Iron Overload 101: All You Need to Know

Iron Overload 101

h2 Misdiagnosed: Iron Overload Symptoms

Iron overload symptoms are commonly misdiagnosed, primarily because most standard blood labs do not test for a complete iron panel. 

Specifically, hereditary hemochromatosis is the most common iron overload genetic disorder, affecting 1 out of every 200-300 people, and is characterized by iron overload symptoms including: 

h3 Iron Overload Symptoms

• Fatigue
• Joint Pain
• Unwanted Weight Loss or Weight Gain
• Stubborn Body Fat & Metabolism
• Diabetes & Blood Sugar Imbalances (hyper and hypoglycemia)
• Autoimmune Disorders
• Loss of Libido or Impotence
• Skin Bronzing
• Heart Palpitations &/or Shortness of Breath
• Depression
• Abdominal Pain
• Constipation
• Osteoporosis or Bone Loss
• Thyroid Disorders 
• Liver Dysfunction (difficulties with detoxification)
• Heart Disease & Stroke Risk
• High Cholesterol or High Blood Pressure
• Memory Loss & Alzheimer’s Risk

Unfortunately while most doctors are trained to look for and evaluate symptoms of iron deficiency or anemia, many doctors are NOT as familiar with evaluating the signs and symptoms of iron overload.

In fact, patients experiencing iron overload symptoms often go undiagnosed for years (or their lifetime), often turning to treat their SYMPTOMS (not the root cause of iron overload ) or learning to “just deal” with their symptoms, as doctors can’t seem to help them find an answer. 

Here’s what you need to know about what iron overload is, what causes iron overload, how to test for iron overload, and iron overload treatment options.

What is Iron Overload?

Iron overload is exactly what it sounds like—too much iron in the body. 

Iron is an essential mineral found in red blood cells that carries oxygen from your lungs and transports it throughout the rest of your body. It also fires up your metabolic processes to give you more energy. 

However, too much of a good thing is NOT a good thing.

If we have too much iron in our body (iron overload), it can cause the rusting of other organs—especially our heart, lungs, liver and hormone glands—and trigger inflammation throughout the body. 

Hello iron overload symptoms like:

• Blood sugar roller coasters
• Low libido and sex drive
• A stubborn metabolism
• Unwanted weight loss or gain
• Joint pain
• Fatigue and low energy
• Heart disease 
• Poor digestion (constipation, impaired liver detoxification)
• Bone loss
• Poor workout progress and muscle development 
• And other disease risks like: Alzheimer’s/Dementia, Diabetes, Cancer, etc.

H2 What Causes Iron Overload? 

The most common causes of iron overload include:

• genetic mutations (that contribute to excess iron storage) 
• excess iron supplementation (i.e. people who take iron supplements for iron deficiency can be at risk if they continue to take them for months or years0. 

Classic hereditary hemochromatosis (iron overload) is known as an autosomal recessive disorder (something you get from your mom or dad), involving a mutation of both copies of the HFE gene on chromosome 6.

The most common genetic mutations are known as “C282Y,” “H63D” and/or “S65C.”

Since most people tend to address the symptoms of iron overload (like diabetes, heart disease,    osteoporosis, etc.) and not look for the underlying conditions, iron overload easily goes undiagnosed by family members and beyond. 

H2 Testing for Iron Overload Symptoms

Standard CBC or Wellness blood panels completed at a routine doctor’s check up do not run a complete iron panel.

In fact, most blood work panels ONLY assess the marker for serum Iron alone—the LEAST sensitive marker of iron overload or iron deficiency when it comes to making an accurate diagnosis of “iron overload.”

Further complicating the matter, people can SEEMINGLY have a LOW Iron blood marker on a lab panel, but ACTUALLY have iron OVERLOAD according to all other iron panel test markers, had a full iron blood panel been tested.

This is primarily because looking at Iron alone is NOT a complete picture of what is really going on and results can be skewed. 

A complete Iron blood panel to ask your doctor for includes the following markers:

HEALTHY FUNCTIONAL RANGES FOR IRON MARKERS

Serum Iron: 40-155 ug/dL

Ferritin

Men: 30-400 ng/mL

Pre-Menopausal Women: 15-150 ng/mL

Post Menopausal Women: 15-150 ng/mL

Transferrin Saturation: 15-55%

TIBC

Men: 250-450 ug/dL

Pre-Menopausal Women: 250-450 ug/dL

Post Menopausal Women: 250-450 ug/dL

UIBC: 150-375 ug/dL

sTfR (soluble transferrin receptor): 12.3-27.3 nmol/L

Beyond Iron Panels

Aside from iron markers themselves, other markers that may indicate iron saturation (overload) include elevated fasting glucose and insulin, elevated cholesterol and low thyroid. In many cases, these markers are byproducts of a bigger issue (like iron overload), indicating inflammation in the body. 

