Do we need to worry about our iron status? If so, why? And how?
Iron deficiency and iron overload are two common problems that exist in our society. Iron is critical to antioxidant defence, immune health, thyroid health, energy production (inside the mitochondria of every cell) and a whole host of things going on in the body, beyond just haemoglobin.
Anyone with a complicated set of health problems which has an iron deficiency would be wise to address the iron deficiency as a matter of priority. Anemia is a deficiency is properly functioning red blood cells. One possible reason for this is iron deficiency anemia, a common condition that developed when your blood lacks enough healthy red blood cells, or a lowered ability for the blood to carry oxygen. Iron overload is also very common, and yet most people have never heard of it, and most medical doctors fail to diagnose and treat the issue.
Iron is responsible for transporting oxygen from the lungs to the muscles, into the cells and to produce energy (ATP). Unbalanced iron levels can cause series health implications, how can we perform at our best and recover without energy? We use energy to move, to sleep, to eat, to digest, to make our hormones (like thyroid hormone), to help the immune system produce a bleach-like substance that kills pathogens in the body, etc.…
I have an interest in iron overload as I have the hemochromatosis mutated gene, which impacts iron metabolism. Even mild iron overload can cause increased mortality and morbidity, so early death and disease. Like hemochromatosis, high iron levels are associated with metabolic, cardiovascular, and neurodegenerative problems, although not to the same degree.
High Iron is correlated with impaired glucose tolerance. People with metabolic issues should be checked for iron overload by a healthcare practitioner. Iron overload can reduce insulin synthesis and secretion. It can decrease insulin sensitivity in the liver, and iron deposits in the liver can decrease glucose uptake.
TESTING:
The most important markers for iron testing are:
Serum iron - measures the level of iron in the liquid part of your blood.
Ferritin - measures the amount of stored iron in your body. Ferritin is the main protein that stores iron, especially in the liver and the bone marrow (the inside cavity in bones, where blood cells are made). It's important to be aware that ferritin scores can be affected by oxidative stress (inflammation markers should be checked, e.g. C-Reactive Protein).
Ferritin is our long term storage of iron, and it should not be seen as the bad guy. It is part of the antioxidant defence system and is an antioxidant. Ferritin stores iron and prevents it from becoming free iron.
Transferrin or total iron-binding capacity (TIBC) - A laboratory usually measures one of either transferrin or TIBC. Transferrin is the main transport protein of iron. TIBC is a good indirect measurement of transferrin. Your body makes transferrin in relationship to your need for iron; when iron stores are low, transferrin levels increase, while transferrin is low when there is too much iron. Usually, about one-third of the transferrin is being used to transport iron. Because of this, your blood serum has the extra iron-binding capacity, which is the unsaturated iron-binding capacity (UIBC). The TIBC equals UIBC plus the serum iron measurement. Few laboratories measure UIBC.
Transferrin is our short-term storage of iron and is a good indicator of our recent iron intake.
Transferrin saturation: this is a calculation that represents the percentage of transferrin that is saturated with iron. It is a calculation using either the transferrin or TIBC value when the serum iron concentration is known. This should be between 30-40%
The HFE (H= High, FE = Iron) gene produces a protein that helps transferrin communicate the amount of iron in the body. HFE is the primary gene that can be mutated in hemochromatosis (80-85% of people with hemochromatosis have this mutation, and there are other mutations that can cause hemochromatosis). HFE can act as a sensor to iron levels and as transferrin saturation rises, and then prevent the metabolism of iron from food. Transferrin is the primary marker that can be used to monitor iron status and clearly determines if the iron is going up, or down. Most medical doctors will wait until ferritin is super high before they take action. As always the medical system waits until you are sick, instead of looking at preventative measures.
Once transferrin becomes saturated (too high), we continue to see an increase in transferrin, and hence iron stores in the body. This causes an increase in oxidative stress and inflammation which in turn increases ferritin levels.
Hemochromatosis is a gene adaptation that causes an increase in iron storage. To determine if you have hemochromatosis, you will need to get a genetics test. You will need test your HFE gene status, with the two most relevant genes being H63D (also linked to Alzheimer’s disease) and C282Y. There is not much you can do to change your genes, so the questions becomes, how do you manage your iron levels?
