Iron Overload - Start here

Often we hear about how problematic iron deficiency is, but rarely do we hear about the negative effect of iron overload.  Some of the symptoms of iron overload even match the symptoms of iron deficiency, like fatigue, depression and low libido.

This article will go into all things iron overload, a primer(ib) if you will.

Potential consequences of too much iron

Excess iron causes oxidative/free radical damage to the body’s tissues (for those wanting an explanation of oxidation), leading to its detrimental effects in the body, some of which are listed below.  

• Organ damage

• Pancreas

• Liver

• Heart and cardiovascular system

• Skin

• Brain

• Insulin resistance and Diabetes

• Heart arrhythmia and increased heart attack risk

• Liver cirrhosis

• Alzheimer’s

• Joint pain

• Lower testosterone and lowered libido

• Fatigue

• Depression

Who is likely to be at risk

Those with the genetic mutation for haemochromatosis are most at risk of developing iron overload.  All else being equal, men and post-menopausal women are most likely to be at risk of accumulating excess iron due to the fact that bleeding lowers iron levels.   Iron tends to accumulate as we age and thus the older you are the greater the likelihood of having excess iron.

Dietary factors such as frequent red meat consumption, alcohol consumption and iron supplementation without appropriate testing (no brainer right?) also increase the likelihood of excess iron.

What is haemochromatosis?

Haemochromatosis is a genetic condition where excess iron is absorbed from the diet, due to mutations with the HFE gene (C282Y and H63D) increasing iron absorption in the gut.  Those of European descent are at an increased risk of carrying this gene.
Do I have too much iron?

Rather than guessing, lets get testing (it almost rhymes).  If we were to look at just one marker, that would be serum ferritin, the iron storage protein, but if you’re getting blood drawn anyway you may as well get a full iron panel done.

Now you may be thinking ‘no problems here, my iron tests came back normal, I’m a superstar.’  Not quite (though you may still be a superstar), normal doesn’t necessarily mean healthy or optimal.

The normal range for serum ferritin is 25-155ng/mL for menstruating females and 40-260 ng/mL for adult males according to NPS MedicineWise , though ‘normal’ varies with different laboratories (Melbourne Pathology has a range of 30-500ng/mL for males).  Ferritin levels as low as 140, considered ‘normal’, have been associated with many diseases.  One review concluded that a ferritin range of 20-40ng/mL for women and 50-70ng/mL for men was optimal, simultaneously avoiding iron deficiency and the consequences of iron overload.

So, even if your levels are ‘normal’ you may want to check to see if they’re also healthy.

Protocol for lowering iron

1. Blood letting
   The most efficient way to reduce iron stores quickly.  
   One blood donation of 470mL lowers ferritin levels by about 30-50 ng/mL. An often untalked about benefit is you get a cool sticker with your first donation.
   

2. Iron Chelators
   These are substances that attach to and remove iron stored in the body.   
   Green Tea and Curcumin (found in Turmeric) are both iron chelators
   

3. Inhibiting/reducing iron absorption from foods
   Iron is included in a lot of foods, so avoidance may not be the best option.  Thankfully, there are dietary strategies (article on the way), that can help lower iron absorption from foods.
   
   Polyphenol rich foods such as Green Tea and Turmeric (2 birds 1 stone), the herb Milk Thistle and eggs all inhibit iron absorption.
   
   While there is some overlap between iron chelators and inhibitors, they don’t always do both.
   

4. Supporting and repairing the affected organs and systems
   Turmeric and Milk Thistle provide liver support via their antioxidant effect and the amino acid Taurine is protective of the heart and liver.  Individualised support is recommended depending on how the excess iron manifests for you.

5. Reducing iron consumption
   Pretty self-explanatory
   Some high sources of iron include

• Lean meats

• Organ meats

• Green leafy vegetables

• Iron-fortified cereals

Conclusion

As we can see, iron overload, just like iron deficiency, is something to be wary of.  Rather than just assuming we are iron deficient (or overloaded), it’s quite simple to test and act accordingly.

Using food as medicine is a great strategy to lower or prevent iron accumulation. Sipping on some Green Tea or adding some Turmeric to an iron-rich meal can lower absorption and remove some of your stored iron.  Milk Thistle is another great all-rounder here, inhibiting absorption and improving liver function.