Iron-Out-of-Balance™ in Men
Men can experience Iron-Out-of Balance™ because of too much iron or too little iron; the causes of these imbalances can be inherited or acquired. The most common reason for too much iron (iron overload) in men is hereditary hemochromatosis. The most common reason for too little iron in men is blood loss from the digestive tract (generally disease related).
Too Much Iron in Men—Introduction
Some men are prone to accumulating potentially toxic levels of ingested iron in their organs and glands. Although iron is an essential element for healthy life, too much iron can overwhelm the body’s natural storage capability leading to oxidative stress, tissue damage, early aging and damage DNA leading to spontaneous mutations that can generate cancer or affect the health of unborn children. Iron is particularly dangerous and can catalyze these processes even in small amounts (less than a few extra grams) when mixed with other risk factors such as obesity, family history of diabetes or heart disease, inadequate consumption of antioxidants (fruits and vegetables), unhealthy cholesterol levels, smoking and regular alcohol consumption. Excessive iron ranks prominently in the constellation of risk factors leading to several chronic disease states of vital organs including bones and joints, heart, liver, pancreas, anterior pituitary, thyroid, adrenals, or sex-hormone producing organs. The excess iron causes these organs to function abnormally and produce a long list of symptoms. Although individual symptoms and degree of expression will vary between men (as will the amounts of stored iron), excessive body iron accumulation can also lead to impotence, loss of libido (sexual interest) and function, depression, loss of muscle mass and strength, enlargement and impairment of liver and spleen, loss of body hair, hypothyroidism, hypogonadism (Inadequate functioning of the testes) with noticeable changes (darkening) of semen color, chronic fatigue and joint pain. Too much iron should be suspect in the presence of any of these symptoms especially in combination.
Too much iron in men can be caused by a number of conditions:
genetic: hemochromatosis (HHC) or iron overload; for white males: type I (classic) hemochromatosis caused by mutations of HFE; four rarer non-HFE related disease include type 2 (A and B) hemochromatosis (juvenile hemochromatosis onset before age 30), type 3 hemochromatosis (transferrin receptor 2 hemochromatosis), type 4 (A and B) hemochromatosis (ferroportin disease), and a(hypo)ceruloplasminemia
- Genetic for non-whites: not fully known but suspect is for mutations of genes that regulate hepcidin, transferrin receptor 2 or the ferroportin gene; (Note: these mutations may also occur in white males as modifiers of HFE).
Genetic or acquired chronic hemolytic anemia (mechanical heart valve, blood cell disorders, enzyme deficiencies and rare cases autoimmune disease)
Genetic: X-linked sideroblastic anemia
Acquired iron overload from blood transfusion, excessive alcohol consumption, excessive use of iron supplements
Cell and tissue damage caused by iron can either initiate and/or contribute to the following causes of premature death:
- Cirrhosis of the liver
Cardiovascular diseases, including early death by myocardial infarction (heart attack).
Cancer (particularly cancers of the liver and colon)
Type II diabetes
Septicemia (excessive iron nourishes dangerous microbe colonization)
Early onset neurodegenerative diseases (Alzheimer’s, Parkinson’s, Huntington’s, Lou Gehrig ’s disease)
Fortunately for most men, iron metabolism is tightly regulated by their genes. Most men can consume plenty of iron-packed red meat and even imbibe in some potentially unhealthy habits, and yet not be further harmed by the invisible threat of adding too much iron to that potentially unhealthy mix. That’s because their metabolisms don’t permit absorption of any more iron than what’s needed for the body to function properly, which includes about one extra gram stored in reserve.
About one in three men are predisposed to absorb too much iron. Iron excesses can range from a few extra “unhealthy” grams to as many as fifty or sixty, or about two ounces. Simple blood tests can quickly determine if iron overload is present. This early testing can prevent disease development and progression.
When testing isn’t done and iron is left to accumulate over time, vital organs like the liver will suffer permanent and life-threatening damage. Today, emerging medical science points to relatively small amounts of excess iron as a factor in diminished cardiovascular health and fitness even among relatively young men (i.e. under the age of 50). Recent reports published in major medical journals indicate that vascular health deteriorates progressively starting at age 24 and continues for decades.
Once excessive iron absorption is medically determined (generally through blood tests), the abnormal absorption process can be stopped. In most cases potentially harmful tissue damage can be reversed, as healthy cells will naturally replace damaged ones. This can only happen when the catalyst for that damage, excess iron, is removed. The most effective way to reduce and eliminate potentially toxic iron levels is through phlebotomy (bloodletting) or blood donation. Men prone to iron accumulation make perfect candidates for blood donation. From a physiologically standpoint, they can donate blood more frequently than others. When new blood is created, the body draws from stored iron surpluses to manufacture hemoglobin. Some men diagnosed after iron had accumulated over many years can give blood up to two times a week. Such aggressive iron depletion regimens will generally “reduce” the iron overload, figuratively equivalent of “morbid obesity,” to normal and healthy levels over one or two years of therapy. Only a minor percentage of the male population (less than 1%) will require such aggressive treatment. Donating just one or two units of blood a year can adequately protect most men from the toxic dangers of iron.
Too Little Iron in Men:
The most common reason for too little iron in men is blood loss from the digestive tract such as cancer, hemorrhoids, diverticular disease. Other causes include (but are not limited to) bone marrow abnormalities resulting in impaired blood cell formation resulting in bone marrow failure. Myelodysplastic Syndrome (MDS) or leukemia are among the more severe consequences of bone marrow function problems. Hemolytic anemias mild or extreme can also be due to bone marrow production problems for individuals with sickle cell disease, thalassemia or other rare blood diseases. Early destruction of red blood cells can produce anemia with iron overload a serious combination that requires expert attention. Problems of absorption from diseases such as celiac sprue, Crohn’s disease or conditions such as bariatric surgery (removal or alteration of the stomach or portion of the intestinal tract), and milder forms of hemolytic anemia are also causes to consider. Regardless, if anemia is present, finding the underlying cause is imperative. Patients who are told that they are anemic should never self medicate with iron pills or over-the counter remedies. Anemia is a symptom not a diagnosis. A trained medical professional must investigate the cause of anemia.