Did you know that hemochromatosis is one of the most common genetic disorders in North America? It impacts one in 200 people. In a study involving 1000 people from the United States, 13% were found to have iron overload, while only 3% were found to be iron deficient!
Why would excess iron be so common? One reason is our genetics. There are numerous genes besides the Hemochromatosis gene (HFE) that help the human body retain iron. It is very likely that at one time, not long ago, these genes were advantageous. Iron was not always available through our food supply and retaining it would have been critical to our survival.
In order to have hemochromatosis, a person must carry two copies of the HFE gene. However, carriers or a person with one copy of the gene will usually retain excess iron. Additionally, there are also variations in transporters and the genes that metabolize our red blood cells. When any of the genes that help us metabolize our red blood cells are impacted, iron spills out and floods the body.
Why would excess iron be a problem? Unfortunately, iron is a potent oxidant and can combine with free radicals and form very damaging hydroxyl radicals. These radicals damage our cells, tissues, organs and DNA.
Excess iron has been linked to cirrhosis, non-alcoholic fatty liver disease, cardiovascular disease, cardiac arrhythmias, liver cancer, diabetes, Alzheimer’s disease and other neurodegenerative diseases. It has also been linked to chronic infections and the HFE gene was found to be five times higher in people suffering from chronic Lyme disease. The Danish study found that elevated iron predicts mortality (http://clinchem.aaccjnls.org/content/60/11/1419).
If it is so common, how does it get missed? Often, physicians look at just a basic CBC and your hemoglobin and hematocrit along with your MCV or free iron level. However, you need to look at a complete iron profile and sometimes you need to look at the bone marrow. It can be tough to diagnose. If a person has inflammation, iron can also be bound to proteins.
Additionally, iron can hide in the liver, pancreas, the brain, joints and the heart along with other tissues, making a diagnosis through blood labs alone rather difficult.
Males are more at risk until a female goes through menopause and stops losing blood and iron, at which time their risk increases. People that consume alcohol, take iron-containing supplements, cook with cast iron skillets, or eat a lot of red meat are at higher risk.
How do you know if you are at risk? A trained medical professional should look at your full genetic report, run a full iron profile that includes ferritin and transferrin, and look at a urine porphyrin profile.
So, what should people do? Until you know whether or not you have an issue, avoid iron supplements, multivitamins with iron and processed foods that are fortified with iron (such as most packaged cereals). Also, avoid supplements like N-Acetyl Cysteine (NAC). Cysteine, which can help support glutathione (also known as the “master antioxidant”), can cause things to backfire and accelerates free radical production if excess iron is present. You should also be aware of how your body handles oxidants by looking at things such as your NRF2 pathway and super antioxidant enzymes.
One way to neutralize these dangerous hydroxyl radicals is by consuming hydrogen water. For a person who does have excess iron, the appropriate steps should be taken to reduce it or get it out of their system. This can be done with supplements, such as curcumin or lactoferrin, with a medication such as Desferoxamine, or removing a volume of blood via IV by donating blood or undergoing therapeutic phlebotomy.
Indeed, the iron overload issue is more common than one might believe. In our practice, we’ve found that as many as 75% of our patients have difficulty clearing iron.
If you would like a genetic evaluation, please contact our office at (317) 200-3840.
Ralph Waldo, M.D.