Is Iron Overload Causing Your Bone Loss, Heart Disease or Diabetes?

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Is Iron Overload Causing Your Bone Loss, Heart Disease or Diabetes?
Osteoporosis, diabetes, heart disease, and even cancer may be due to improper iron metabolism in the body. Iron deficiency anemia is the most common nutrient deficiency world-wide, but too much iron stored in the body is also a problem. Iron has a balance in the body. Iron overload can lead to common disorders often attributed to aging, due to high levels of oxidative stress created by excess iron. Catching the disorder early is important to protect body tissues from damage. A simple lab test done at your yearly physical can identify if you are at risk. Nutritional support may help stave off the damaging oxidative effects of iron excess if there is iron overload.

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Iron Overload and Hemochromatosis

Iron overload, when excessive, is called hemochromatosis. It is a metabolic disorder that affects over one million Americans and is most commonly related to genetic defects. Those who have this disorder absorb about four times more iron than normal from the diet and the body is unable to rid itself of the extra iron. As a result, iron builds up inappropriately in the liver, pancreas, heart, joints, brain, and throughout the body. It affects those of British, Scandinavian, Dutch, German, Irish, and French ancestry more than others. Men are more commonly affected than women, but after menopause, the risk in women increases.

Conditions and Symptoms Related to Iron Overload and Hemochromatosis

In untreated and undiagnosed hemochromatosis several health conditions can develop. These include diabetes, heart attacks, heart failure, irregular heart rhythms, osteoarthritis, osteoporosis, liver cancer, cirrhosis, gallbladder disease, depression, impotence, infertility, hypothyroidism, hypogonadism and some cancers. Hypogonadism can occur with men, women, and children too. Normal production of testosterone and estrogen fails to occur because of iron overload. Several neurodegenerative disorders like Alzheimer’s disease, early onset Parkinson’s, epilepsy, multiple sclerosis, and Huntington’s disease may be affected by excess iron or iron storage disorders.

The symptoms of iron overload and hemochromatosis are often related to the tissue or organ that is damaged. However, it can be hard to recognize since numerous disorders, even low iron, can cause the same symptoms. Symptoms may include fatigue, lack of energy, abdominal pain, brain fog, poor sex drive, erectile dysfunction, menstrual cycle irregularities, early menopause, irregular heart beat, blood sugar problems, and underactive thyroid, pituitary, and adrenal gland function. Even changes in emotional behavior can be attributed to iron excess. The skin may become an abnormal color, bronze, reddish or ashen-gray.

Hemochromatosis Types

There are two types of hemochromatosis, primary and secondary. Primary hemochromatosis is caused by defects in the HFE gene or other genes. If you inherit a copy of the gene from each parent, then you are at risk for hemochromatosis. If you have only one gene, then you are a carrier and can pass the risk along to your children, but it is not likely that you will develop primary hemochromatosis. HFE is considered the main defective gene.

Secondary hemochromatosis occurs as a result of another health condition that causes iron overload. Certain types of anemia (thalassemia and sideroblastic anemia), chronic liver disease like chronic hepatitis C, alcoholic liver disease, or nonalcoholic fatty liver disease, kidney dialysis, or blood transfusions can cause secondary hemochromatosis. Inappropriate or excess intake with iron injections or supplements may also cause secondary hemochromatosis.

Simple blood tests like serum ferritin, transferrin saturation, and liver function (ALT, AST) tests are screening tests to see if you are at risk. If the lab values of these tests are elevated, your physician may require additional testing to definitively diagnose hemochromatosis. MRI imaging may be done on the liver to show the amount of iron stored. The liver is often the primary site of iron deposition. The heart and pancreas are other common primary sites of iron deposition. Genetic testing can show if you have the defective HFE genes.

If you have never had your iron levels checked, make efforts to be proactive with your health. Remember, iron is needed by the body, but it has to be in balance. Too little iron is an extensive problem throughout the world. Iron overload is not as common of an issue. However, for those who have developed this concern or have the familial risk, it is essential to be as proactive in protecting tissues from iron overload injury.

Managing Iron Overload – Be Proactive

When iron overload or hemochromatosis is diagnosed, the standard medical treatment is to avoid iron containing foods and supplements. Avoiding vitamin C may also be recommended as vitamin C helps iron absorb. Frequent blood donations and iron chelation therapy are advised as well with periodic lab evaluations. Unfortunately, this is often the extent of the treatment and management. Outside of this basic approach, protecting tissues on a cellular level from the iron overload oxidative stress simply fails to occur in discussion. Iron is needed in order to maintain life. However, iron overload is problematic and damaging to tissues. Similarly, iron deficiency also causes serious challenges to tissues in the body. Both issues cause significant problems in the body and must be properly evaluated and treated. Talk with your health care provider about getting a simple blood test for serum ferritin, transferrin saturation, and liver enzymes.

