Fact Sheet
1. Undetected or untreated excess iron kills after inflicting injury to a variety of body organs.2. The patient's and physician's concern must be to detect any excess iron instead of "establishing
a diagnosis of hemochromatosis."3. A complete physical must include: Total Iron Binding Capacity (TIBC) and Serum Iron (SI).
Divide the SI by TIBC for percentage of Transferrin Saturation TS. Normal range: 12-45%. The same blood may be used to measure Serum Ferritin. Normal range: 5 to 150.4. If TS is elevated, the individual should begin treatment. Some literature suggests treatment when ferritin alone is elevated. Giving blood does no harm, and instead is beneficial to health. About one-fourth of patients have iron-loading anemia (low hemoglobin). Treatment is the same unless the anemia is so severe that blood transfusions are required. Maintaining a hemoglobin of 10 or hematocrit of 30 percent makes the patient treatable with bloodletting. Severely anemic patients require iron removal by an iron chelator, Desferal. All anemic patients benefit with B complex supplements, including folic acid, B12 and B6.
5. Hemochromatosis is completely preventable. When diagnosis is in doubt, the patient should begin a trial of weekly phlebotomies at the blood bank. Four to six weeks will usually provide the answer. Getting rid of a little excess iron will only improve health.
6. The patient should take to the blood bank a physician's order for weekly phlebotomies. Cutoff on hematocrit should be between 30 and 35 percent.
7. A liver biopsy is not always necessary, and should not be allowed to delay treatment.
8. When iron levels test low, the cause must be found. This can be a valuable clue to cancer, ulcer or other chronic blood loss or infection. It's dangerous to medicate with iron without first testing and second, finding the reason for any deficiency.
9. DNA testing is not reasonable for diagnosis. Labs do not test for all of the 40 mutations so far published. Others wait to be identified.
10. Discovering excess iron without vigorous treatment is useless. The patient's goal is to prevent liver cancer, heart attack or stroke. He does that by unloading storage iron as fast as possible. Objective: ferritin below 10.
11. All blood relatives of the patient must be evaluated and monitored yearly.
12. A low iron diet is not recommended. Avoid alcohol, vitamin C additives and raw seafood. The Vibrio vulnificus in some raw seafood kills a number of people every year, usually those with undetected iron overload.
13. Symptoms vary too much to help with diagnosis. Chronic fatigue, arthritis, anemia (iron-loading anemia is one symptom), and elevated liver enzymes must not be ignored. Hemoglobin level does not indicate iron status. A disorder of thyroid or any part of the body can be a symptom of iron overload.
14. Excess iron lowers the immune system. Many diseases will show a poor outcome unless any excess iron is removed: AIDs, cancer and hepatitis, for example.
15. Iron does cross the blood brain barrier, contrary to old belief. Excess iron stored in the brain has been found to exacerbate severity in Alzheimer's, MS, Lou Gehrig's, Parkinson's and other diseases. Iron in the brain also leads to psychological problems.
16. Hereditary hemochromatosis is only one of several iron-loading diseases. But its frequency alone is one in 200 people with double mutations and 13 percent of the population with a single mutation. Two populations have been studied that have twice this prevalence. Irish-Americans and African-Americans have one in 100 with double expression of the mutations and 20 percent with single expression. Iron overload is called the most common genetic disease. Tragically, it is still under diagnosed.
17. The goal of medicine is to provide maximum preventive care at the least expense. Patients must be aware of iron overload for their own protection. IOD honors the increasing number of physicians who are updating their information on iron overload.
IOD
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