Hi again! I hope you've been enjoying my 5-installment series on iron and human health.
In this part, the third installment, I will talk about the problems associated with an iron deficiency and iron overload.
The previous two parts have discussed the topics of:
Let's now explore the topic of this blog post, iron deficiency, overload, and the benfeits of optimal levels.
If you want to read any of these individual actions below, then click on them:
Let's start with a definition:
Iron deficiency can lead to a condition called "iron deficiency anemia", in which your blood contains too little iron.
Anemia and iron deficiency are thus not the same.
The reason for distinguishing between these two concepts is because anemia can be caused through several mechanisms--iron deficiency being merely one of them. I had mentioned that difference in passing in the previous section.
Anemia simply means that the body does not create sufficient red blood cells or that existing blood cells contain very little hemoglobin.
If you've got low hemoglobin, you'll automatically have low iron in these blood cells as well, as iron is needed to create hemoglobin. Remember that iron is needed in blood cells to carry the oxygen that you breathe throughout your body.
You can also be anemic due to hereditary conditions, for example, which is not directly caused by having too little iron available, even though the consequence of anemia is the same.
(Both vitamin B9 and B12 are also needed to create homoglobin.)
In that non-aenemic variation, iron stores are still sufficient that hemoglobin levels are not lowered, even though the total body store of iron has dramatically declined.
The problem is that you'll already start experiencing negative health effects with a non-anemic iron deficiency - this circumstance is thus far from optimal.
So how do you know whether you're at risk for getting anemia?
Let's find out:
The following population groups are at most risk for iron deficiency:
Keep in mind that you don't have to experience all these symptoms in order to be iron deficient. If you've got iron deficiency, for example, you may only experience tiredness and slower healing, while not having nail and hair problems.
The more extreme the iron deficiency gets (as measured by ferritin, for example), the more symptoms you'll probably experience. As iron is so important for most processes in the body, you can also experience symptoms not included in the above list.
With a lower calorie intake, you're automatically more at risk for having iron deficiencies. The reason for that relationship is simple: with lower calorie intake you're more prone to consume fewer milligrams of iron.
Several diseases also cause you to have lower iron levels.[428; 429] Your immune system can be very active and dramatically lower the iron content in the blood, for example, in order to starve pathogens from their iron needs.
Iron deficiency anemia is not benign and increases overall disease risk.
An impaired immune system (making you more defenseless against disease) and heart problems (e.g. heart failure, in which your heart doesn't pump strongly enough for the body's needs) are examples of eventual consequences of a deficiency.
If low iron levels show up on your lab test, it's thus imperative to consider how much iron you're taking in from food (a topic that will be treated later). If you do consume enough iron, it's necessary to check why you've become anemic.
So that's deficiency--let's now look at iron overload:
In the previous section I've talked about the dangers of iron deficiency--iron overload or "hemochromatosis", on the other hand, is also threatening.
The word "hemochromatosis" can literally be translated into "iron colored blood". In reality, the name is often used to not only denote excesses of iron in the blood, but also in other places of the body.
So let's consider that hemochromatosis danger:
Remember the "hepcidin" I talked about in the second section?
If you're predisposed to iron overload, then you can be deficient in that "hepcidin" compound. Hepcidin is necessary to regulate iron absorption in the intestines - lower hepcidin levels lead to greater iron uptake.
With unfettered iron absorption, the mineral will eventually be deposited in several organs, such as the heart, liver, joints, and even skin.
Having a genetic predisposition to accumulate iron and blood transfusions are the main two causes of iron overload.
Lastly, aging is another cause of iron overload (in the wrong places).
(Advanced explanation: because hepcidin function also originates in relation to the liver, it's simple to hypothesize that liver function is integral to iron metabolism. Studies confirm that hypothesis, hepcidin functioning is off in multiple liver diseases.[225; 226; 227; 228] While more research is needed, liver function looks closely related to iron status in the body. Supporting evidence: alcohol consumption is also tied to excess body iron stores.[231; 232; 233; 234])
If you have a genetic predisposition to accumulate iron, you'll retain up to three times as much iron as a person who does not have the genetic disposition.
Just as a deficiency, iron overload increases your risk for getting several diseases:
Being tired and joint problems are the most commonly experienced symptoms...
Please observe that many iron deficiency anemia and overload symptoms overlap - testing is thus key (a point I'll keep re-emphasizing).
So what's the catch?
Even in developed countries like the US iron is actually a massive problem.
Let me convince you with some statistics:
1 million Americans have a strong genetic predisposition of excessive iron accumulation in their bodies. Roughly one in 8-10 Americans also carry the gene that puts them or their children at risk for iron accumulation.
15 million Americans, moreover, are currently living with excessive iron levels.
You can assume that these numbers are roughly the same if you're living in Northern countries, as Caucasians carry the biggest risk for the aforementioned genetic predispositions.
How many people do you know who are aware of their body handles iron?
Let me guesstimate: 1% of your acquaintances?
Those percentages lead me to a simple logical inference:
According to the statistics, at least 8% are at risk, meaning that only 1 in 8 is aware of how their body handles iron - that's far too little.
While I'm not considering all negative health effects of iron overload in this blog post, let's zoom in on a single very important side-effect: "insulin resistance".
Opinions differ as of why cells don't take up that glucose anymore. One explanation is that insulin no longer does it job, so that glucose remains the bloodstream and cannot be transferred to the cells.
