Dr Clare Bailey: When your iron levels become a problem

Back in the middle ages one of the most popular treatments was blood-letting. You went to your doctor with a headache and they might have prescribed a leech or nicked a vein to draw some blood to ‘balance your humours’. Most of the time it did more harm than good, but for those with genetic haemochromatosis (GH) it would have been a lifesaver.

genetic haemochromatosis
Maite Franchi/Folio Art

GH is the most common genetic condition in those of Northern European descent, yet many people have never heard of it. Also known as ‘iron overload’ as the body stores more iron than it needs, GH affects over 250,000 people in the UK, but the charity Haemochromatosis UK says it’s massively underdiagnosed. It can cause significant disability, even though it is easy to test and treat.

GH may have evolved to enable people to absorb more iron and have healthier babies in times when food was scarce. But in times of plenty, storing too much iron can be damaging. If you have GH, iron usually starts accumulating in your body from your 30s. Iron is deposited in vital organs including the liver, pancreas and heart, as well as in the joints. Untreated, this can cause irreparable damage.

As GH leads to nonspecific symptoms it can be hard to identify. So how would you know if you have it? If you have a close relative with GH you would be advised to have testing to diagnose it early. Symptoms include fatigue, weakness and joint pain.

You may experience pain in the upper right side of your abdomen from inflammation of the liver, which increases the risk of cirrhosis or liver cancer, along with quadrupling the chance of liver disease. You are more likely to suffer from secondary diabetes, cardiomyopathy (damaged heart muscles) as well as impaired brain function and depression. It also doubles the risk of arthritis. People can also experience hair thinning or a change in skin colour, such as a permanent ‘tan’ or a grey tone.

A simple blood test to check your ‘iron stores’ and then a genetic test are used to diagnose GH. If confirmed, an MRI scan may also be carried out to check for liver damage. Early diagnosis means that excess iron can start to be removed from the body before organs are damaged. Treatments include…

Blood-letting – this may sound medieval, but removing some blood, known as a venesection, keeps iron stores at healthy limits. Any organ damage that has already occurred will need treatment and monitoring.

Reducing iron-rich foods and supplements such as high doses of vitamin C, fructose, red meat, sugar and limiting alcohol with meals as it increases iron absorption and can lead to liver damage.

Increasing foods that slow absorption of iron, such as tea, dairy products, leafy greens, nuts, wholegrains, cereals and berries.

Currently there are no formal screening programmes, despite the diagnosis often being missed or delayed. Health professionals need to be more alert to the possibility of haemochromatosis given that the test is easy, treatment is usually simple and it can save lives. So if you’re worried do talk to your GP.

A clever way to fight flu

fish
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In winter many of us are low in vitamin D and although eating plenty of oily fish, cod liver oil and mushrooms can help, without exposure to moderate levels of sunlight our reserves get depleted. This particularly applies to those with darker skin, or those who avoid sunshine.

New research shows that an important function of vitamin D is to boost your ability to fight infections and reduce inflammation. One of the ways it does this is by supporting your gut microbiome. With flu season underway this is encouraging news.

Most of us need more vitamin D at this time of year so consider speaking to your pharmacist, who can recommend a moderate top-up dose.

If you have a question you would like answered, email drclarebailey@you.co.uk