Being proactive against the oxidative stress is the key. Iron excess provokes high levels of reactive oxygen species (ROS) which creates high levels of free radical damage. Fortunately, there are several nutrients that researchers have identified that protect the tissues from iron overload. This can help put a person more in control of managing this health concern rather than simply hoping blood donations are enough. Here are some areas to focus on.

Iron Overload and Bone Health

Bone tissue is one of the tissues that can be hit hard with iron overload and high levels of oxidative stress. The immediate assumption of bone loss in women is attributed to estrogen loss. Recent information shows bone loss is also due to the oxidative stress or high levels of ROS that come from aging and iron overload. Bone breakdown occurs with the oxidative stress, which causes changes to the bone architecture. The internal microstructure breaks down.

In women, iron overload problems are not often identified until after the age of 50, i.e. after menopause. Normal menstruation often prevents the build-up of iron but once the menses has ceased, then those who are at risk may find themselves with iron overload after the age of 50 and the development of bone loss. Rather than the erroneous assumption that the bone loss, fatigue, joint aches, and blood sugar problems are due to turning 50, the practitioner should be connecting the dots. Iron overload should be considered part of the diagnostic work up for osteoporosis rather than just writing the prescription for Boniva or estrogen. The mechanism for bone loss is completely different.

Others who struggle with medical disorders that interfere with normal iron metabolism will have problems with bone marrow failure and other bone health problems too. No matter which type of iron overload concern you have, protecting the bones is a must.

Researchers have identified two compounds in particular that help protect bones against iron overload induced osteoporosis. NAC (N-Acetyl-Cysteine), which quenches ROS free radicals has been shown to stop the progression related with iron injury bone loss. Other animal studies have demonstrated that treatment with NAC reduced the bone loss from the iron overload. The Journal of Nutritional Biochemistry recently recommended that resveratrol be used as a dietary supplement to prevent and treat osteoporosis from excess iron.

Protecting the Heart in Iron Overload

Heart injury induced by iron overload is a prevalent cause for heart failure worldwide. When iron excess hits the heart, it causes a release or disruption of calcium, making calcium work abnormally and leading to plaques of calcium on vessel walls, i.e. atherosclerosis. It also causes the heart to become stiff and fibrotic from the iron injury. Anyone diagnosed with congestive heart failure or cardiac problems should be evaluated for iron problems. In the case of the heart and mitochondria, too much iron and too little iron are both detrimental to cardiac metabolic function.

Several studies highlight the power and promising restoration that the nutrient resveratrol brings to the table for serious iron overload injury. New research demonstrated a complete normalization of various stages of iron overload to human and animal heart cells in response to resveratrol therapy. In this study, resveratrol reduced the pathological remodeling of the heart, i.e. the development of heart disease and congestive heart failure and normalized blood pressure.

Liver Protection

Liver cancer is one of the most common deadly cancers in the world. Among the causes is iron overload. Current treatments often focus on removing the diseased parts of the liver or liver transplantation, which have been found mostly ineffective. The journal Cancer Treatment Review highlighted resveratrol as a promising molecule for prevention and treatment of liver cancer. NAC and taurine have both been shown to be highly protective against iron-induced oxidative stress in the liver. Taurine is a conditional amino acid. It is normally made from other amino acids, but in times of stress or illness higher amounts of it may be needed. Oxidative stress to the liver, heart, kidneys, and brain increases the amount of taurine needed for protection.

Pancreas, Diabetes, and Iron

Iron-overload-induced pancreas damage occurs due to the high levels of ROS free radicals that damage the insulin-producing beta cells in the pancreas. It was found that the increased damage and diabetes developments correlated to inadequate glutathione levels. Several nutrients help make or recycle the master antioxidant glutathione. These include NAC, glycine, milk thistle, whey protein, lipoic acid, methylated forms of vitamins B2, B6, B12, folate, biotin, vitamin C and E, and sulfur-rich vegetables (onions, broccoli, etc.). You will see an overlap of these nutrients needed for other tissues.

Protecting the Brain

Several neurological disorders worsen when iron excess develops. Carnosine, is known to protect the brain from iron excess. Other brain supporting nutrients like acetyl-l-carnitine and r-alpha lipoic acid also protect the brain and other tissues like the liver, pancreas, and connective tissue from iron induced damage. Any nutrient that helps make or support glutathione will help protect the brain from iron overload.

