ADA: Iron Predicts Diabetes Risk

[KastaDiva]

http://www.diabetesincontrol.com/issue161/item11.shtml

ADA: Iron Predicts Diabetes Risk

Women in the highest quintile of ferritin concentration were 2.66 times more likely to have diabetes, compared with those in the lowest quintile, the study showed. ..... Mean ferritin level was 109 ng/mL among cases and 71.7 ng/mL among controls (P<0.001).

[Study title: Body Iron Stores in Relation To Risk of Type 2 Diabetes in Women. Abstract 306-OR]


I have posted a lot recently about the dangers of iron overload. My introduction to the topic of iron overload was Eades' Protein Power Life Plan, in the chapter on iron.

Since I've had to deal with a situation with my mom...anemia...low red cells, hemoglobin and hematocrit, in which the doctor said to increase iron consumption, but yet with her having elevated serum ferritin, I knew that giving mom more iron was not the answer. And because mom has elevated serum ferritin, and I wasn't sure about her not having hereditary hemochromatosis, I had iron studies done which revealed I also have elevated serum ferritin. But, my iron studies also showed I do not have hemochromatosis, but I do have excess stored iron. Hemochromatosis is a hereditary disease, and if one family member has it, all family members must be tested for it, and proper treatment started ASAP.

My point in posting this: according to lab ranges, my serum ferritin is "normal." My result is 229, and normal is 6-250. According to Eades, serum ferritin should be between 15 and 50. According to the book, The Iron Elephant, serum ferritin in women shouldn't be above 150, but also, it should really be closer to 10. The lower the serum ferritin, the better.

I found the above info in my diabetes archives, and re-read the report. The mean serum ferritin of those nurses that developed diabetes was 109! Having a "normal" serum ferritin increases risk of diabetes! This lends more credence to what Eades and Crawford say about the dangers of iron overload. Crawford also points out that normal ranges for serum ferritin (and other iron tests) have been skewed...made abnormally broad...by the inclusion of people with undiagnosed hemochromatosis. True normal range should be <50.

Crawford (The Iron Elephant) says that basic lab metabolic panels need to include iron studies, because iron overload is so common and so un-and mis-diagnosed. She also says every diabetic needs to have iron studies done. After reading the report of the above study, I certainly agree!

I encourage everyone to have their blood tested for iron overload. Iron overload is very common, and if left untreated, can cause serious health problems. The tests needed are total serum iron, total iron binding capacity, calculation of transferrin saturation %, and serum ferritin.

KD

[lynne2u]

So how do you treat iron overload?

Lynne

[luvs3pugs]

It's mainly treated by donating blood to rid ones iron intake. Also, you have to watch out for sodium, if I am correct.
This is also called bronze's diabetes. My mother has this.

[Diana]

I am always borderline Anemic.....

[KastaDiva]

Lynn, as luv said, you donate blood. And, you need to find out if the State/blood bank where you live allows blood donations from people with iron overload. Some blood banks won't accept it, and will even charge high fees for merely doing a therapuetic phlebotomy. This is rather ironic, because there is a higher percentage of undiagnosed people with hemochromatosis than is realized, and the blood banks will accept their blood, but when it's discovered they have hemochromatosis, suddenly the blood is no longer acceptable. There is nothing wrong with that blood...it just now has a disease name attached to it. A lot of States now realize there is nothing wrong with this blood, and blood banks will accept it, but you need to find out how it's dealt with where you live.

As of right now giving blood is the most efficient way to lower stored iron. People with hemochromatosis have to give blood twice weekly for the first few months, or until the serum ferritin is below 10. People like my mom and I, 2 or 3 donations given at 3 month intervals would probably suffice, since we don't have the genetic problems seen in people with hemochromatosis.

luv, vit C enhances absorption of iron, and also facilitates it getting into the heart, which is not a good thing. I don't recall reading any connection with sodium.

Have you been checked for hemochromatosis, since your mom has bronzed diabetes? In case you aren't aware of this, family members have to be checked because it is hereditary. Often times it isn't checked in family members because maybe the doctor doesn't understand the importance of it, nor the importance of getting early treatment BEFORE complications set in. In families where both parents have the genes for hemochromatosis, it's a given the kids will have it. If only one parent has it, maybe or maybe not the kids will get it. Crawford lists the probabilities in her book. But, the bottom line is, everyone in the family must be checked.

