Wednesday, May 10, 2017

Iron Overload: The Disease That's Like the Guest That Never Leaves

Why should anybody care about iron overload diseases? What is it about iron that makes it a special concern in human health? Shouldn't we all be taking Geritol?

Many of us who are of the age that we need to take serious care of iron overload disease are old enough to remember the slick television advertising campaigns for the alcohol-and-iron tonic Geritol. In the 1950's, you could open up the newspaper and see an ad featuring a woman sitting in a chair leaning against an ironing board. The caption read "After flu, cold, and sore throat, if you feel run down because of tired blood, take Geritol." In the next frame you could see the same woman with a beaming smile, holding her iron up in the air, with the caption, "Feel stronger fast in excellent condition!"

In the 1970's, the wildly popular Lawrence Welk Show featured a commercial in which a husband admires his Geritol-swigging wife's domestic prowess and then entones, with puppy dog eyes, "My wife--I think I'll keep her." Geritol became a staple for every aging sitcom character from Archie Bunker to Fred Sanford. Hundreds of millions of people heard the iron supplement slogan, "When you've got your health, you've got just about everything."

Unfortunately for 2.5 million or more of us who are becoming the twenty-first century's Geritol Generation, iron has not helped us keep our health. For those of us who have various conditions that make our bodies absorb or retain unusual amounts of iron, the decades of iron excess are leading to literal rust. And like the houseguest who never realizes it's time to get packing, iron builds up in our parenchymal organs, the brain, colon, liver, lungs, pancreas, and skin in particular, causing an astonishing array of health problems.

There are dozens of diseases that cause excessive accumulation of iron. The most common of these in the USA, although it's often not diagnosed, is hereditary hemochromatosis. In this genetic disease, the colon is unusually permeable to iron.

Iron overload is often a complication of sickle cell disease, occurring at sickle cells are destroyed and release their iron. It's a complication of another blood disorder, beta-thalassemia. Iron overload results from African siderosis, alcohol abuse, and viral hepatitis. It is among the sequellae of aceruloplasminemia, atransferrinemia, dysmetabolic iron overload syndrome, fatty liver, juvenile hemochromatosis, neonatal hemochromatosis, and enzyme diseases. It can be caused by inhalation (working with asbestos products, grinding steel, mining iron, and inhaling tobacco smoke), ingestion (eating iron-fortified foods, eating excessive amounts of red meat, alcohol used in excess, and iron supplements), injection (walking over rusty metal, multiple blood transfusions), and decompartmentalization (destruction of red blood cells or destruction of liver tissue).

Iron overload can overwhelm the endocrine glands, the joints, the heart, and the liver. It can cause arthritis, diabetes, and bronzing of the skin. It can cause erectile dysfunction, infertility, shrinking of the external sex organs, hypothyroidism, and early menopause. It can lead to cancer, heart attacks, and fatal infections.

Some people with iron overload disease are never diagnosed. Some people, like my father, die of fatal infections just a few weeks after diagnosis in their ninth decade of life. Symptoms may appear at age 25 or age 55. The course of iron overload diseases differs from person to person. All iron overload diseases, however, require medical treatment.

That does not mean there is nothing you can do. Diet makes a difference. A number of nutritional supplements augment what your doctor can do to help you manage the symptoms of iron overload disease. Two nutritional supplements even seem to act as chelators, although they should be used with caution.

The critical first step, however, is getting an accurate diagnosis. The US Centers for Disease Control found that in a group of nearly 3000 people who had hereditary hemochromatosis, over 67 per cent had been given multiple misdiagnoses before being properly diagnosed as suffering iron overload disease. They saw an average of three doctors and waited an average of 9 years before getting the right diagnosis. So, in my next post, let's take a look at testing to know whether you have iron overload disease.

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