What is He­mochro­mato­sis?

What you need to know about this sur­pris­ingly com­mon iron stor­age dis­or­der

Better Nutrition - - CONTENTS - BY EMILY A. KANE, ND, LAC

Get the facts about this sur­pris­ingly com­mon iron stor­age dis­or­der.

a:He­mochro­mato­sis is a con­di­tion in which iron can ac­cu­mu­late and cre­ate dam­age and infl am­ma­tion in the body. This ex­cess iron can be very cor­ro­sive to the in­ter­nal or­gans, and if left un­treated, can has­ten or­gan degra­da­tion and even lead to death.

The main marker for he­mochro­mato­sis is high serum fer­ritin lev­els. A nor­mal fer­ritin level is 50– 100 ng/ mL of serum. Be­low 10 is sug­ges­tive of ane­mia, and lev­els above 200 ng/ mL in men and 150 ng/ ml in women war­rant fur­ther eval­u­a­tion for he­mochro­mato­sis. The nor­mal iron con­tent of a hu­man body is about 3– 4 grams, which is held mostly in the red blood cells. Iron helps “mag­ne­tize” oxy­gen onto the red blood cells. We also store a small amount on a mol­e­cule called fer­ritin that can hold up to 4,500 mol­e­cules of iron.

Signs and Symp­toms

Some 10 per­cent of peo­ple are het­erozy­gous for the hered­i­tary form of he­mochro­mato­sis ( the most com­mon); 0.5 per­cent in­her­ited the ge­netic mu­ta­tion from both par­ents, and are thus ho­mozy­gous for the more se­vere dis­ease form.

Confi rma­tion may be ob­tained with ge­netic testing. If pos­i­tive, rel­a­tives should be tested by age 30, if pos­si­ble. The most im­por­tant things to know about iron over­load, ac­cord­ing to Alex Vasquez, DC, ND, DO ( infl am­ma­tion­mas­tery. com), are:

It can hap­pen to any­one at any age Testing with fer­ritin is es­sen­tial— ev­ery­body should have this test not later than age 30 and then again at age 50 Ge­netic testing for he­mochro­mato­sis will miss other pri­mary and sec­ondary forms of iron over­load, so serum fer­ritin is the bet­ter test

The main rea­sons to sus­pect this di­ag­no­sis and talk to your doc­tor, in­clude:

Un­ex­plained ab­nor­mal­i­ties in liver func­tion tests or chronic liver dis­ease such as cir­rho­sis. Car­diac en­large­ment with or with­out heart fail­ure Di­a­betes mel­li­tus Hy­pog­o­nadism, with de­creased li­bido and im­po­tence in men Skin hy­per­pig­men­ta­tion Un­ex­plained fa­tigue Joint pain, es­pe­cially in­volv­ing the sec­ond and third fi nger joints Pos­i­tive fam­ily his­tory of iron over­load

Treat­ment

Luck­ily, he­mochro­mato­sis is read­ily treated by phle­botomy, or “blood­let­ting.” Peo­ple who have been di­ag­nosed with he­mochro­mato­sis need to have reg­u­lar ( weekly or bi­weekly) phle­botomy un­til iron lev­els re­turn to nor­mal. They then need to be mon­i­tored to as­sess a sub­se­quent phle­botomy sched­ule.

For ex­am­ple, a pa­tient who has confi rmed hered­i­tary he­mochro­mato­sis ( HH) with an es­ti­mated 10 grams of iron stor­age will need phle­botomy weekly for 50 weeks to de­plete the ex­cess stores. One “unit” of blood ( 500 mL) is taken weekly. Each 500mL of whole blood re­moved re­duces iron load by about 250 mg. The goal is to get serum fer­ritin to 50– 100 ng/ mL.

Another op­tion is chela­tion ( bind­ing) of iron. The main phar­ma­ceu­ti­cal prod­uct for this is called de­fer­ox­am­ine, but many iron­binders ex­ist in na­ture, in­clud­ing tan­nins ( black tea), ox­alates ( spinach), and cal­cium ( sar­dines, yo­gurt, and ro­bust greens such as kale). Con­sum­ing th­ese foods may be a good op­tion for main­tain­ing op­ti­mal iron lev­els af­ter the ini­tial phle­botomy push.

What is he­mochro­mato­sis and what can I do about it? — An­gel­ica T., Sioux Falls, SD

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