Being a Blood Donor can help you stay healthy!
IRON OVERLOAD
(HEMOCHROMATOSIS)
CURSE or BLESSING?
Iron Overload (Hemochromatosis) is a genetic disorder in which the body fails to recognize that it has ingested enough iron. A normal person absorbs about 10% of ingested iron whereas a person with this disorder may absorb up to 20% of ingested iron. Once absorbed, the body has no way to eliminate it, so it builds up in various tissues and organs where it can cause problems such as arthritis, liver failure, heart failure, diabetes, and a range of other problems. In serious cases it can be fatal if left untreated.
This is a complex disorder which can be difficult to diagnose. The most common gene variation is in the C282Y, but there are over 40 others which can play a role, thus one cannot rely solely on the C282Y variation to confirm the diagnosis. The best indicator of a problem is the ferritin blood test which provides an indication of the level of stored iron in the body. Free iron is toxic to cells as it acts as a catalyst in the formation of free radicals from reactive oxygen species via the Fenton Reaction. Ferritin serves to store iron in a non-toxic form, to deposit it in a safe form, and to transport it to areas where it is required. Unfortunately, many health professionals regard a ferritin level of 200 in women and 300 in men as normal. The Iron Overload Organization in the US recommends that this level should not exceed 100 in healthy individuals but that this level may be skewed by infection or inflammation. Any reading over 100 should be investigated to find the cause. It is generally accepted that once hemochromatosis is diagnosed, the ferritin level should be maintained at about 50. If a level of 50 is good for these patients, why is it not good for the rest of the population? The present limits of 200 to 300 were probably set long ago before it was realized how much damage can be caused by excess stored iron. It is time these recommended levels be reduced.
Early Symptoms Often Go Unnoticed:
In spite of being the most common genetic disorder among persons of Northern European descent, hemochromatosis remains relatively unknown. Until recently, physicians were taught that HHC was extremely rare, so symptoms were attributed to other causes. Many early symptoms go unnoticed so individuals with hemochromatosis go undiagnosed until irreversible damage has occurred. Even post mortem, hemochromatosis is often overlooked as a possible cause of death. That is why hereditary hemochromatosis has been called "the silent killer".
Symptoms of excess stored iron do not necessarily appear in a particular order, and importantly, not all hemochromatosis sufferers will have every symptom. The following symptoms have been associated with hemochromatosis, and any combination of two or more should prompt further investigation:
-chronic fatigue
-joint pain
-arthritis, especially of the knuckles of the first and second finger, and thumb
-a change in skin colour, either bronzing like a tan that never fades or a slate gray
-abdominal pain and distention
-restless legs syndrome
-menstrual irregularities and premature menopause
-loss of body hair
-loss of libido or sexual drive
-impotence
-sudden weight loss
-thyroid problems
-mood swings and other personality changes such as severe depression or anger
-elevated liver enzyme levels, such as AST, ALT, GGT or alk phos, on routine blood work
-elevated triglyceride levels
-increased glucose levels (blood sugars)
-diabetes (adult onset or Type II)
-enlarged liver, cirrhosis or other liver conditions
-irregular heartbeat (arrhythmia)
-congestive heart failure or cardiomyopathy, a disease of the heart muscle
Preventing Life Threatening Complications:
Without any kind of intervention, damage to organs from too much iron can eventually result in life threatening significant diseases, such as:
-cirrhosis, with all its complications such as liver cancer and internal hemorrhage
-congestive heart failure
-diabetes
It is unfortunate that many Doctors seem content to treat the symptoms rather than to find the underlying cause of the problem.
The old saying “An ounce of prevention is worth a pound of cure” is very true in relation to iron overload. With this disorder problems usually do not present themselves until later in life. These problems can be totally prevented by starting to check a person’s hemoglobin and ferritin when they are in their twenties. If a person’s hemoglobin is in the upper half of the normal range or their ferritin is over 100, then they should become regular blood donors. If this were done at an early age, the problems caused by iron overload can be prevented. By being a blood donor, you are not only helping others who are in need of blood, but the life you save could well be your own.
Although hemochromatosis can cause serious problems if left untreated, it also results in a number of benefits to those who have the genetic predisposition for it.
Iron is important for development, and iron deficiency has serious consequences for learning ability and growth. In turn, the growth rate affects iron status, and iron demand tends to exceed supply in periods of rapid growth. It is hypothesized that sustained enhanced iron absorption in patients with hemochromatosis has a beneficial effect on growth. A study has shown that men with hemochromatosis were 4.3 cm taller and women were 3.3 cm taller than the general population.
Having access to iron helps bacteria grow and multiply in a host. One would think that, because people with hemochromatosis have an excess of iron, they would be particularly susceptible to infection. But curiously, an exception lies in their macrophages, which have less iron than a normal person’s. (Macrophages are the body’s front line of defence against infections) So when a normal person’s macrophages encounter an invading pathogen, the pathogen can use the iron in the white blood cells to grow, later spreading the infection through the lymphatic system. In a person with hemochromatosis the lower iron content of the macrophages helps them to stifle infections before they take hold.
The bubonic plague afflicted Europe for centuries, killing between 30 and 50% of populations where it spread - a total of around 25 million people. Because of their resistance to infection, It has been hypothesized that young people with the hemochromatosis genes experienced lower mortality during the Black Death and lived to reproductive age, thus spreading the genetic variation through the population, even though it can have adverse consequences in later life.
A considerable number of virulent species of bacteria multiply mainly in iron-rich macrophages of their mammalian hosts. Among these fastidious pathogens are strains of Chlamydia, Coxiella, Francisella, Legionella, Mycobacterium, Salmonella and Yersinia. Iron deficiency of macrophages of persons with hereditary hemochromatosis gene variations may result in increased resistance to members of these bacterial pathogens. People with genes that result in hereditary hemochromatosis may be protected against coronary artery disease associated with Chlamydia and Coxiella infection in the absence of iron overload.
To reap the benefits that the Hemochromatosis genes provide, one must start in their twenties to ensure they do not accumulate excess stored iron. They must not wait until damage is done to take action.
For those that do not have these genes, it is also important to prevent the accumulation of excess stored iron as this will make you less susceptible to a number of infectious deceases which require iron to grow and multiply.