In the book, The Iron Elephant, the author lists 8 hurdles to getting proper diagnosis and treatment. One of those hurdles was criteria of diagnosis. Some doctors won't diagnose it until the triad of complications shows up...the cirrhosis, bronzed diabetes, and something else I can't remember right now. I don't think it serves the patient well for them to have to wait for the complications to occur before they get diagnosed and treated. By that time, it's often too late. Doctors need to forget the "diagnosis" and treat the iron overload, BEFORE permanent complications occur. This is called preventative medicine. Why should patients have to acquire the complications before they are treated for their iron overload?!

One final question, luv. How aggressive is your mom's treatment? Another problem with treating iron overload is what Crawford calls timid treatment. The patients aren't allowed to donate blood as often as is needed to quickly get the iron store depleted. Depending on the level of stored iron, people with iron overload may need to give blood twice weekly until stored iron is below 10. If she is only allowed to donate blood every three months, that is not enough to bring down the level of stored iron, because people with hereditary hemochromatosis store a lot more than is being removed in that amount of time.

Diana, how exactly was your borderline anemia diagnosed? Merely on either a complete blood count or a hemoglobin or hematocrit? This is not sufficient to diagnose IRON deficient anemia. Doctors don't understand that hemoglobin does not equal iron. Most anemias are caused by B vit deficiencies, not iron deficiencies. Granted, there are some people that are truly low on iron, but this is not the norm. If you haven't had the proper iron tests done to show you are truly low in iron, it is a dangerous mistake to take iron merely because you may have a low hemoglobin.

If you are borderline anemic, it is most important for you to discover the cause before taking iron or increasing foods higher in iron. The body hides iron in cases of chronic infection and undiagnosed cancer, making it appear one is low on iron. Taking iron in these situations could have serious consequences. Low iron could also be a sign of internal bleeding. Low iron could also be a symptom of iron overload, or of other iron storage disorders such as thalassemia.

In my mom's case, I forgot to mention that her serum iron, TIBC and saturation were also low, with the elevated stored iron. It appears she is low on iron EXCEPT she has excess stored iron. Her situation fits the above....and we are in the process of testing for cancer and internal bleeding, because we've ruled out the other causes of low iron.

So, I guess my point is, if you are borderline anemic, what does that mean exactly, and is the doctor assuming it is low iron, and how was the slight anemia diagnosed...what method was used to determine this? If it wasn't determined by the proper iron tests, you don't know for sure you have iron deficient anemia, and if you are taking iron for this, you most definitely need to have your stored iron levels checked. And you need to find the cause of your borderline anemia.

I'm editing this post to add the 8 hurdles to getting a diagnosis and proper treatment:

One--Iron levels not tested.

Two--Iron levels tested, but improperly interpreted.

Three--The anemia iron overloaded patient given iron.

Four--Failure to stain liver biopsy specimen for iron.

Five--Symptoms aren't "right."

Six--Timid treatment.

Seven--Disbelief.

Eight--Failure to check relatives.

KD

[KastaDiva]

I found two more reports in my diabetes archives about the connection between iron overload and diabetes:

http://www.docguide.com/news/content...44&c=&count=10

Iron Depletion Improves Vascular Dysfunction In Type 2 Diabetes

A DGReview of :"Blood Letting in High-Ferritin Type 2 Diabetes: Effects on vascular reactivity."


Here is another important report:
http://www.medscape.com/viewarticle/439591_print

Cross-Talk Between Iron Metabolism and Diabetes

Diabetes 51(8):2348-2354, 2002. © 2002 American Diabetes Association, Inc.
Posted 08/29/2002

Abstract and Introduction

Abstract

Emerging scientific evidence has disclosed unsuspected influences between iron metabolism and type 2 diabetes. The relationship is bi-directional—iron affects glucose metabolism, and glucose metabolism impinges on several iron metabolic pathways.

[bonbon]

It seems the more you know, the weirder the body gets. Thanks once again for great info KD. I had heard of this phenomenon, but not in relation to diabetes.

[KastaDiva]

Hi bonbon,

Iron overload is an interesting disorder, and deadly if undiagnosed and untreated.

Here are the title headings of some of the chapters and excerpts from some chapters in the book, The Iron Elephant, by Roberta Crawford:

Chapter 1: Untreated Iron Overload Kills

Chapter 2: Untreated Iron Overload Can Make You Sexually Impotent

Excerpt: When you consult a professional about any kind of sexual or reproductive dysfunction, you are not receiving proper help if your iron satus is ignored. Your sexuality problems are not being thoroughtly investigated unless therapists measure your iron levels.