Men are more susceptible to hemochromatosis signs and symptoms at a younger age. Menstruating women lose iron each month and hence it more common to have iron deficiency even is they have the hemochromatosis genes. A menopausal woman’s iron levels can potential shoot up if the hemochromatosis gene is active.
Hemochromatosis can predispose us to all different kinds of degenerative diseases and compromise our ability to maintain our health and wellness. High levels of free iron in the body can produce free radicals which damage the cells, the metabolism, and the structural components of all tissues. Hemochromatosis is, a BIG deal, and it's surprising that the medical system seems to ignore it altogether.
There is a critical need to have the right balance of iron, not too low, not too high, but just right. The recommended daily allowance (RDA) of iron is:
8mg daily allowance
18mg daily allowance for menstruating females
27mg daily allowance for pregnant women
Can also depend on certain illnesses
Genetic issues (such as hemochromatosis), health issues and other nutrient deficiencies like vitamin B6 and copper can compromise the absorption and regulation of iron. Understanding how we absorb and use iron is critical to balancing out iron levels and maintaining our health.
IRON RICH FOODS:
If you have an iron deficiency you will want to increase your iron intake from food. If you have high iron levels you will want to lower your iron intake. The best bioavailable source of iron is heme iron.
Heme iron is found in animal meat. Nonheme iron is found in plants, dairy products, and in some meats as well. Unlike heme iron, nonheme iron absorption is greatly influenced by food components in the same meal. These include enhancers such as vitamin C and other acids, as well as sources of heme iron and inhibitors such as phytic acid, polyphenols, and soy protein.
Iron absorption can also be inhibited by calcium so, be mindful of supplements and dairy consumption when eating iron-rich foods. Low iron levels in children can compromise brain development, this is why a vegetarian and vegan diet is not recommended for children.
If you have high iron, you could avoid heme iron and never eat shellfish or red meat. You could cut out vitamin-C, and you could increase calcium intake when eating hem iron-rich food. BUT then you would end up with a copper and vitamin B6 deficiency which is never a good outcome. A deficiency in these nutrients can increase oxidative stress and can impact iron transportation in the body. So it doesn’t solve the problem. Unfortunately, food high in hem iron is also some of the most nutrient-dense foods on the planet (i.e. liver).
BLOOD DONATION
If you have high iron levels, it would be wise to donate blood regularly. Bleeding is the most effective way to remove iron from the body, and it has a positive benefit to society when it’s donated.
IRON SUPPLEMENTS
Men should NEVER supplement with iron as we do not have a monthly menstruation cycle and lose iron. There is a low chance for men to be deficient in iron and if this is the case, a good hard look at gut health and diet is required.
Iron supplements often have very low bioavailability, like plant foods. Iron supplements often go undigested in the gut and can feed undesirable bacteria and cause oxidative stress. Often iron supplement that is used to treat anima can cause gut issues. Iron supplements are often added to refined grains; this is another good reason to avoid refined grains.
Iron Smart liposomal iron and Proferrin ES heme iron provide iron in forms that are likely to be better absorbed without causing as many gastrointestinal side effects.
Food is always the best source of iron and people with anaemia should aim to increase the intake of heme iron-rich foods.
MEDICAL SUPERVISION:
If you have hemochromatosis, you must work closely with your doctor to monitor it and stay on top of it. If you have anemia, you should also work closely with your doctor to monitor it and stay on top of it.
At the end of 2018, my iron studies were:
Iron: 24umol/L
Transferrin: 1.8g/L
Trans Sat: 52% (high)
Ferritin: 303ug/L (high)
After donating blood every 3months and paying more attention to my intake of iron-rich foods, my September 2019 iron studies were:
Iron: 21umol/L
Transferrin: 1.7g/L
Trans Sat: 49% (high)
Ferritin: 123ug/L
These numbers are heading in the right direction, and with close monitoring, I can stay on top of my hemochromatosis and health.