Ferritin and Iron

Ferritin and Iron – what it all means

What is Ferritin?

by LeanMachine

Ferritin is an intracellular (inside the cell) protein, in the shape of a hollow sphere. Ferritin stores iron by allowing entry of iron as ferric hydroxide phosphate complexes, and when the body needs iron, releases it as required.
Ferritin is produced by almost every living organism, from bacteria to plants, animals and humans.
In humans, ferritin is a buffer against iron deficiency and iron overload, and is found in most tissues as a cytosolic protein, which means it is inside the cytoplasm, the fluid inside each cell between the outer wall and the nucleus (The nucleus contains our DNA).
Although nearly all Ferritin is stored in body cells, small amounts are secreted into blood where it works as a carrier of iron.
Plasma ferritin (in the blood) is also an indirect marker of the total amount of iron stored in the body. Serum ferritin levels help determine iron deficiency (anaemia) or iron overload.
Ferritin keeps iron in a soluble, non-toxic form, and has up to 20% iron content. Free ferritin (not combined with iron) is called apoferritin.
In most cases, low Ferritin levels and low iron levels are associated with anemia, where there are not enough red blood cells for iron to attach to.
High Ferritin levels are normally associated with high iron levels, but not always. Other tests may be required in some cases.
Ferritin is found mostly inside cells, and a small amount in blood.

Ferritin test results

Many labs use different testing machines and methods. Patients are usually (but not always) asked to fast overnight before the test.
The Mayo Clinic suggests the following normal values, which can differ from lab to lab:

  • Men: 24 to 336 ng/ml (nanograms per milliliter)
  • Women: 11 to 307 ng/ml (nanograms per milliliter)

High Ferritin

Ferritin is an acute phase reactant, meaning that if there is inflammation in the body, ferritin levels will rise.
The most common causes of high Ferritin include:

  • Obestity
  • Daily and/or excess alcohol consumption
  • Inflammation

For example, because much of the Ferritin is stored in the liver, inflammation causes liver cells to break down, releasing Ferritin into the blood.
Other causes of high Ferritin levels are:

  • Damage to ferritin-containing organs like liver, spleen, and bone marrow
  • Hemochromatosis
  • Liver disease
  • Chronic infection
  • Autoimmune disorders
  • Leukemia
  • Hodgkin’s Lymphoma
  • Type 2 Diabetes
  • Hyperthyroidism
  • Frequent blood transfusions
  • Iron poisoning
  • Adult Still’s Disease
  • rheumatoid arthritis or other autoimmune disease

Although ferritin levels can be high in the above conditions, they are seldom used to diagnose or monitor any of these conditions.

Other Tests

If ferritin levels are high, the doctor will normally order:

  • Serum iron test (a measure of the amount of iron circulating in thye blood)
  • TIBC (Total Iron Binding Capacity) test, a measure of the amount of transferrin
  • % Transferrin Saturation test, the percentage of iron in transferrin

The Ferritin / Iron Relationship

When results are not typical, this chart helps to diagnose the condition:

Condition Iron TIBC/Transferrin UIBC %Transferrin Saturation Ferritin
Iron Deficiency Low High High Low Low
Hemochromatosis High Low Low High High
Chronic Illness Low Low Low/Normal Low Normal/High
Hemolytic Anemia High Normal/Low Low/Normal High High
Sideroblastic Anemia Normal/High Normal/Low Low/Normal High High
Iron Poisoning High Normal Low High Normal

Why do we need Iron?

Iron is essential for healthy blood, oxygen transport, immunity and many other health factors, but must be just the right amount – not too little and not too much.
Low Iron
If we have too little iron, we cannot make enough haemoglobin or red blood cells, reducing our ability to carry oxygen to all parts of the body. See symptoms below.
High Iron
If we have too much iron, the oxidative damage to blood cells causes damage to the entire cardiovascular system, especially the endothelial cells (the inside lining of all blood vessels, lymph vessels and the chambers of the heart), the kidneys and the liver.
Red blood cells are made in the bone marrow, and have a lifespan of around 4 months, when they die (the process called Necrosis).
The body makes around 200 billion new red blood cells every day, along with around 10 billion white cells and about 400 billion platelets every day, and around the same amount die every day.
Dead red blood cells are then broken down by Macrophages (special white blood cells) in the spleen. Some are disposed of in the digestive tract (which makes our poo brown) and parts of other cells are re-used. Haemoglobin is further broken down to salvage the iron, and this iron is then stored in the liver.
Too much iron in the liver can cause Cirrhosis (Scar tissue replacing healthy cells).
The body does not know how to get rid of excess iron, it only knows how to store it in ferritin. If conditions lead to a gradual buildup of iron, this iron overload can lead to many health problems, even death.
See symtoms of high iron below.

