The other side of an iron problem: Hemochromatosis
Yes, many thyroid patients find themselves with too low levels of iron, causing issues with raising NDT or T3. Read the NDT doesnt work for me page to understand this issue.
But a small percentage of patients might find themselves with the opposite problem—very high levels of both iron, % saturation AND ferritin. All three. And one main reason is called Hemochromatosis, a genetic issue which can cause iron overload.
So my first clue for Hemochromatosis is in iron tests?
Yes! We’ve noticed that those with hemochromatosis will tend to be high in ALL THREE iron labs i.e. serum iron, % saturation and ferritin.
How did I get this?
Hemochromatosis is an inherited disorder, i.e. if you have it, it’s highly likely you have ancestors with it. It’s also said to occur mostly in Caucasians.
Are there symptoms?
Not always. You might have few if any symptoms for awhile. But symptoms could then appear, such as darkening of your skin, fatigue or weakness, liver problems revealed by labs, heart issues such as an irregular heartbeat, joint pain. Some even report stomach pain.
And this abnormal accumulation of iron can be very dangerous if not discovered, lowered and kept in check. It will usually over-accumulate in your joints, heart, liver, pituitary…and in men, the testicles.
What is a more definitive test for my doctor to diagnose it?
Genes involved in having the Hemochromatosis mutation are C282Y and H63D, with the former, i.e. C282Y being the most common. From http://www.medicinenet.com/iron_overload/page3.htm:
A C282Y homozygote is a person who has inherited one mutated C282Y gene from each parent. A C282Y homozygote is considered at risk of developing iron overload. In fact, C282Y homozygotes account for 95% of all hereditary hemochromatosis. Conversely, not every C282Y homozygote develops iron overload. Studies have shown that an estimated 50% of C282Y homozygotes may not develop iron overload or its complications.
A C282Y/H63D compound heterozygote is a person who has inherited one mutated C282Y gene from one parent and a second mutated H63D gene from the other parent. Most compound heterozygotes have normal iron levels though some can develop mild to moderate iron overload.
A C282Y heterozygote is a person who has inherited one mutated C282Y gene from one parent but a second normal HFE gene from the other parent. Children born of two C282Y heterozygotes have a 25% chance of being a C282Y homozygote and, therefore, will be at risk of developing hemochromatosis. A C282Y heterozygote does not develop iron overload.
Could I have had this a long time?
Yes, Some individuals could go decades without even knowing they have this problem if they never tested iron, making it all the more dangerous. It could lead to liver cirrhosis and an increased risk of developing cancer in your liver, say experts.
For a more definitive diagnosis, a doctor may order a biopsy of your liver i.e. the removal of tissue which will be tested. But simply doing genetic testing can reveal it.
How do I treat hemochromatosis?
Your doctor will recommend simply giving blood, called phlebotomy, and can occur every few months to keep your iron levels under control. Patients are often told to avoid Vitamin C, since it increases iron absorption.
***This is also why it’s recommended on the iron page to never go longer than 4 weeks without retesting your iron levels…just in case you have this disorder and you send your iron levels too high!
What if only my iron and % saturation are high, and ferritin is low?
That may not be hemochromatosis. Having a MTHFR or other methylation mutation can cause iron to go too high, but usually it’s just serum iron and % saturation that’s high with this mutation, while ferritin is low. It puts us in a low iron state, because with the mutation, we aren’t breaking the iron down for use.
To read about BOTH hemochromatosis vs MTHFR, go here.