• In response to anemia, EPO production by kidney causes erythroblast hyperplasia in bone marrow causing increased ERFE production by erythroblasts
• Circulating ERFE directly acts on liver to suppress hepcidin production, resulting in reduced hepcidin in the blood.
Low levels of circulating hepcidin allow efflux of stored iron from macrophages and hepatocytes plus increased dietary
iron absorption
• This process delivers more transferrin-bound iron to the developing erythroblasts, resulting in increased heme and hemoglobin synthesis