red blood cells image
Healthy red blood cells.
As the cell approaches death, or is infected with a parasite or bacteria, or has a genetic defect, or is cancerous, then the shape, smoothness and size may be affected.
Sometimes the doctor can ask the lab for a visual examination of red blood cells to check for any cell changes noted above, and in some labs this check is carried out by a computer system.

When NOT to take iron supplements

NEVER take iron supplements if there are these conditions present:

  • hemochromatosis
  • hemosiderosis
  • hemolytic anemia
  • Diagnosed iron overload conditions
  • Healthy, normal iron levels

Iron and Haemoglobin (also Hemoglobin or Hbg)

Haemoglobin is a protein contained in red blood cells, and Iron is the central atom of the haemoglobin molecule.
Over half of the Iron in the body is stored in haemoglobin, 10 to 20% in Ferritin, and the rest in the protein transferrin (the iron transport protein). Small amounts are found in myoglobin, cytochromes, as unbound serum iron and in body tissues and muscles.
Excess iron is usually stored in the Liver, Spleen and Bone Marrow, but also in the Pancreas, Joints, Skin, Pituitary, Adrenals, Thyroid, Heart and other organs.
The haemoglobin molecule is a very large molecule, almost identical to the Chlorophyll molecule in plants, (which has a central atom of Magnesium instead of iron, giving grass it’s green colour). Chlorophyll is commonly best known for “cleansing of the blood”.
Haemoglobin in red blood cells carries oxygen from the lungs to every part of the body, then returns carbon dioxide back to the lungs.
Haemoglobin is composed of four globulin chains (protein molecules) which are connected together, and in adults, haemoglobin contains two alpha-globulin chains and two beta-globulin chains.
In foetuses and infants, haemoglobin contains two alpha chains and two gamma chains, and during growth to an adult, gamma chains are slowly removed, replaced by beta chains to form adult haemoglobin.
Every globulin chain contains the heme molecule as the central structure, and iron is embedded in the heme molecule, essential for the transport of oxygen and carbon dioxide, and the iron also gives blood the red colour. When oxygen-rich blood is travelling through arteries to feed the body, it is a bright red colour, and on the return journey through the veins, it is depleted of oxygen, rich in carbon dioxide and is a dull red colour.
Haemoglobin is also essential to help maintain the shape of every red blood cell, which resembles a donut with a dished centre rather than a hole. Any abnormal shape can cause poor flow through blood vessels.

Haemoglobin Testing

Haemoglobin tests are available from a small hand-held meter similar to a glucose meter for diabetics, requiring only a pin-prick to draw a tiny drop of blood.
If the doctor orders a haemoglobin blood test, there will normally be a number of other tests required, so blood is drawn from a vein in the elbow.

Typical haemoglobin blood results – Adult males: 130g/L to 170g/L
Typical haemoglobin blood results – Adult females: 120g/L to 150g/L

Units of Measure for haemoglogin

Some labs report haemoglobin in grams per decilitre (g/dL) while most Australian labs report at grams per litle (g/L).
The difference is a factor of ten, as a decilitre is a tenth of a litre, so 12.3 g/dL = 123 g/L.
Other units of measure: millimoles per Litre (mmol/L).
To convert g/dL to mmol/L multiply by 0.6206
To convert g/L to mmol/L multiply by .06206
For example, 123 g/L = 123 x .06206 = 7.63 mmol/L

Types of dietary Iron

There are two main types of dietary iron, heme iron found in meat and other animal products, and non-heme iron found in vegetable products. Also known as heam and non-heam iron.
Generally, heme iron is better absorbed than non-heme iron, leaving vegans more at risk for iron insufficiency.
A healthy body self-regulates iron levels, by absorbing more iron when we need it, and absorbing less iron when we do not need it, but sometimes regulation is upset or overloaded.