Diagnoses of heart disease, high cholesterol, autoimmune disease, diabetes and hypothyroidism can also be precursors to uncovering that iron overload is actually the problem—not the diagnosed disease itself.

For instance, women are more at risk for developing heart disease later in life, often when menopause or peri-menopause has set in—and there is less elimination of blood as during menstruation (i.e. build up of iron stores over time).       

If iron overload or the genetic condition hemochromatosis is suspected according to your lab results, a gene mutation test, such as 23&Me, can help identify if you have the HFE genetic makeup.                                                                       

H2 Iron Overload Treatment

If you suspect iron overload, or you’re diagnosed with it, here are some essential natural treatment steps you can take to improve your health and eliminate iron:

H3 Eat This

1. Eat Real Anti-inflammatory Foods
   An anti-inflammatory diet can be tremendously beneficial in the early stages of iron overload—primarily because it is an anti-inflammatory diet that can help keep inflammation caused by iron overload at bay. Opt for real, colorful foods including: 

• • • Clean Filtered Water
    • Sustainable proteins (wild caught, pastured poultry, grass-fed beef)
    • Starchy tubers (potatoes, sweet potatoes, winter squashes, carrots)
    • Fiber rich veggies (greens, broccoli, asparagus). 
    • Avoid inflammatory foods including: unsoaked/unsprouted nuts/seeds, conventional meats and eggs, conventional dairy, grains, nightshade vegetables, high amounts of fructose (more than 1-2 servings of fruit each day) and added sugar/sweeteners. 

2.  Reduce Heme-Iron Intake

• • • No iron supplements
    • Reduce intake of the most iron-rich animal proteins-mostly shellfish (clam, oysters, crab, mussels) and organ meats (chicken liver, beef liver) (vegetable based sources of “non-heme” iron are not as much of a concern, such as spinach, beet greens, baked potatoes, seeds and tomatoes. 
    • Limit red meat and lamb to 3 servings per week or less
    • Limit use of cast iron cookware- use ceramic or stainless steel cookware instead.
    • Eat foods that DECREASE iron absorption including: 
      • • Oxylates (greens, beets, dark chocolate, tea, organic coffee)
        • Calcium
           

3. Avoid foods and supplements that INCREASE iron absorption and/or inflammation

• • • Vitamin C Supplements. 100 mg of vitamin C increases iron absorption in a meal by
    • over fourfold. Vitamin C in foods is fine.
    • Hydrochloric acid (HCL) supplements 
    • Sugar & Alcohol. Consume in moderation only.

H3 Supplement Smart

http://www.lifeextension.com/Protocols/Metabolic-Health/Hemochromatosis/Page-09 

Liposomal Curcumin 

Curcumin, a key bioactive component of the spice turmeric, is an antioxidant iron chelator. In one study (1), treatment of iron-overloaded rats with curcumin resulted in marked decreases in iron accumulation within liver and spleen, confirming previous rat studies revealing treatment with turmeric significantly reduces serum and tissue iron levels, relieves oxidative stress and antioxidant status, and has a protective effect on organs (like liver and kidney function) (2,3). The liposomal https://amzn.to/2jVKUMn form is most absorbable.

CBD Oil

Also an anti-inflammatory, that is being coined the “Windex” of all body imbalance—specifically for busting inflammation. One study of the brain function of iron overloaded rats found promising results when researchers examined the effects of CBD. The levels of proteins that cause cell death in the brain returned to the normal levels with CBD treatment and the researchers concluded that CBD may have protected the brain from the rapid cell death associated with iron (4). Check out this Hemp (CBD) oil http://primemybody.com/home/, taken sublingually under the tongue in 1-2 drop increments.

Glutathione

Glutathione is an antioxidant in the body within our cells that aids in detoxification, immunity, digestion and nutrient uptake, and disease/toxin prevention. Glutathione deficiency causes cells to be more vulnerable to oxidative stress, such as iron overload. Hence, supplementation with this essential antioxidant can further aid in overall cell health and normalization of iron levels. Liposomal is preferred. https://amzn.to/2wH7FwL 

Probiotics

The gut is the gateway to health (anti-inflammation included). Since iron overload inflames organs throughout your body, optimizing gut health and gut bacteria is essential to promote optimal health. A 2018 study (5) revealed probiotics in combination with Lactoferrin supplementation was a double whammy in decreasing iron saturation. Soil based strains   are the most reliable supplements sold commercially. Couple supplementation with regular intakes of fermented foods and prebiotics to get the most bacterial diversity in your gut and body.   

Lactoferrin Supplementation

Lactoferrin is a protein that binds iron found in areas of your body outside of the bloodstream, such as the mucous membranes, gastrointestinal tract, and reproductive tissues (Jiang 2011) (6) In nature, it is present at high concentrations in milk, and you can find it in supplement form here. https://amzn.to/2IFbcR3  Take 300 mg of apolactoferrin twice a day on an empty stomach. 

