Do You Have Too Much Iron?

February 22, 2001

THURSDAY, Feb. 22 (HealthScout) -- You might be in your Geritol years, but do you really need to take extra iron?

Chances are, the answer's no. In fact, new research finds more elderly Americans have too much iron in their blood instead of not enough -- the opposite of what's found in most of the rest of the world where iron deficiency is common.

But what too much iron in the blood means is far from clear.

"There is a raging controversy at the moment about whether high iron stores are a risk factor for cardiovascular disease, colon cancer and diabetes. Some studies have shown an association, but others have not. It's something we need more information about," says Dr. Richard Wood, a Tufts University nutrition expert and co-author of the latest study, which appears in this month's American Journal of Clinical Nutrition.

Wood and his colleagues analyzed blood iron levels in more than 1,000 men and women, aged 67 to 96, who are in the Framingham Heart study, a landmark, long-term look at various health issues.

Three percent of the subjects had abnormally low iron levels, as measured by circulating ferritin (an iron-rich protein), hemoglobin and other gauges. But nearly 13 percent had too much of the mineral -- more than 300 micrograms per liter of blood for men, and more than 200 micrograms per liter for women.

Because chronic diseases, especially inflammatory ailments like arthritis, are known to lower a person's iron levels, Wood's group focused on 182 people with these conditions. They found that though their symptoms mimicked anemia, their conditions weren't caused by too little iron intake. Among the 182 people, the risk of too much iron in the blood was 1.5 times higher than for study as a whole. And the risk of anemia was 2.6 times greater than average, though most was attributable not to low iron intake, but to poor production of the red blood cells which carry the mineral.

An estimated one in 300 people in this country have a genetic disorder called hemochromatosis in which the body builds up too much iron. The disease is linked to a wide range of serious health problems, including diabetes, cirrhosis of the liver, arthritis, heart failure and liver cancer.

Another one in 10 Americans carry a single copy of the mutant iron gene, which causes them to hoard iron. "What the health effects of that condition are is unclear," Wood says.

Dr. Jerome L. Sullivan, an iron expert at the University of Florida, proposed in the early 1980s that getting rid of stored iron protected the heart and might help explain why heart attacks are so rare among menstruating women.

Sullivan says the latest findings likely won't surprise many researchers who've come to believe that too much iron is a more serious problem in the United States than iron deficiency. Elsewhere in the world, the opposite is clearly the case.

"This is a view that is held by a number of people already," says Sullivan. While problems result from either extreme, he says no one knows what level of stored iron is harmful.

"Really rather low levels of stored iron may promote heart disease both in the elderly" and younger people, he says.

What To Do

The National Academy of Sciences recently announced new vitamin and mineral intake guidelines, which recommend that men and post-menopausal women get at least 8 milligrams a day of iron. Younger women should get at least 18 milligrams per day.

The latest work doesn't challenge that recommendation, at least not yet, Wood says. "There have been some studies which have suggested that excess iron is related to chronic diseases. If it were true, it would be of concern, but I'm not sure that everyone agrees," he says.

"General advice on iron levels is probably always misplaced," says Sullivan.

"Iron levels should be apprised on an individual basis. People would be best advised to find out what their iron level is rather than stopping iron supplements or starting to take them," he says. Your doctor should be able to order the test.

To learn more about hemochromatosis, visit the Centers for Disease Control and Prevention. For more on iron deficiency, try the University of Maryland Medicine.

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