Free Erythrocyte Protoporphyrin (FEP) levels increase in iron deficiency anemia because:
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Correct answer: Iron is unavailable for the protoporphyrin to heme step
In the final step of heme synthesis, iron is inserted into the protoporphyrin IX ring. When iron is unavailable, the 'empty' protoporphyrin molecules accumulate within the red blood cells, leading to an elevated FEP.
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