Alpha Lipoic Acid. Alpha lipoic acid is a vital antioxidant and enzyme co-factor that has promising chelating capacities for binding iron and decreasing strss. In cellular form, alpha-lipoic acid protects neurons against oxidative damage by iron. In a preclinical trial, R-alpha-lipoic acid (R-LA) was fed to older rats with age-related accumulation of iron in the cerebral cortex. Following 2 weeks of R-LA supplementation, iron levels dropped to those indicative of younger rats (Suh 2005). (7)

Acetyl-L Carnitine. Carnitine is an internal shuttle that helps move fatty acids into the mitochondria for conversion into energy. Carnitine esters, like acetyl-L-carnitine has antioxidant properties, and when combined with alpha lipoic acid, acetyl-L-carnitine works to eliminate free radicals in cultures of iron-overloaded human fibroblasts (Lal 2008). (8)

Pectin & Prebiotic Fiber. Pectin is an indigestible fiber that binds tightly to non-heme iron, thus interfering with its absorption. In a small study of 13 patients with idiopathic hemochromatosis (conducted before the genetics of hemochromatosis had been discovered), iron absorption decreased by nearly half following a loading dose of 9 grams/m2 of pectin (about 15 grams for the average adult). Cellulose fiber had no effect on iron binding (Monnier 1980) (9).                                                                   

H3 Get Your Blood Drawn (Blood Donation or Prescription Phlebotomy) 

One of the most effective ways to maintain appropriate iron levels is to periodically donate blood. Typically donations can be made every eight weeks, and are recommended until iron levels on blood panels normalize.

In some cases, your doctor (general practitioner or hematologist/oncologist) will need to prescribe phlebotomies a your doctor’s office or clinic because blood banks cannot take super high amounts of iron in the blood, or your health may require this route (such as weighing under 115 pounds at the blood donation center). 

Donate blood at a frequency that maintains serum ferritin <150 ng/mL (men) or <100 ng/mL (women) and iron saturation <45%, ensuring that hemoglobin stays >13% and ferritin does not drop below 30 ng/mL.

Resources

1. Badria, F. A., Ibrahim, A. S., Badria, A. F., & Elmarakby, A. A. (2015). Curcumin Attenuates Iron Accumulation and Oxidative Stress in the Liver and Spleen of Chronic Iron-Overloaded Rats. PLoS ONE, 10(7), e0134156. http://doi.org/10.1371/journal.pone.0134156

2. Lebda, M. (2014). Acute Iron Overload and Potential Chemotherapeutic Effect of Turmeric in Rats. Int. Journal of Pure & Applied Bioscience. 2 (2): 86-94. http://www.ijpab.com/form/2014%20Volume%202,%20issue%202/IJPAB-2014-2-2-86-94.pdf. 

3. Chin, D., Huebbe, P., Frank, J., Rimbach, G., & Pallauf, K. (2014). Curcumin may impair iron status when fed to mice for six months. Redox Biology, 2, 563–569. http://doi.org/10.1016/j.redox.2014.01.018

4. da Silva, V.K., de Freitas, B.S., da Silva Dornelles, A. et al. Mol Neurobiol (2014) 49: 222. https://doi.org/10.1007/s12035-013-8514-7

5. Eunju Park, Hyun-Dong Paik & Seung-Min Lee (2017) Combined effects of whey protein hydrolysates and probiotics on oxidative stress induced by an iron-overloaded diet in rats, International Journal of Food Sciences and Nutrition, 69:3, 298-307, DOI: 10.1080/09637486.2017.1354977

6. Jiang R, Lopez V, Kelleher SL, et al. Apo- and holo-lactoferrin are both internalized by lactoferrin receptor via clathrin-mediated endocytosis but differentially affect ERK-signaling and cell proliferation in Caco-2 cells. J Cell Physiol. 2011 Nov;226(11):3022-31.

7. Jung H. Suh, Régis Moreau, Shi-Hua D. Heath & Tory M. Hagen (2005) Dietary supplementation with (R)-α-lipoic acid reverses the age-related accumulation of iron and depletion of antioxidants in the rat cerebral cortex, Redox Report, 10:1, 52-60, DOI: 10.1179/135100005X21624

8. Ashutosh Lal, Wafa Atamna, David W. Killilea, Jung H. Suh & Bruce N. Ames (2008) Lipoic acid and acetyl-carnitine reverse iron-induced oxidative stress in human fibroblasts, Redox Report, 13:1, 2-10, DOI: 10.1179/135100008X259150

9. Monnier L, Colette C, Aguirre L, Mirouze J. Evidence and mechanism for pectin-reduced intestinal inorganic iron absorption in idiopathic hemochromatosis. Am J ClinNutr. 1980;33(6):1225-1232.

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