Iron in Your Blood

Iron is essential for human life, as it is a key part of various proteins and enzymes, involved in the transport of oxygen and the regulation of cell growth and differentiation, among many other uses.

June 05, 2013 

Story at-a-glance

• While iron is essential for human life, too much iron can cause heart disease and cancer. This is actually far more common than iron deficiency
• Checking your iron levels is one of the most important tests that everyone should have done on a regular basis as part of a preventive, proactive health screen; it can be done with a simple blood test called a serum ferritin test; your ferritin level should be between 20 and 80 ng/ml, and 40 to 60 is ideal. If your iron levels are elevated or you have hemochromatosis, donating your blood or obtaining a prescription for therapeutic phlebotomy is one of the best solutions
• There is speculation that the genetic mutation linked to hemochromatosis may have emerged to help protect ancient humans from iron deficiency resulting from a switch from a hunter-gatherer “Paleo” diet to one based on carb-heavy farming

By Dr. Mercola

Iron is essential for human life, as it is a key part of various proteins and enzymes, involved in the transport of oxygen and the regulation of cell growth and differentiation, among many other uses.

One of the most important roles of iron is to provide hemoglobin (the protein in red blood cells), a mechanism through which it can bind to oxygen and carry it throughout your tissues, as without proper oxygenation, your cells quickly start dying.

If you have too little iron, you may experience fatigue, decreased immunity or iron-deficiency anemia, which can be serious if left untreated. This is common in children and premenopausal women.

But what many people fail to realize is that too much iron can be equally deadly, and is actually far more common than iron deficiency, thanks to a hereditary disease known as hemochromatosis.

This Health Issue Has Been of Major Importance to Me and My Family

This test saved my dad's life 20 years ago when I discovered he had a ferritin level close to 1000. It was because he has beta-thalassemia. With regular phlebotomies, his iron levels normalized and now the only side effect he has is type 1 diabetes. The high iron levels damaged his pancreatic islet cells and now he has what is called "bronze" diabetes and so requires the use of insulin.

I also inherited this from him so this is a personal issue. Thankfully, I am able to keep my iron levels normal by removing about a quart of blood a year. This is removed not all at once but over a few dozen deposits.

I screened all my patients with ferritin levels and noticed nearly one-fourth of them had elevated levels. So I would strongly encourage you and your family to be screened annually for this, as it is SO MUCH easier to prevent iron overload than it is to treat it.

Ferritin Screen – One of Your Most Important Health Tests

Checking your iron levels is easy and can be done with a simple blood test called a serum ferritin test. I believe this is one of the most important tests that everyone should have done on a regular basis as part of a preventive, proactive health screen.

The test measures the carrier molecule of iron, a protein found inside cells called ferritin, which stores the iron. If your ferritin levels are low, it means your iron levels are also low.

The healthy range of serum ferritin lies between 20 and 80 ng/ml. Below 20 is a strong indicator that you are iron deficient, and above 80 suggests you have an iron surplus. The ideal range is between 40-60 ng/ml.

The higher the number over 100 the worse the iron overload, with levels over 300 being particularly toxic and will eventually cause serious damage in nearly everyone that sustains those levels long term. It's important to find out if your levels are high because your body has a limited capacity to excrete iron, which means it can easily build up in organs like your liver, heart and pancreas. This is dangerous because iron is a potent oxidizer and can damage your body tissues contributing to serious health issues, including:

Cirrhosis	Liver cancer	Cardiac arrhythmias
Type one diabetes	Alzheimer's disease	Bacterial and viral infections

Cancer researchers have also found new evidence that bowel cancers are two to three times more likely to develop when dietary iron is too high in your body.1

Risk Factors for Iron Overload

People with hemochromatosis are not the only ones who may accumulate more iron than is healthy. While premenopausal women who are menstruating regularly rarely suffer from iron overload, most adult men and postmenopausal women tend to be at a high risk, as they don't have a monthly blood loss (one of the best ways you can get rid of excess iron is by bleeding).

Another common cause of excess iron is the regular consumption of alcohol, which will increase the absorption of any iron in your diet. For instance, if you drink wine with your steak, you will likely be absorbing more iron than you need. Other potential causes of high iron levels include:

• Cooking in iron pots or pans. Cooking acidic foods in these types of pots or pans will cause even higher levels of iron absorption.
• Eating processed food products like cereals and white breads that are "fortified' with iron. The iron they use in these products is inorganic iron, not much different than rust and it is far more dangerous than the iron in meat.
• Drinking well water that is high in iron. The key here is to make sure you have some type of iron precipitator and/or a reverse osmosis water filter.
• Taking multiple vitamins and mineral supplements, as both of these frequently have iron in them.

Could Reducing Your Iron Level Be a Safer Alternative to Statins?

We may have garnered some valuable information about how iron drives inflammation from studying statins drugs, of all things. Statins are of course,cholesterol drugs. Statins have an anti-inflammatory effect on your body by reducing oxidative stress, which is something the drug companies tend not to disclose. The fact that statin drugs reduce inflammation, and reduce inflammatory markers like C-reactive protein, may explain why statins decrease heart attacks in some people. This benefit has nothing to do with the action of lowering cholesterol, but rather the reduction of inflammation.

