Dr. Sinatra

Iron is necessary throughout life for stimulating the production of hemoglobin, the red blood cell pigment that carries oxygen to our cells. Without it, we couldn’t survive. And growing children and menstruating women do need to be mindful of their iron consumption.

However, newer research indicates that iron overload, or hemachromatosis, is one of the heart risk factors you need to be paying attention to.

Hemachromatosis is an acquired or hereditary defect of iron metabolism in which excess iron is deposited in tissues and not available for oxygen transport. Iron is stored in muscles and other tissues, and unless it is lost through menstruation or donating blood, over the years toxic levels can accumulate in your system.

No one is yet sure exactly how elevated levels of iron contribute to heart disease, but researchers have a number of ideas. In the early 1980s, Jerome Sullivan, a pathologist, noticed that women who had undergone hysterectomies had increased incidence of heart disease. He suggested that if losing blood protected menstruating women from heart disease, men donating blood might also have similar protection. Sullivan’s findings, published in Lancet in 1981, were years ahead of their time, yet his theories have been accepted only recently.

A 1992 Finnish study examined the role of iron in coronary artery disease. After studying 1,900 men ages 42 to 60 for five years, researchers found that those with excessive levels of ferritin were more than twice as likely to have heart attacks, and that every one-percent increase in ferritin translated into a four percent increase in heart attack risk.

Women and Iron

Half of American women will die of cardiovascular problems such as heart attack and stroke. Yet risk levels among women vary tremendously. Menstruating women produce estrogen, which is heart protective, and most lose a significant amount of iron in the blood each month. This can add up to 400–500 mg of ferritin iron per year (about equal to two pints of blood).

In contrast, postmenopausal women are four times more likely to have heart attacks. Not only do they lose the protection of regular menstrual iron depletion, their levels of ferritin begin to rise steadily after menopause, more than doubling between 55 and 65, and even more after that.

Are You in a State of Iron Overload?

Ten percent of American adults may carry the gene for hereditary hemochromatosis. Physicians are often perplexed by their symptoms of fatigue, abdominal pain, organ failure, immune dysfunction, skin bronzing, irritable bowel syndrome, menstrual irregularity, hair loss, and explosive diarrhea. Many people have such symptoms for years but iron overload is not diagnosed until years of damage have taken place.

CAUTION: If you complain of fatigue to your doctor, he or she might prescribe iron, which is the last thing you need! If you are already in iron overload, this can be dangerous. So before you take iron supplements, insist that your physician order up a special iron test called a serum ferritin. If your serum ferritin level is greater than 120, you need to take steps to reduce it. In addition, if two other parameters of iron measurement—serum iron binding capacity and serum iron—are elevated, you have iron overload or hereditary hemochromatosis.

The Dr. Sinatra Solution

1. Know your serum ferritin level. Women of child-bearing age should have ferritin levels roughly between 15 and 45. Men and postmenopausal women should be between 50 and 120. If your levels are over 120, reduce iron in your diet. If levels are over 200, donate blood at least two to three times a year.
2. Cut iron consumption. Remember, red meat is loaded with iron and high quantities of saturated fats and cholesterol. Be aware of “iron fortified” grains and cereals, and avoid any that contain more than 25 percent of the RDA of iron.
3. Do not take multivitamins fortified with substantial doses of supplemental iron.
4. Do not use iron cookware unless you are iron deficient.
5. If you are in an iron overload situation, do not take more than 300 mg of vitamin C per day. Vitamin C can enhance the absorption of iron and become a pro-oxidant rather than an antioxidant.
6. Have your water supply assessed for environmental toxins as well as iron. Iron is ubiquitous in vitamin/mineral preparations and foods, as well as in our water supply. Consider a water filter.