21 July 2017 · Jarrod Cooper
Iron is one of the most abundant minerals on earth and is present in many foods, both animal and plant. If the mineral is so plentiful, why are there so many people showing signs of anaemia even though they take supplements? Perhaps iron deficiency anaemia is not quite anaemia at all, but chronic inflammation or a problem with bioavailable copper — explained below, along with why iron supplements may not be the right way to correct the symptoms of anaemia.
On the other side of the equation, 1 in 5 men and post-menopausal women have excessive levels of ferritin (iron stored in tissue). These high levels can contribute to a number of health conditions, including erectile dysfunction, diabetes, faster ageing, low testosterone, and kidney and liver disease.
People with ferritin levels above 100 µg/L should consider donating blood to reduce their levels of stored and oxidised iron.
The function of iron
In humans, iron has a number of roles:
- Oxygen transport — the best-known purpose of iron. Iron is part of the protein haemoglobin, which carries oxygen from the lungs through the body via our red blood cells. Haemoglobin accounts for up to 60% of the iron in the body.
- Myoglobin — iron is needed for the formation of myoglobin, which helps store oxygen in muscle cells and gives muscle its red colour.
- Immunity — weak immunity is associated with both low and excess iron. Iron is needed to let the body's immune response work effectively. Our immune system stops invading microbes by depriving them of iron through an immune defence substance known as lactoferrin, produced in breast milk and in our gut.
- Enzymes — enzymes are abundant in our system and take part in many chemical reactions. Iron is needed for a number of enzyme reactions that drive the cells and produce energy.
What is the optimal iron level?
There are different schools of thought about how much iron we need. As described above, iron is crucial to our health and wellbeing. Dr Mercola sets out in an article on elevated iron levels that ferritin should be between 20 and 80 µg/L, with an optimal range between 40 and 60 µg/L.
Ferritin is a protein that holds iron and releases it when the body needs it. People with ferritin above 100 µg/L are at risk of symptoms of iron overload and of damage to the body. Some people have a condition known as haemochromatosis, which causes excess iron to be stored, but many people without it have accumulated too much iron and have a silent and often untreated underlying cause.
Just as iron rusts in nature through oxidation, iron in our body also oxidises, causing breakdown. This excess iron accelerates ageing and tissue damage, which can contribute to a number of conditions, among them heart disease, diabetes, bacterial and viral infections and liver disease.
Ferritin levels above 100 µg/L should be brought down to avoid chronic disease and tissue damage. Many doctors are happy to see ferritin far higher than 100 µg/L — get tested and look into it.
Some of you may have ferritin within this ideal range but have been told to take supplements, or may have symptoms of anaemia such as lethargy, poor memory and concentration, breathlessness on exertion, pale skin, dizziness and so on.
Perhaps the answer lies in the way our body uses iron and transports it, along with the way it interacts with other minerals such as copper.
So with all this iron around, why am I anaemic?
This is a good question, and it calls for an approach that reduces chronic inflammation and balances the minerals in the body.
Supplementing iron is usually not the answer, and will only lead to more oxidised iron in the body and further accumulation of iron in the liver.
True iron deficiency anaemia is not very common in the Western world; those most at risk are women during pregnancy and people on long-term, poorly managed vegetarian diets.
We need to look at why the iron in the body is not being used properly, and at other minerals that are missing, such as magnesium and bioavailable copper. As iron accumulates over time, the magnesium in our system falls. More iron oxide is produced, which further increases the rate of ageing and catabolism and lowers energy through less ATP production.
Supplementing magnesium is crucial for a number of reasons, including letting the enzyme pathways function properly and helping regulate calcium, vitamin D and other minerals.
Without bioavailable copper, iron will not be converted properly. Iron therefore cannot be absorbed without bioavailable copper.
Copper imbalance is more common in women, and usually the reason they are diagnosed with iron deficiency anaemia is that the symptoms of copper anaemia are exactly the same. High oestrogen has an affinity with high bio-unavailable copper.