How is Iron absorbed?

Iron in food is processed in the high-acid stomach, where it is changed into a form that allows it to be absorbed.
Absorption takes place mainly in the duodenum (part of the small intestine) and also to a lesser extent near the end of the small intestinal tract.
Heme iron (from meat) passes through the intestinal wall fairly intact, while non-heme iron (plant-based iron) is absorbed more when iron stores are low, and less when iron stores are high. After absorption, iron is transported by the transferrin protein, which can be considered as a “dedicated taxi” to carry iron around the body.

Iron for Vegetarians

Nutritionists have said for years that vegetarians, and especially vegans, will always suffer from inadequate iron intake, but this is not necessarily true. Vegans and vegetarians can get quite enough iron with a sensible diet. A bigger risk for this group is inadequate folate and vitamin B-12. B-12 is only available from animal products, and B-12 is essential for absorption and utilisation of iron. As we age, our stomach acid level drops, and as soon as it drops below a certain point, we can no longer produce vitamin B-12, and must supplement. LeanMachine advises most people over 50 should supplement with B-12 and folate.

Pregnancy

Iron in Pregnancy

Iron is essential for the growing fetus, and the average pregnant female needs almost 50% more iron because the body makes 50% more blood to accomodate the growing fetus, especially in the second and third trimesters, where iron requirement increases from 18mg to 27mg daily. However, iron levels must be checked regularly throughout the pregnancy, as too much can be as much or more damaging than too little. Mothers with iron-deficiency anemia have increased risk of premature birth, resulting in low birth weight, while mothers with anemia but normal iron stores do not have the same risk. Mothers with higher than normal iron stores also have increased risk for premature babies, so it is important to attain iron levels within the normal range for all pregnant women.

Folate in Pregnancy

Most people know that folate is essential for a healthy fetus, but most people do not know that the time when the fetus needs folate is just 3 weeks after conception, still in the enbryonic stage. Many women do not even know they are pregnant at 3 weeks, so folate intake is essential for all women of child-bearing age. Also everyone on a calorie-restricted diet, and the elderly. Folate is important for brain and general health, it is not just for pregnancy.
Caution: Iron-rich foods are beneficial, but no liver, as liver contains large amouints of vitamin A, which can increase the risk of birth defects. Of course, supplements containing large amounts of vitamin A should be avoided. Because both mother and infant still require vitamin A for health and immunity, choose a supplement with no more than 2500 IU.

Anaemia, Anemia

Anaemia is a condition where we do not have enough haemoglobin, which is usually, but not always, related to iron deficiency. Lack of folate and/or vitamin B-12, Sickle Cell Anaemia or other blood disorders can cause Anaemia.
Anemia is commonly related to blood loss, typically from:

  • Donating blood
  • Heavy menstrual bleeding
  • Internal bleeding
  • Blood loss from injury
  • Too many dialysis treatments
  • Fibroids
  • Lead or other heavy metal poisoning
  • Toxic chemical poisoning
  • Alcohol abuse

Anaemia from prescription medication

Many prescription medications inhibit iron absorption, including:

  • Tetracyclines (Achromycin, Sumycin) or similar antibiotics, such as minocycline (Minocin, Dynacin), doxycycline (Vibramycin, Monodox), demeclocycline (Declomycin), oxytetracycline (Terramycin), or troleandomycin (TAO)
  • Fluoroquinolone antibiotics such as ciprofloxacin (Cipro), enoxacin (Penetrex), ofloxacin (Floxin), norfloxacin (Noroxin), levofloxacin (Levaquin), lomefloxacin (Maxaquin), grepafloxacin (Raxar), sparfloxacin (Zagam), or trovafloxacin (Trovan)
  • Levothyroxine (Synthroid, Levoxyl or other thyroid medications)
  • Trientine
  • Levodopa (Larodopa, Dopar, Sinemet)
  • Methyldopa (Aldomet, a blood pressure drug)
  • Penicillamine (Cuprimine, antibiotic)
  • Any antacid, proscription or off-the-shelf

If you need the above medications, take them at least 2 hours apart from any iron supplements, or the advice from your doctor.

