Thursday, January 16, 2014

The Two Faces of Iron - Anemia or Hemochromatosis


Iron is an essential mineral for human development and day to day functioning. It's the oxygen carrying component of red blood cells and is used by many other cellular processes. Recent research shows that children who are even moderately low in iron have increased difficulty with mathematics. This is one of the reasons why some girls develop difficulties with mathematics only after the onset of menarche (menstruation). Low iron levels can also cause anemia with severe fatigue, brittle nails, frequent infections and behavioral challenges, slowed growth development and growth rate in children.

At the other end of the spectrum is Hemochromatosis or iron overload; the most common genetic malfunction in Caucasians. Usually the digestive system is the gate keeper for iron; allowing more or less to pass into the system as needed. In Hemochromatosis, the body just keeps absorbing more and more; storing in the liver, brain and other bodily organs. High iron literally causes your body to rust (oxidize) and is a major risk factor for liver and other cancers, cognitive decline/dementia and iron induced arthritis.

Women who are regularly menstruating rarely have any issues until menopause due to the blood loss. Males most commonly start to show symptoms in their forties.

I typically recommend every male or post menopausal woman have their serum ferritin levels checked periodically. If levels are at or above 80 ng/ml, request a genetic test for Hemochromatosis. For many, simply donating blood regularly will keep iron levels in the optimum range of 50 ng/ml, others may need therapeutic phlebotomy where a pint of blood is drawn at intervals to maintain healthy levels.

Hemochromatosis

I personally have Hemochromatosis. I developed unexplained hip joint pain and increasing episodes of pain in the end knuckles of my pointer, middle and ring fingers. I began a personal journey looking for answers. I found out that the symptoms listed are classic telltales of Hemochromatosis. When I requested testing, the results came back at 330 ng/ml. Bizarrely, my first hematologist said these were not worrisome levels. I became a little perturbed, since the medical reference range goes up to 300 and this is pretty darn generous. If you're above that, you have a problem; even if you don't have Hemochromatosis. I insisted on genetic testing and with those results the picture changed; they ordered immediate phlebotomy.

Once I was diagnosed, I began to discuss with my first hematologist my supplement regime. Being old school and arrogant, he refused to enter into any sort of discussion or take the time to answer questions. He simply ordered me to stop taking all supplements with iron in them (specifically Equilib). I won't work with that sort of physician and asked for a second opinion. My new hematologist said go ahead and continue the supplements. The iron content was not high and I would be having blood drawn anyway, so there was no reason not to continue.

What else can I do?

  • Avoid alcohol and high dose vitamin C. Both significantly increase the uptake of iron.

  • Donate blood regularly. It's the right thing to do, and will quite likely keep your iron levels at or below 50 ng/ml which is the level recommended by the Mayo Clinic and many others.

  • Have your serum ferritin levels checked regularly.

What if I don't have Hemochromatosis?

In my opinion, everyone should seek to keep their serum ferritin at 40-80 ng/ml, especially as we start to age, as a neuro-protective measure.

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