Chapter 3: Untreated Iron Overload Can Give You Cancer

excerpt: Excessive storage iron in the liver is carcinogenic for primary liver cancer. Studies show that a third of all diagnosed patients develop cancer, if the diagnosis is made after sufficient damage to cause cirrhosis (scarring of the liver). Liver cancer has been found to be 219 times more frequent amoung hemochromatosis patients who were diagnosed after cirrhosis. ....A link between excess iron and leukemia was reported in June Goodfield's thrilling book, "An Imagined World, a record of scientific discovery." ...we have learned that iron does depress the immune system. Tumors require iron. For this reason when there is a finding of iron deficiency, you must search for cancer. ....Eugene Weinberg, PhD, conducted studies at Indiana Univ on the relationship of cancer to iron....he quotes a study that found that "in 20 humans, the mean dry weight of iron in breast cancers was three fold greater than that of nhormal breast tissue." It has been found that 88% of patients with metastasizing breast cncer had elevated serum ferritin levels. .... Weinberg demonstrated that in both infection and malignancy, iron is shifted to storage tissues. The severity of cancer is related to displacement of iron. When the patient recovers, iron levels return to normal. This is why it is essential to search for cancer when transferrin saturation or serum ferritin are low. The individual that takes iron just because blood work shows low iron is turning off th efire alarm and ignoring the fire. Your body attempts to withhold iron from turmor cells, and can do it more successfully when you are not iron overloaded.

Chapter 4: Untreated Iron Overload Can Give You Arthritis

excerpt: If someone shakes your hand with a hurting grip and the pain lingers, you should arrange to test your iron levels. Other joints become sore or aching, inflamed or swollen: knees, hips, jaw, shoulder. .... Joints most affected are those of the hands and wrists, and weight bearing joints. .... Along with polyarthritis, there may be acute synovitis, an inflammation fo the membrane that sheaths tendons. The most common kind of iron-caused arthritis is chondrocalcinosis, also known as pseudo-gout, caused by iron deposits in the joints or by iron injury to the joints. ...It is important to distinguish hemochomatosis arthropathy from other arthritic diseases both to avoid unwarranted therapy and to allow early treatment with phlebotomy. .... Many people whose arthritis is iron caused are unaware they have iron overload.

Chapter 5: Untreated Iron Overload Can Give You Heart Disease

excerpt: ....iron "even at levels long regarded as normal, may have deleterious effects in the heart." Ironic Blood Vol 6, No 6. ....Jerome Sullivan sees excess iron in the heart as a poison that causes arrhythmias and damage to the heart muscle. Most people who have iron caused heart disease are unaware of their iron overload.

Chapter 6: Untreated Iron Overload Can Give You Liver Cirrhosis

excerpt: Cirrhosis is not mandatory to confirm the diagnosis of hemochromatosis. Patients would rather not wait for the damage. Damage can be prevented.

Chapter 7: Untreated Iron Overload Can Give You Diabetes

excerpt: Clinical manifestations of diabetes in a hemochromatosis patient are indistinguishable from those of any diabetes. Severity depends upon the amount of iron load and whether the diabetes is discovered early or late in the course of iron accumulation. You can expect improvement in about half of all patients when you unload the iron aggressively. Some patients are ble to reduce or discontinue insulin injections. This outcome depends on the promptness of diagnosis. It depends on the vigor of therapy. ...Blood sugar is difficult to regulte when the underlying cause of pancreas damage is excess iron, unless that iron is removed. .... It is preferable to find the iron overload before pancreas damage, but every diabetic should be carefully evaluated for iron.

Chapter 8: Untreated Iron Overload Can Impair Your Immune System

excerpt: Everyone with a depressed immune system needs to know their iron status. After the iron is unloaded, immune response greatly improves. ...Weinberg writes that people are much more susceptible to infections at times of high iron elevation.

Chapter 9: Untreated Iron Overload Can Make You Tired, Tired, Tired

excerpt: Many undiagnosed patients with hemochromatosis are labeled as hypochondriacs. Doctors caring for patients with hemochromatosis should be aware of the high associated incidence of thyroid dysfunction. .... Some patients escape the fatigue and other complications until end stage. It is important not to let this give one a false sense of safety, that they don't have hemochromatosis.

Chapter 10: Detect It Early, Unload the Excess, Avoid Complications

excerpt: Without therapy, idiopathic hemochromatosis is a fatal disease.....death usually results from cardiac failure in younger patients and from liver disease or its complications in older patients.


This book deals more with hereditary hemochromatosis, but through out the book the author mentions that iron overload is the important word, not hemochromatosis. People can have complications of iron overload without having hemochromatosis. This is one of the reasons why I am pushing this so much right now....to educate people and to encourage them to get their iron tests done. Complications of iron overload can be reversed if it's caught and treated soon enough.

KD