And the reverse is true: Iron can inhibit the absorption of the following medications:

  • Bisphosphonates
  • Ciproflaxacin
  • Entacapone
  • Levodopa
  • Penicillamine

IDA (Iron Deficiency Anaemia)
In most cases of anaemia, a blood test will reveal low haemoglobin and low ferritin, a result of iron deficiency, and the doctor will normally recommend iron supplementation or dietary changes or both.
ACD (Anaemia of Chronic Disease)
The body has an automatic safety mechanism against harmful invaders, cancer or bacteria.
When sensing an invader, the body will move all iron it can from red blood cells back to ferritin, because all invaders need iron to thrive. The body will leave just enough iron in haemoglobin for the cells to survive, but not enough to feed the invader.
We must NEVER take extra iron in these cases, as we are only feeding the invader and doing more harm to our body.
ACD can be diagnosed by blood tests where we have low haemoglobin, but high ferritin. A C-Reactive Protein test is advised as well as ferritin if ACD is suspected.
When the disease clears up, the body will automatically return iron levels to normal.
Many doctors do not order ferritin tests when iron is low, resulting in the patient taking iron supplements which can cause damage or even death, so an accurate diagnosis of IDA or ACD is essential.
In some cases, IDA and ACD can occur at the same time, making diagnosis more difficult.
One traditional test is bone marrow aspiration with iron staining, but the Serum Transferrin Receptor test can help differentiate between IDA and ACD.
The Serum Transferrin Receptor test is significantly less affected by inflammation than the Serum Ferritin test. Results can be high in IDA and usually low in ACD, and the ratio of Serum Transferrin Receptor to the logarithim of Serum Ferritin concentration is more helpful to distinguish ACD from IDA than is either individual test.
Kidney Damage
If the patient has any kidney damage (sometimes as a result of high iron) then it is possible to have high iron in the body tissues, while regular iron and ferritin tests results are normal or even low. In these cases, a specialist should supervise all testing.

Factors affecting ferritin/iron levels

Menopausal women often (but not always) have low iron, especially if periods are heavy, while post-menopausal women usually have normal iron.
Blood donors will often have low iron. Red Cross blood donation centres always test haemoglobin levels, and if too low (or even too high), that person cannot donate blood.
For an adult male, the normal range is 125g/L to 185g/L
For an adult woman, the normal range is 115g/L to 165g/L.
For donations of whole blood for males, the acceptable range is 120 to 165g/L for women, and 130 to 185g/L for men.
For donations of plasma and platelets, the acceptable range is 115 to 165g/L for women, and 125 to 185g/L for men.
If below 130 (male) or 120 (female), that person should build up their iron reserves and seek medical advice.
Bleeding in the GI (Gastro-Intestinal) tract can cause low iron, as in any other form of blood loss.
Bleeding because of haemorrhoids or anal fissures, or bleeding from cancer or inflammation in the small intestine, colon or stomach will cause low iron. If stools are dark, or there is any unexplained abdomen pain, see your doctor.
Various foods and vitamins can increase or decrease iron absorption – see below.
Foods high in iron are also generally high in Vitamin B12, and both are required for correct ferritin/iron metabolism and healthy Red Blood Cells.
Vegetarians in particular are susceptible to low iron and B12, as both come mainly from animal products.
As we age, we tend to have reduced stomach acid, resulting in less B12 absorption, and to a lesser extent, reduced absorption of all other minerals, vitamins and other nutrients.
If we take supplemental iron, the body will absorb less iron from the diet.
If we have a low-iron diet, the body responds by absorbing more iron from anything available in food.

Phytic Acid

Absorption of iron can be inhibited by phytic acid (phytata) which is found mostly in wheat-based foods, and to a much lesser extent in non-gluten grains, legumes, nuts, unprocessed bran. Thy phytic acid binds with iron, preventing absorption and passing through the body. When wholegrain cereals are processed, much of the phytic acid is lost, also iron, zinc and other beneficial nutrients. Although phytic acid is an antioxidant and can reduce risk of some cancers and other diseases, it does negatively affect the intestinal lining, especially in those with celiac disease. Even in those who are not celiacs, everyone generally does better on a gluten-free diet, avoiding all grains and especially wheat-based grains and other gluten-containing grains.

