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This will lead to an allostatic adaptation by the fish, where setpoints are changed to minimize the load under the new conditions (Korte et al., 2007)

With anemia of inflammatory disease, the increased iron sequestered within macrophages may actually promote synthesis of ferroportin, which may partly offset the hepcidin- and other cytokine-mediated downregulation or degradation, allowing heme synthesis to continue and preventing a severe anemia in contrast to that seen with a true iron deficiency anemia

This cytokine imbalance is closely related to symptom severity, cognitive deficits, and treatment response