Heme synthesis is the biochemical pathway that produces heme, an iron-containing molecule that is an essential part of hemoglobin. The pathway has many steps that occur in both the cytosol and mitochondria of cells. A deficiency in any of the enzymes or substrates involved can cause a condition called porphyria. The first reaction is the rate-limiting step of condensing glycine and succinyl-CoA to form delta-aminolevulinic acid (ALA). Subsequent steps modify ALA and its derivatives to ultimately form protoporphyrin IX. The last step is the insertion of an iron ion into protoporphyrin IX by the enzyme ferrochelatase to complete heme synthesis.