Slimmers may have low iron

Those more at risk for low iron are mainly young women who want to lose weight by eating a calorie-restricted diet, which can also be a low-iron diet.
Even worse if they have heavy menstrual periods, and worse again if they may be vegans or vegetarians.

Polyphenols

Iron absorption is inhibited by tea, herbal tea, coffee, cocoa, red wine and other polyphenol and tannin foods.

Genetics

Sickle cell disease, thalassemia and haemochromatosis can all be inherited, and genetic testing for these and other genes affecting ferritin/iron is available.

Sickle Cell Anaemia

An inherited condition, mainly descendants of African people. A problem with the haemoglobin beta gene causes some red blood cells to become sickle-shaped, especially in hot, dry and intense exercise conditions. This reduces the oxygen-carrying ability of the haemoglobin.
25% of the population in West Africa have the sicklemia trait, also high in South and Central Americans, especially in Panama. Sometimes appears in Mediterranean countries like Italy, Greece, and Spain. Malaria may be a factor, as Indians, Middle Easterners (e.g. Arabs and Iranians), Native Americans, North Africans, and Turks have small but significant cases.
People with Sickle Cell Anemia actually have an advantage in some countries, as they are able to survive better if infected with Malaria. The “sickleing” of the red blood cells is promoted when the Malaria parasite enters, and the body’s own immune system is then able to identify and destroy the cell, along with the malaria parasite.

Thalassemia

An inherited condition, originating in Mediterranean countries, causing weakening and destruction of red blood cells by mutant genes, affecting haemoglobin production. Similar to Sickle-Cell Anaemia.

Haemochromatosis

Haemocromatosis (also haemochromatosis or hemochromatosis), is primarily found in people with Greek or Italian ancestry, and causes the body to absorb up to 3 times more iron than normal, allowing high iron buildup. If your mother or father has the gene, you generally do not have a problem, but if both have the gene you are likely to have hemochromotosis. Generally, symptoms do not show up until later in life, as iron builds slowly, but there are many fifferent forms.
Around 1 in 188 Australians have the HFE genotype C282Y mutation, the most dangerous kind, although 1 in 8 people are carriers for this gene. There are many primary (inherited) types, including:

  • Type 1 – Classical haemochromatosis – Gene Mutation – HFE Genes C282Y and H63D, often with variations. C282Y is more serious.
  • Type 2A – Juvenile haemochromatosis – HJV (Haemojuvelin), also known as RGMc and HFE2 Genes
  • Type 2B – Hepcidin antimicrobial peptide (HAMP) or HFE2B Gene
  • Type 3 – Gene Mutation – Transferrin receptor-2 (TFR2 or HFE3 Genes)
  • Type 4 – African Iron Overload – Ferroportin (SLC11A3/SLC40A1 Genes)
  • Neonatal haemochromatosis – unknown cause
  • Acaeruloplasminaemia (very rare) – Caeruloplasmin
  • Congenital atransferrinaemia (very rare) – Transferrin
  • GRACILE syndrome (very rare) – BCS1L Gene

Also secondary types, which are not inherited, but acquired, especially if the patient has received many repeated blood transfusions:

  • Severe chronic haemolysis – either intravascular haemolysis or ineffective erythropoiesis (haemolysis within the bone marrow)
  • Excess iron from the diet
  • Excess iron from supplements. Any supplements must be kept away from children – this is the common cause of poisoning for children under age 6, mainly with Ferrous Sulfate as the supplement.

Conditions may involve mutant genes inherited from both parents, so patients may have widely differing symptoms.