General Protection for Children and Adults

Children are also at risk for DNA damage from high iron levels related to thalassemia disorders. Antioxidant status was found to be low in children with the disorder; however supplementation with NAC and vitamin E significantly lowered the oxidative stress. NAC was shown to specifically reduce DNA damage.

Even twenty years ago, research showed that patients with thalassemia and hepatitis C related iron overload had further tissue injury because of depleted fat soluble antioxidants. All patients in that study had very significant drops in vitamin C (-44%), vitamin E (-42%), vitamin A (-44%), beta-carotene (-29%), and lycopene (-67%). Without enough antioxidants present in the cell membranes, the iron overload caused higher levels of lipid peroxidation or damage to fatty structures. This caused the antioxidants stored in the fatty tissues to be more rapidly used up, leading to a much higher need to protect the body.

Lactoferrin, which is present in colostrum, has a very strong binding capacity to iron. It can bind onto iron more tightly than hemoglobin, transferrin, or myoglobin. These are proteins that transport iron. Taking lactoferrin will snatch up iron first, making it a possible method of treatment. In fact, scientists have proposed that lactoferrin be used to protect tissues from ROS free radicals because it binds onto excess or unwanted iron. Research shows that lactoferrin can reverse iron overload that occurs with chronic inflammation and aging. Lactoferrin can easily be taken at any age.

Iron is a necessary nutrient and has a definitive place in the body, but it is essential for health to know your iron status. Insufficient iron is a common nutritional deficiency and must be restored and supplemented. However, iron overload and hemochromatosis can easily be overlooked and may be linked with heart problems, diabetes, bone loss, cancer and symptoms listed above. Iron overload disorders cause marked increased production of the some of the worst types of free radicals, ROS. The ROS must be quenched otherwise cellular damage occurs. When facing iron build-up and overload, the risk for organ damage is real and permanent. The approach of regularly giving blood is therapeutic and medically recommended, but with this disorder the question lingers – is it enough to prevent further damage? You can’t turn back the hands of time, but you can be proactive in identifying if there is a risk and using nutritional support to combat the oxidative stress.

Adequate antioxidants, especially those that make glutathione and the fat soluble nutrients are essential and even life protecting in this context. Researchers across the globe have provided a number of natural options that help protect tissues affected by iron excess. In many of these cases, the nutrients were even suggested as “chemoprevention”, i.e. use these compounds before the illness permanently damages the tissue. If we are going to be a society focused on health care, we can’t just assume that difficulties with blood sugar, heart disease, neurodegeneration, osteoarthritis, osteoporosis and more are simply by-products of aging. If your gut sense says something isn’t right, listen to it. Start exploring options and be proactive with protecting yourself against high levels of oxidative stress induced by faulty iron metabolism and overload.

Nutritional Options

N-Acetyl-Cysteine (NAC) – NAC is a major backbone for glutathione production. This essential antioxidant plays an integral part of detoxification, mucous membrane health, immune integrity and brain. It is now recognized as essential for protecting against iron overload.

Resveratrol – Resveratrol, often touted as the fountain of youth, helps protect bones and liver from costly tissue damage. Consider this nutrient support for heart, brain, bones, pancreas, and more.

Glutathione building nutrients – Glutathione is a master antioxidant at the crux of function throughout the body. Several nutrients are needed to make and keep this master antioxidant at the top of its game. Without adequate stores of glutathione, health becomes elusive. Whole glutathione as a dietary supplement does not easily absorb in the digestive tract and cross cell membranes. It is best produced from within the cell. Nutrients like NAC, glycine, milk thistle, whey protein, lipoic acid, and methylated forms of vitamins B2, B6, B12, folate, biotin, vitamin C and E help make glutathione.

Carnosine – Known for its ability to protect against diabetes and Advanced Glycation End-products (AGEs), the antioxidant carnosine also helps protect the brain from iron-induced stress. It provides great protection against two common problems (neurodegeneration and diabetes) that may be triggered by excess iron.

Lactoferrin – Lactoferrin is best known for immune support and digestive tract protection, as it highly concentrated in colostrum and in mother’s milk. Lactoferrin offers the support of mopping up excess iron before it becomes a problem.

Taurine – When the body is under higher amounts of stress, taurine needs may increase. Taurine is normally made by the body. This amino acid helps to stabilize cell membranes and regulate electrolytes. The liver, heart, kidneys, eyes, brain, pancreas and platelets require taurine in higher amounts to function. Those with a vegetarian diet are commonly lacking taurine.

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