Copper dysregulation will lower ferritin levels, as seen in blood tests. Even people who are copper-toxic, with high copper in the liver, brain and kidneys, cannot make iron bioavailable.
In addition, when there is infection or chronic inflammation in the body, it pulls iron into the liver to "starve" the infection and releases copper into the blood from the liver to fight it. This may explain why anaemia-type symptoms are seen in chronic infection and inflammation.
Furthermore, when ceruloplasmin is low, copper is not transported in the blood effectively to kill the virus or pathogen — which further explains why those with low bioavailable copper are so susceptible to infections and viral outbreaks.
The secret to having copper available lies in the copper-transporting protein known as ceruloplasmin. Ceruloplasmin ensures that copper is transported properly, so that proteins can attach to iron and it can be used correctly.
How to raise ceruloplasmin and help correct anaemia
Ceruloplasmin can be hard to raise; a properly functioning liver and adrenal glands are needed. Many patients with hypothyroidism also have a deficiency of bioavailable copper. Adequate ceruloplasmin levels help balance the iron/copper dysregulation, and the recommended serum ceruloplasmin level should be 35–40 mg/dL. Producing ceruloplasmin requires retinol, whole-food vitamin C and copper.
A number of factors can lower ceruloplasmin, including supplemental iron, calcium, ascorbic acid (synthetic vitamin C), high-dose zinc supplements, excessive stress and GMO foods. A full mineral balancing programme is often required.
Steps to raise ceruloplasmin
- Take cod liver oil to increase retinol in the liver — 1 tablespoon a day.
- Supplement magnesium to support stress, adrenal and enzyme reactions. Dr Carolyn Dean, author of The Magnesium Miracle, recommends around 10 mg/kg a day. Look for magnesium glycinate or malate for the best absorption, which will not interfere with ceruloplasmin production.
- Take whole-food vitamin C as a source of copper, 400–800 mg a day.
- Add biotin (B7, 500–1000 mcg) and riboflavin-5-phosphate (active B2, 25–50 mg) to regulate iron and copper in the liver. There are a small number of multi-B products that contain a range of B vitamins and no iron, calcium or vitamin D in their ingredients.
- Take boron to support ceruloplasmin production (prunes, apples, chickpeas, avocado, pears, almonds and carrots are good sources).
- A paleo-type diet with enough protein and healthy fats and plenty of fruit and vegetables is most suitable.
- Support thyroid health and assess iodine status; see whether a supplement is needed.
Iron overload
Believe it or not, iron overload is more common than true iron deficiency anaemia. As mentioned, those most at risk are older men and post-menopausal women.
After childhood, adults accumulate roughly 1 mg of excess iron a day, stored mainly in the liver. A 40-year-old man will have twice as much as a woman, because of menstruation.
Symptoms of iron overload usually appear in men over 40 and later in women who are through the menopause. Many men much younger than forty have also been shown to have excessive ferritin stores at levels of 100 or more.
Iron accumulates through food. Excessive consumption of meat and of iron-fortified foods increases intake. Regular alcohol use also increases ferritin storage in the liver. From this alone you can see why many young men have high ferritin.
An excess of stored ferritin leads to reduced testosterone, and to reduced levels of thyroxine in the thyroid, insulin in the pancreas and hormones in the adrenal and pituitary glands — not to mention all the chronic disease states that high ferritin contributes to.
Donating blood is the easiest way to reduce your ferritin stores; a single donation of around 470 ml will on average lower ferritin by 30 µg/L.
Other ways to reduce stored iron are by cutting red meat, avoiding cast iron pans, eating rice bran (a natural iron chelator) and avoiding iron-fortified foods (mainly commercial wheat and cereal products). Many "popular" cereals and breads contain high levels of fortified iron.
This is a translation of a published article and is not medical advice. Iron and copper levels are assessed by tests and by a doctor; do not change supplements or donate blood on the basis of an article alone.
The original: naturopathlife.com.au