Another explanation is that the cells are already filled up with glucose, and that glucose is not properly used within these cells, which ensures that most glucose remains in the bloodstream.
Many indications exist that iron overload decreases the cell's ability to take up carbohydrates.[350; 351; 352; 353; 354; 355] The relationship between increased iron stores and insulin resistance seems linear in many studies.
In other words, the higher your iron stores, the lower your cell's ability to process carbohydrates (sugars).
Now, the main problem is that insulin resistance and/or diabetes both increase your risk for several other diseases, such as heart and blood vessel problems, brain disease (such as Alzheimer), increased inflammation, obesity, and others.[356; 357; 358; 359; 360; 361; 362; 363]
You'll thus want to prevent insulin resistance if at all possible.
Want more proof of the relationship between iron accumulation and insulin resistance?
Astounding fact: blood donations and blood transfusions (e.g. a decrease or increase in iron-rich blood) instantly affects that insulin resistance.
Insulin resistance immediately decreases after a blood donation--transfusions generally have the opposite effect.[365; 366] A straightforward relationship between excess iron and insulin resistance thus exists.
Summary of the previous sections: how you manage your iron status can thus have an enormous effect on your overall health. Joint health, overall metabolism, energy, brain functioning, and the handling of oxygen are all adversely influenced by iron deficiency or overload.
In the next section, you'll learn more about the benefits which optimal iron status can confer upon your health.
Finally arriving at iron's benefits...
So let's consider what all that hassle was all about.
You now know all about iron deficiency and overload, but not yet about what massive benefits optimal iron levels can have...
The following section hopefully convinces you that optimal iron levels in your body are worth having.
Let's grab the keys to the kingdom...
Keep in mind that you get all the benefits listed below with neither a deficiency nor an iron excess, and thus exclusively with optimal iron levels. Iron:
Many cells of your immune system are dependent on iron, such as "macrophages", which destroy pathogens, "lymphocytes", which act as a defense in your lymph system, and "monocytes", which are a type of white blood cell.
Let me explain:
A harmful substance such as a virus or bacteria may enter your nose, gut, or skin, and trigger an immune response. That immune response is only adequate if immune cells contain the right amount of iron.
As a result of sufficient iron in these cells, for example, the body can protect itself against infections. Without sufficient iron you'll be more susceptible to diseases such as tuberculosis or malaria.
Hence eat some meat to keep your immune system strong...
Moving on again:
Improving the availability of oxygen will help almost any process in your body, either directly or indirectly.
The "energy powerhouses" of your cells, called "mitochondria", straightforwardly use the oxygen that you breathe in. Iron is also in those mitochondria. Without sufficient iron, mitochondria can thus not properly function, and oxygen cannot be used correctly.
As a result, iron has a huge effect on your athletic performance. The more athletic activity you engage in, especially endurance sports, the greater the number of red blood cells your body contains. Your overall endurance also increases with sufficient iron.
Having more red blood cells entails that you've got more iron stored in your blood.
But let's look at the flipside of the equation: blood donations can lower your exercise capacity if your iron levels are barely sufficient. If you go too far in donating the opposite effects thus occur: remember that shortness of breath is a common symptom of having low iron levels, which is indirectly caused by having lower oxygen levels.
With excessive blood donations, maximum power output (your explosiveness as an athlete) and maximum oxygen consumption can take weeks to fully recover. Replenishing to sufficient iron levels achieves reverses that effect.
The bright spot is that you can have increased performance the next day if you ingest adequate iron after having a deficiency. You'll learn about that strategy in a later section.
Yes, shocker! Hair, skin, and nail growth are all affected by iron in your body.
With sufficient iron, you'll have normal hair growth, for example. Low iron levels may even play a role in premature hair graying. Hair loss may also result of iron deficiency, which is cured by getting your iron levels up.
How about skin health?
You probably know about the effects of iron in that case: remember those pale looking people?
While pale skin is a very poor predictor of iron deficiency anemia, lots of people with anemia do in fact have pale skin. Because of lower hemoglobin levels you'll have discolored skin with anemia. Lower hemoglobin causes less oxygen to be present in the skin.
With sufficient iron levels, on the contrary, you'll have a glowing pink skin that looks really healthy.
Iron is also required for proper wound healing, moreover. Iron deficiency, on the contrary, is just one of the reasons of slow wound healing.
Nails, lastly, are affected in their shape through the iron status of your body. Unfortunately, the effects of iron on nail health are not studied well yet, although a deficiency will cause problems.
Next, a benefit everyone loves:
So that's it, the full list of benefits you'll get when your body has optimal iron levels.
In the next installment of this blog post series, you'll learn how to manage your iron status through your food intake, and how different foods affect that process.
Hopefully you're now fully convinced your iron status matters a lot for your health. For that reason, I'll continue this blog post series where I left off today. The next installments cover the topics of:
If you want toknow your iron status right now, then read my second installment of this series about lab testing. If you're not insured, getting to know your iron levels will cost you around $100 USD at most.
The next blog post will also teach you how to eat the right foods to prevent deficiency and overload, and, give you strategies to manage your levels easily!
This is a post by Bart Wolbers. Bart finished degrees in Physical Therapy (B), Philosophy (BA and MA), Philosophy of Science and Technology (MS - with distinction), and Clinical Health Science (MS), and is currently a health consultant at Alexfergus.com.
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