In a study published in the April 2013 issue of American Journal of Public Health2, researchers found that statins improved cardiovascular outcomes at least partially by countering the proinflammatory effects of excess iron stores. In this study, the improved outcomes were associated with lower ferritin levels but not with "improved" lipid status. Researchers concluded iron reduction might be a safe and low-cost alternative to statins. An earlier study in the American Heart Journal3 also showed that people with a lower iron burden had less risk for heart attack and stroke.

These studies add credence to what I learned a few years ago from Dr. Steven Sinatra, one of the leading natural cardiologists in the world, that statins' only health benefit is that of reducing inflammation.

This may be helpful for a small percentage of individuals who have a very high risk of dying from a heart attack, but NOT for those who simply have "high" cholesterol levels. Statin drugs are vastly overprescribed and are not worth the risk for the vast majority of you. In some cases, they may actually increase your risk of stroke. If elevated iron is the driving force behind your inflammation and cardiovascular disease, then it makes far more sense to simply reduce your iron level, as opposed to taking a statin drug that has the potential for many adverse effects.

What to Do if Your Iron Levels Are Too High

The good news if you find out that your iron levels are elevated or you have hemochromatosis is that remedying the condition is relatively simple. Some people advise using iron chelators like phytic acid or IP6, but I tried that with my dad and it failed miserably so I would not recommend it. Donating your blood is a far safer, more effective and inexpensive approach for this problem.

If, for some reason, a blood donor center is unable to accept your blood for donation you can obtain a prescription for therapeutic phlebotomy. At the same time, you will want to be sure to avoid consuming excess iron in the form of supplements, in your drinking water (well water), from iron cookware, or in fortified processed foods.

Additionally:

• Certain phenolic-rich herbs and spices, such as green tea and rosemary, can reduce iron absorption4
• The primary polyphenol in turmeric known as curcumin actually acts as an iron chelator, and in mice studies, diets supplemented with this spice extract exhibited a decline in levels of ferritin in the liver5
• Astaxanthin, which has been researched to have over 100 potential health benefits, has been shown to reduce iron-induced oxidative damage6

The Ancient Origins of Iron Overload

How and why hemochromatosis – now one of the most prevalent genetic diseases in the United States – emerged is the subject of numerous theories and speculation – but its true history remains a complex mystery. In a fascinating article on the topic, The Atlantic7 recently highlighted the notion that everyone who inherited the C282Y mutation responsible for the majority of hemochromatosis cases got it from the same person. In other words, one distant ancestor passed on the mutation, which now favors people of Northern European decent.

No one knows the precise identity of the founder, but initial speculation that it was someone of Irish descent has given way to the possibility that it may have actually arisen in a Viking civilization or, even earlier, in a central European hunter-gatherer.

It takes two inherited copies of the mutation (one from the mother and one from the father) to cause the disease (and even then only some people will actually get sick). If you have just one mutation, you won't become ill but you will absorb slightly more iron than the rest of the population, a trait that may have given people an advantage when dietary sources of iron were scarce.

Did the Hemochromatosis Mutation Emerge to Protect Humans from a Carb-Heavy Agricultural Diet?

There is speculation that the hemochromatosis mutation may have spread in ancient Europe around the time that man transitioned from hunter-gatherer to farmer. Unlike the Paleolithic diet of the "cavemen," which by necessity included a relatively balanced diet of iron-rich meat, fish and plant foods, farming may have led humans to rely on an overabundance of grain carbohydrates. The featured article reported:

"Fossil evidence indicates early European farmers stood roughly 6 inches shorter than their hunter-gatherer ancestors, a possible indication of malnutrition… Average height and life expectancy fell, as bone infections, dental cavities, and skeletal malformations associated with anemia rose. While the exact composition of the Paleolithic plate remains debated, most agree that European hunter-gatherers ate more meat than those in modern farming communities. And this animal protein was an excellent source of one familiar micronutrient: iron.

The World Health Organization estimates that 1.6 billion persons worldwide current suffer from the lack of red blood cells known as anemia -- half of which may be caused by iron deficiency. One's inner paleo might wonder whether this pandemic of iron deficiency began in the Neolithic era as diets bloated with carbohydrates replaced those rich in meat and fish.

Anemia decreases the oxygen carrying capacity of the blood; if marked, this will hinder an individual's ability to stay healthy, find food, and reproduce. The C282Y mutation increases iron absorption, and it may have inadvertently protected carriers against this threat."

The Hemochromatosis Link to the Plague

Another intriguing theory suggests that the hemochromatosis mutation may have protected against the Black Death of the 14th century, by preventing the Yersinia pestis bacteria from reproducing inside of human immune cells.

"During the Black Death, mortality may have been highest, up to 50-66 percent, in the British Isles -- a future hotbed of hereditary hemochromatosis … In this most unsympathetic environment, minute DNA differences may decide survival or death. A genetic advantage would quickly spread through the island population -- it would have less value on the mainland where plague mortality may have been lower," the featured article reported.

But this theory is challenged by conflicting information that suggests the plague bacteria use iron from its host to enhance its ability to infect cells. People with hemochromatosis may therefore be among the most vulnerable to succumbing to plague infections, which suggests the mutation may have nothing to do with survival. It could, perhaps, be an artifact of natural selection or there may be a different explanation entirely…

http://articles.mercola.com/sites/articles/archive/2013/06/05/elevated-iron-levels.aspx

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