Iron is a trace element obtained from your diet, which your body can store but not easily excrete. Excess accumulation of iron occurs with several medical conditions and can result in long-term damage to your organs. Early recognition and treatment can help diminish the health impact of iron overload.
Normal Iron Metabolism
Your body normally absorbs about 10 percent of the iron from the food you eat, and carries it through the bloodstream attached to the transport protein transferrin. Most of this iron gets used in producing hemoglobin for red cells, some for other proteins and the rest stored as ferritin or hemosiderin. Only a small amount of your iron is lost each day, mostly in shed skin cells or intermittently with menstrual bleeding. Your body has the ability to increase iron absorption in times of need, such as during childhood growth or after significant blood loss, and can also partially decrease absorption in response to high levels of iron in the liver.
Excess Iron Accumulation
Iron overload can occur because your body lacks the ability to excrete significant amounts of iron. Excess accumulation can result over long periods of time with liver disease, kidney disease or overuse of iron supplements, and more quickly from multiple blood transfusions for certain types of chronic anemia. Some blood diseases with ineffective red cell formation, like thalassemia major, also signal your body to increase iron absorption, further adding to accumulation. The genetic disorder hereditary hemochromatosis, relatively common in people of Northern European descent, causes the absorption of too much iron from your diet . In all these circumstances, excess iron gradually builds up in your organs, especially the liver, heart and endocrine glands, causing progressive scarring and damage.
Detecting Iron Overload
Iron overload is usually a silent disorder until organ damage appears, except for fatigue or changes found on blood tests. With progressive organ damage, symptoms such as joint pain, abdominal pain, heart failure, liver cirrhosis, and endocrine problems including diabetes appear. Initial laboratory testing measures circulating and storage iron levels, with blood iron and ferritin elevated, and the transferrin protein highly saturated with transport iron. Genetic testing is available to diagnose hereditary hemochromatosis, and can be used to screen other family members for early disease as well.
Treatment and Prognosis
Organ damage from iron overload cannot always be reversed, so early recognition and preventing further iron accumulation are key. For disorders such as hereditary hemochromatosis, the usual treatment is therapeutic phlebotomy. This involves removing a pint of blood, and the iron it contains, at regular intervals until your iron levels drop back to normal, and then continuing as needed to maintain those iron levels. If you can't tolerate these blood draws because of anemia or heart problems, chelating drugs that bind iron in the blood and help your body excrete it can be used. If you are at risk for iron overload, you should avoid taking iron supplements, not take vitamin C with meals since it promotes iron uptake and limit alcohol use that can add to liver damage.
Member Comments