Symptoms – Low Ferritin/Iron

  • Brittle Nails and/or spoon-shaped fingernails (koilonychia)
  • Intolerance to Cold
  • Craving or Eating Non-Foods – dirt, hair, coins, etc (Pica)
  • Irritibility, Loss of Concentration, Dizziness
  • Pale appearance, especially membranes – inside of mouth and eyelids
  • Headache
  • Increased infections
  • RLS (Restless Leg Syndrome)
  • Shortness of Breath
  • Weakness
  • Fatigue
  • Loss of Appetite
  • Mouth Ulcers
  • Dry Mouth and/or Sore Tongue
  • Arrhythmia (irregular heart beat)
  • Dizziness
  • Tinnitus (Ringing in the ears)
  • Drowsiness
  • Loss of Consciousness (Syncope)
  • Enlarged spleen
  • Vitamin B12 deficiency
  • Vitamin D3 deficiency
  • Stunted growth
  • Weight Loss
  • For women, delivering premature babies

Symptoms – High Ferritin/Iron

  • Chronic fatigue, tiredness, weakness
  • Joint pain or aches
  • Abdominal pain
  • Increased risk of Diabetes mellitus (Type 2)
  • Arrhythmia (irregular heart beat)
  • Congestive heart failure
  • Heart attack
  • Changes in skin colour to bronze, ashen-grey or green
  • Period is irregular or stops (women)
  • Low Libido
  • Osteoporosis
  • Osteoarthritis
  • Hair loss
  • Enlarged liver or spleen
  • Impotence (men)
  • Infertility
  • hypogonadism
  • Hypothyroidism
  • Depression
  • Mood swings
  • Low adrenal function
  • Neurodegenerative disease
  • High blood glucose
  • High liver enzymes – ALT, AST, GGT
  • High serum iron and serum ferritin
  • Weight Loss

How Much Iron do we Need?

Depends on who we are.
For post-menopausal women and healthy men, 8mg daily.
For menopausal women or blood donors, 18mg daily to replace iron in lost blood.
For pregnant women, 27mg daily for rapid growth and development.
Typically, total iron in the body amounts to 3 to 4 grams, about half in the blood: mainly hemoglobin, then in ferritin, blood proteins, plasma, and the balance in tissues, muscles, bone marrow, enzymes, hemosiderin.

Which Iron?

Many cheap iron supplements contain Ferrous Sulfate, but this is an inorganic variety with increased risk of toxic side-effects. This is also the type with a high risk of poisoning if over-dosed.
Safer alternatives are iron bisglycinate, iron polymaltose, carbonyl iron (iron pentacarbonyl).
Many iron-fortified breakfast cereals give all of menopausal women’s iron requirement, but this is too much for men and children.

  • The added iron can be from ferrous sulfate, the dangerous inorganic kind (never specified on the label)
  • Children and men then receive twice as much iron as they need
  • Multiple servings or meals of cereal means many more serves of extra iron
  • The milk usually added may inhibit iron absorption, but some people use hot water or juice on their cereal which have no calcium

Of course, a healthy body will not absorb extra iron when it already has enough, but for people with a tendency to absorb more, this can be very dangerous.

To INCREASE Ferritin/Iron

  • Some breakfast cereals are fortified with extra iron, but in many if not all cases with Ferrous Sulfate, so this method NOT recommended by LeanMachine
  • Red meat – beef, lamb, kangaroo and organ meats, especially liver are rich in iron
  • Increase intake of lentils, beans, raisins, dates, prunes, figs, apricots, potatoes (with skin), broccoli, beets, leafy green vegetables, whole grain breads, nuts and seeds, blackstrap molasses, oatmeal.
  • Reduce alcohol consumption. One drink daily with food is OK, but overdoing it will cause liver damage
  • Vitamin C (orange juice, fruit, supplements) will increase absorption of iron from food
  • Avoid donating blood too often, or not at all if haemoglobin is less than 130 (men) or 120 (women)
  • Build testosterone, by diet and exercise and/or supplementation to help build new red blood cells
  • If vitamin B-12 and/or Folate is low, supplement or change diet
  • Supplements containing Ferrous Sulfate should be avoided as this is the inorganic form. Safer option is Chelated Iron
  • Low haemoglobin can be associated with low copper. Supplementation of Copper may help if copper tests low, but copper supplements interfere with iron absorption, so shoul not be taken together.
  • For very low levels, haemoglobin will also be low, which is a life-threatening condition, and a blood transfusion and/or EPO (Erythropoietin) may be required. EPO is a hormone produced by the kidneys which promotes the bone marrow to produce red blood cells

