Match2022. Best of success during the interview season. Some links to start connecting w #IntMed programs: https://t.co/7cyHpz8SBi https://t.co/hNPcYRlCvm https://t.co/i0vuQcmOXy
I can feel my presentation skills improving. #intmed
@GerhardHerman I agree - exposure is critical! We struggle to provide that because with few faculty, we're already stretched thin training our #VascularMedicine fellow, CVD fellow, and #vascsurg fellows. I'd love to include #IntMed residents as well, just need more bandwidth. #VascMedJC
If any @IowaMed soon-to-be MDs are considering a preliminary year in #InternalMedicineResidency, they should consider our program @uihealthcare where they'll be treated like any other member of our #IntMed family. #Match2021 https://t.co/lES765HYnB https://t.co/I8mYf2sffi
Ibrutinib Associated Cardiotoxicity |Dr RR Baliga's MUST KNOW FACTS PODCASTs for PHYSICIANS| #CardioOncology #Leukemia #Medtwitter #Cardiotwitter @ICOSociety @EuroCardioOnc #MedEd #CardioEd @ACPinternists @OhioStateHeart #cancer #oncology @doximity #Intmed https://t.co/8kDqgcW7hD
#PennsyPerspectives: Meet our Asst PD Lauren Catalano, MD, MSc as she describes what makes Pennsylvania Hospital so special for her!
Link: https://t.co/wWP3rwNqgZ
#ERAS #Match2021 #MedEd #InternalMedicine #IntMed #PennMedicine #PennsylvaniaHospital #IMProud #MedTwitter
#PennsyPerspectives:
Meet the Section Chief of Hospital Medicine (and @ImPennsy residency grad!) Michael Rehr, DO!
Link: https://t.co/GeOC7cR0zh
#ERAS #Match2021 #MedEd #InternalMedicine #IntMed #PennMedicine #PennsylvaniaHospital #IMProud #MedTwitter
#PennsyPerspectives: Meet one of Assistant Program Directors, Dr. Teddy Wu!
Link: https://t.co/qNoBI8KAyB
#ERAS #Match2021 #MedEd #InternalMedicine #IntMed #PennMedicine #PennsylvaniaHospital #IMProud #MedTwitter
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