I have seen a few clients lately with ferritin levels (your stored iron) in the 300-500 range, this is not high enough to concern doctors because it is not causing immediate health problems, but long term high iron will lead to chronic health problems and inflammation. The time to reduce your high ferritin levels is now before it becomes a major problem.
Iron overload is a major contributing factor to many chronic health problems like heart disease, diabetes, gout, liver disease and neurological diseases like Alzheimer’s and dementia. Yet it is often undiagnosed or overlooked by conventional medicine, unless iron levels are in the extreme range. Iron overload is not as common as iron deficiency but it can have more damaging long term health affects.
Iron overload affects men a lot more than women, this is because women menstruate throughout their life, this regular monthly bleeding is a good way of keeping iron levels from being too high. Once women have reached menopause their risk of iron overload increases, and also their risk of heart disease, diabetes and other chronic illnesses increase, as they are no longer protected by monthly bleeding.
Hemochromatosis affects between 1-200 and 1-500 people, depending on which study that you look at and your ancestry. It is associated with significant health problems and early mortality but few people are tested for it, and of the clients that I have seen with hemochromatosis most are told they have nothing to worry about unless their ferritin goes above 1,000 …. which is the level where severe organ damage occurs. Ferritin is the storage form of iron.
Classic hereditary hemochromatosis is an autosomal recessive genetic disorder, it is a mutation of both copies of the HFE gene which leads to high stores of iron in the organs and tissues. Autosomal recessive means that you need two copies of the gene to develop the disease, this is not entirely accurate as even having one copy of the gene (which is known as a carrier) can lead to high iron levels.
Even having a single cope of the HFE gene for hemochromatosis can increase your risk of developing cancer by 2 to 8 X the average risk, and 2.3 to 6.6 X the average risk of developing heart disease.
If you are tested for hemochromatosis and are told that you have only one copy of the gene it is still important to regularly check your iron and ferritin levels to make sure that they are in the optimal range.
This can be elevations in ferritin above 200 (reference range is usually 20-320), and iron saturation above 50 (reference range is 20-55), so even if you are in the normal range you are at risk of oxidative damage caused by high iron stores.
Since the discovery of the C282Y mutation of the HFE gene at least 20 others have been discovered, but at this stage when you get tested for hemochromatosis you are only tested for the C282Y and H63D gene. While these account for nearly 90% of all genetic mutations leading to high iron levels, if you have persistent high iron but test negative to these genes you may still have a genetic mutation in one of the other genes.
The cheapest way to test for iron overload is with a genetic test through 23andme, they don’t actually give you the health reports, but from 23andme you can download your raw genetic data and from this we can get the health information.
At Planet Naturopath we can help decode your 23andme information which will help you understand if you have the genes for hemochromatosis (including the rare genes that doctors don’t test for), MTHFR, APOE4 or thousands of other genes that are associated with potential health problems.
Some people fear the information that they will find out through genetic testing, but I see that knowing this information empowers you to make the right diet and nutrition choices to help prevent diseases from occurring.
The symptoms of high iron levels are non specific, and can be associated with many other health conditions, including low iron. This is why high iron levels can be difficult to diagnose and doing an iron studies test which measures iron, ferritin, iron saturation and total iron binding capacity is the best way to see if you are at risk of high iron.
A good analogy of how high iron levels can lead to chronic disease is that a build up of iron causes your body to rust on the inside, imagine your organs like your liver, heart and brain rusting and you will get a good picture of what can be happening on the inside of your body.
It is this oxidation that leads to health problems, for example LDL cholesterol has been associated with heart disease and atherosclerosis but the latest research shows that it is the oxidized LDL cholesterol that is what causes the problems, and not LDL itself. Oxidation inside your body creates inflammation which is the driving force behind all chronic health conditions!
This is especially true if you have the APOE4 gene which is associated with heart disease and neurological conditions, increased iron speeds up the oxidation and knowing this genetic information can help guide you to keeping your iron levels at the lower end of the optimal range.
Women – the optimal range is between 50-100
Men – the optimal range is between 75-150
High ferritin which is your storage form of iron can also be caused by inflammation, and it is important to distinguish between high iron caused by iron overload, and high iron caused by inflammation as the treatment will be very different.
A good way to test to find out if your iron is elevated by inflammation is to also test for HsCRP which is sensitive inflammation marker, the reference range is usually 0-6 but ideally you want to be less than 2. Another marker to measure is HbA1C which is a marker of glycation of red blood cells, this will be elevated with insulin resistance as well as inflammation, the ideal levels is below 5.4
After reading all of the dangers of iron overload you are probably wondering if you should restrict all intake of iron!! This is not necessary for the majority of people as the body tightly regulates the storage of iron, and most people easily excrete any excess iron that they do not need. Iron is still a very important mineral and while you do not want high levels, you also do not want to be deficient in iron as it is essential for energy production and other aspects of metabolism.
I do recommend avoiding all iron supplements unless you have had a blood test showing that you are low in iron, you should not take an iron supplement “just in case”, or because you have been low in the past. High iron caused by supplementation is quite common, which is why I recommend retesting every 3-4 months if you have low iron levels and are taking supplements to address this.
Donating blood is the best way to lower your iron levels, if you have excessive levels of iron this may need to be done through your doctor, but if your iron is elevated you can simply donate blood at the local blood bank. This is a great way to keep your iron levels in the optimal range of 75-150, as well as being a great community service as the blood bank is always needing donations.
Donating blood can be done 2-4 times a year depending on your iron levels. People who donate blood regularly have been shown to have less age related diseases and live longer.
If your iron is high giving blood is the best and fastest way to lower it, but there are also some supplements that can help to speed up the process.
Lactoferrin occurs naturally in breast milk and it suppresses the growth of iron dependent pathogens in infants, you can also get this in a supplement to help chelate iron from your body. Studies have shown that lactoferrin is the only supplement that can remove stored iron from the body, I recommend the brand Life Extension which can be purchased from www.iherb.com or www.amazon.com
Other nutrients that can help block the uptake of iron are Inositol hexakisphospate (IP6), Zinc and calcium, though I would be wary of supplementing with calcium due to its association with hear disease.
I hope all that talk of genes and inflammatory marker did not confuse you! Here is quick summary of the key points that you need to do to get your ferritin levels into the optimal range of 75-150 for men and 50-100 for women.
1/ Reduce high intake of iron in food from organ meats, red meats and shellfish (this is only necessary if levels are above 350-400 as the benefits of organ meats for other nutrients is important)
2/ Avoid all supplements that contain iron
3/ Avoid substances that increase iron absorption, this includes Vitamin C, Betaine HCL, alcohol, sugar and beta-carotene.
4/ Donate blood if you have a mild elevation, and if it is above 400 consider phlebotomy with a doctor or hematologist.
5/ Supplement with Lactoferrin and IP6
For more detailed information on iron overload check out Chris Kresser’s Video
Michael is head consultant at Planet Naturopath - Functional Medicine and Nutrition Solutions. As Seen