Iron Overload

This is a dangerous condition, and if iron overload is suspected, the first test may be:
Serum Transferrin Saturation
This test measures the amount of iron attached to the transferrin protein in blood. Levels over 45% are normally considered too high.
Serum Ferritin
Determines the total amount of iron stored in the cells, considered high when above 1000ng/mL or 2247 pmol/L.
Normal range: 12-350ng/mL (27-786 pmol/L) for men and 12-300ng/mL (27-674 pmol/L) for women.
Ideal range: 40-60ng/mL

Further tests may include a Liver Biopsy, SQUID (Superconducting Quantum Interference Device), or MRI (Magnetic Resonance Imaging).

To DECREASE Ferritin/Iron

Blood donation (therapeutic venesection) is usually the best method, and helps save lives of others.
If ineligible for Red Cross donations, private organisations can do this. Usually a ferritin reading of several hundred can be brought down to the normal range after half a dozen or so blood donations.
The only down side is that donations must be spread out over many months to allow the body to build new blood.
Next best option is using IP6 (Inositol Hexaphosphate) which can chelate excess iron from the body.
IP6 can help when the body cannot excrete excess ferritin/iron on it’s own, which is normally the case. Also the best alternative when blood donation is impossible, impracticable or ruled out for religious reasons.

More serious cases of iron overload can be treated with:
Deferoxamine (Desferal®) – administered via a needle from a pump attached to the body for 8 to 10 hours a day.
Deferasirox (Exjade®) – a tablet dissolved in a glass of water or juice, taken once a day.
Both methods can have undesirable side-effects, including hearing and vision loss, nausea, diarrhea, rash, kidney or liver injury, so LeanMachine recommends first using blood donation, IP6 and diet measures first, unless overload is very severe.

  • Donate Blood at the Red Cross. Reduces old blood recycling, leading to reduced iron stores which are used up in making new blood. May take several sessions over several months.
  • Take IP6 (Inositol Hexaphosphate)
  • Eat cabbage every day (cooked, not raw). No scientific studies have been carried out with cabbage, but anecdotal evidence says it works (perhaps by filling up on cabbage, the patient may not feel like red meat…)
  • Avoid red meat, and especially liver and other organ meats
  • Drink green tea, black tea, oolong tea or coffee, and/or take a Green Tea Extract
  • Take Vitamin E, Vitamin B-6, Manganese, Curcumin.
  • Avoid taking Vitamin C, as this can increase iron absorption by 300%, and avaoid eating foods rich in vitamin C at the same time as foods rich in iron such as red meat
  • Do not cook in iron pots or pans, even if you have low iron, as metallic iron is bad for the body, only the inorganic kind can be used effectively.
  • Avoid alcohol, especially wine with steak
  • Never take iron supplements (if you take a multivitamin, or a “womens health” supplement, ensure it has no iron)
  • Never drink well water or bore water unless it has been tested free from iron (and other harmful metals and/or salts).
  • Take Astaxanthin – an extremely powerful antioxidant, 550 times better than Vitamin E. Will not chelate iron, but will help repair damage caused by iron overload.

The Diet to Decrease Iron

Green tea, black tea, oolong tea and coffee all contain tannins which inhibit iron absorption, so drinking these with a meal can help lower ferritin and iron levels.
Drinking milk with a meal also helps reduce iron absorption because the calcium in milk competes with iron for absorption.
Although Calcium supplements can reduce iron absorption, they can also cause increased plaque in arteries and double risk of heart attacks, especially the type used in cheap supplements, so should be avoided. Most people get plenty of calcium from regular food, and although calcium is esential for health and bones, we are better supplementing with Boron, Magnesium and Vitamin D3 for bones.
Eat an egg every day, as eggs contain a compound that impairs absorption of iron. Chicken and fish are better choices than red meats, although they still contain easily-absorbed heme iron.
Breakfast cereals with whole grains contain iron, but many are fortified with extra iron and should be avoided. Try a boiled egg for breakfast instead.

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Last Updated: 12th December 2015. Copyright © 1999-2016 Brenton Wight – LeanMachine

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