Iron Overload
The Liver Helps Regulate How Much Iron Is In Your Body
The condition of having too much iron in your body is a common one, and yet for many doctors and their patients it is a confusing and complex subject. Everyone knows about iron deficiency, which is common in women, but when it comes to iron excess most people have no idea what it means. The mineral iron would have to be the most essential mineral to animal life. Three quarters (75%) of the body's total iron content is found inside the red blood cells and is part of a protein (hemoglobin) that enables red cells to carry life giving oxygen to every cell in our body. Ten to twenty percent of iron is stored in a protein called ferritin. The rest, which is not very much (say 5 to 10% of the total body iron), is transported around the body on another protein called transferrin and a small amount is free in the blood. We can do tests to measure all these forms of iron with one simple blood test, and this enables us to see if you have too little iron in your body, too much iron in your body or just the right amount! This is important as too little iron will make you weak and anemic, and too much iron can cause a lot of diseases including cancer. The liver has a big role in regulating how much iron is in your body! The liver makes a hormone called hepcidin, which controls how much iron is absorbed from the intestines. An average normal daily loss of iron from the body over several months is around 1 to 2 milligrams, and this loss occurs from loss of intestinal cells and skin cells and in women from menstrual bleeding. To compensate for this daily loss of iron, the liver hormone hepcidin allows 1 to 2 mg of iron to be absorbed from food in the intestines. The balance is carefully controlled by hepcidin and it's amazing that only 10% of daily dietary iron intake is absorbed. This is important because the body has no mechanism to excrete iron from the body, other than by abnormal bleeding. To measure your iron levels, you should have your blood taken whilst you are fasting in the morning and do not take any iron supplements for at least 24 hours before your blood test.What causes too much iron in the body?
Hemochromatosis
The inherited disorder of hemochromatosis causes severe iron excess or overload in the body. It is caused by an abnormal mutation (known as C282Y) in the HFE gene and you have to have 2 of these to have hemochromatosis. This abnormality causes increased absorption of iron from the intestines; around 3 times that of normal absorption. This occurs because of a deficiency in hepcidin in the liver. Hemochromatosis is rather common and affects 1 in 200 people of Caucasian race who carry two C282Y mutations on their HFE genes. Another type of gene mutation called H63D can cause iron overload in association with one C282Y mutation, but to a much lesser degree. People with hemochromatosis can suffer severe consequences of iron overload including liver scarring (cirrhosis), liver cancer, heart disease, diabetes, arthritis, low sex hormones and a bronzing of the skin color. The excess iron damages various organs in the body. It is important to diagnose hemochromatosis early by doing a blood test for the HFE gene mutation and iron studies to check serum iron, ferritin, transferrin saturation and serum iron. It is possible to prevent excess iron from causing organ damage by removing blood on a regular basis. The treatment of blood removal is known as venesection. It may take many months or even several years to unload the body of excess iron and the venesections must be done regularly. Hemochromatosis disease is entirely preventable but a doctor must have a high degree of awareness of hemochromatosis in people of Caucasian descent.High ferritin
If the blood test reveals excessively high levels of ferritin this means that the stores of iron in the body are too high. This condition is much more common than hemochromatosis, which can be excluded by doing the test for the C282Y mutation in the HFE gene. If this mutation is not present, then the cause of the high iron stores (ferritin) is not hemochromatosis. Only 10% of cases of high ferritin are caused by hemochromatosis. The most common causes of high ferritin are -- Syndrome X and fatty liver caused by high insulin levels
- Liver disease
- Diabetes
- Obesity
- Cancer
- Infection
- Problems with the immune system causing excess inflammation
- Excess alcohol intake
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