Hepcidin

Where it comes from

Made in

Hepatocytes of the liver

Sent out by

Rising iron stores and inflammation (interleukin-6) push it up; the need for new red cells, signalled by erythroferrone, pulls it down

Acts on

• The gut lining cells that absorb iron
• The macrophages that recycle iron
• The liver cells that store iron

What it does

• Locks iron inside cells and out of the blood
• Explains the anaemia of chronic disease: inflammation raises hepcidin and starves red cells of iron ¹
• Too little of it, as in hereditary haemochromatosis, lets iron overload the organs

In medicine

• Rusfertide, a hepcidin mimetic, is approved in the United States (2026) for polycythaemia vera, to curb the excess of red cells ³
• Hepcidin blood tests are used in research to tell iron deficiency from inflammation ¹
• The Iron Metabolism area of the Evigenics report reads HFE, the gene upstream of hepcidin

Beyond the body’s own use

• Rusfertide, injected weekly, cut the need for blood removal in the 293-patient phase 3 VERIFY trial: 77% of those treated needed no phlebotomy against 33% on placebo, and fewer than half as many were still above a haematocrit of 45% ²
• Blocking hepcidin is the opposite bet, tried for the anaemia of chronic disease and of kidney disease, where too much of it starves red cells of iron; nothing in that line is approved
• The hepcidin blood test remains mainly a research measure, because the assays do not agree well enough to set a reference range ¹; ferritin and transferrin saturation are still the clinical measures of iron