Iron is essential not only for proper hemoglobin function but also for the production of cellular energy, immune function, and brain function. It is especially important for learning and memory in growing children. Iron supplementation may also be necessary in endurance athletes, pregnant women, those taking arthritis medication regularly, and for those taking an aspirin a day. Later in life, it becomes less essential. Low iron levels are known to increase the likelihood of infection and can increase the generation of free radicals in tissues. Low levels are also responsible for poor wound healing.
Because of the problem of anemia, especially in premenopausal women, the government, in all its wisdom, decided to force by law, beginning in the late 1970s, the fortification of certain foods with iron. These include all grains and pasta products. Unfortunately, they seemed to have ignored the expanding medical literature demonstrating the harmful effects of too much iron, especially in the elderly and those with cancer and neurodegenerative diseases. Even Sweden, which was one of the first countries to require iron fortification of certain foods, repealed their rule in 1995 when studies indicated that iron was responsible for a significant increase in liver cancer in women.
We know for instance, that even high normal levels of iron increase tumor growth.459 Also, during bacterial and viral infections, iron supplementation can promote the growth of these organisms, making treatment difficult. I know of many doctors who give iron supplements to patients who have severe infections.
We also know that iron plays a major role in degenerative diseases of the nervous system, as well as aging of all tissues.460 At one time it was thought that only free iron was the culprit in these disorders, but new evidence indicates that even iron bound to ferritin can be harmful. Ferritin is a special protein that binds iron in the tissues in an attempt to prevent harm caused by free iron. It works very efficiently at lower iron levels, but is impaired when iron levels in the body are too high.
Recent studies have found that elevated iron levels are associated with all neurodegenerative diseases. This is especially true of Parkinson's disease, where iron accumulates in the substantia nigra nucleus as an early event.461 In the presence of the pigments neuromelanin (found in the substantia nigra) and 6-hydroxydopamine (a metabolite of dopamine), iron is especially harmful.462 This mixture produces a large amount of the free-radical precursor, hydrogen peroxide, which eventually destroys neurons, producing the same pattern of destruction seen in Parkinson's disease. There is even some evidence that people destined to develop Parkinson's disease have a defect in iron metabolism.
As we age, we accumulate more iron. The importance of this observation is demonstrated by the fact that men are four times more likely to suffer a coronary heart attack than premenopausal women at age forty-five years. At this age, men have iron stores four times higher than women. Further, men with higher iron levels have heart attack rates two times higher than men with lower levels. In both men and women, iron stores peak between age forty and sixty years.
For this reason, iron intake after a certain age should be substantially reduced. For men, that should be around twenty-five years of age, and for women, after menopause. It has even been hypothesized that women have lower incidences of heart attacks and strokes before menopause because of regular iron loss resulting from menstruation.463 After menopause, women accumulate iron at a rate that exceeds men's—and develop heart attacks and strokes at a rate equal to men. This does not mean you should never take iron. There are actually conditions for which iron supplements are recommended, but anyone on such a program should be carefully tested and monitored.
I have seen numerous women treated by doctors who assume that all anemia in women is due to iron deficiency. As a result, and as is often the case, iron supplements were hastily given—with no tests for iron levels beforehand, and no monitoring during treatment whatsoever. I have even seen women who took iron for years before coming to me, whose doctors had never ordered follow-up studies to test their iron levels. This is a very dangerous practice, especially in the elderly, who are already accumulating too much free iron.
In addition to neurodegenerative disorders and cancer, several other diseases put people at an especially high risk of iron injury. Anyone with an autoimmune disease, such as lupus or rheumatoid arthritis, should not take iron supplements unless their levels are extremely low. It is important to emphasize that rapid correction of iron levels can actually exacerbate these disorders.
Diabetics, those with degenerative eye diseases (such as macular degeneration), or severe liver or kidney diseases, should also be very careful with iron supplementation. We know that diabetics develop a 40 percent increase in retinal glutamate levels and as a result, free-radical generation and lipid peroxidation increase by 100 percent. Iron greatly increases damage associated with glutamate-induced excitotoxicity. It is also known that high iron levels are associated with a dramatic increase in cataract formation.
First, you should be tested for iron levels, iron-binding capacity, ferritin levels and transferrin saturation. If your iron level is well below normal values, you should begin taking supplements with an iron preparation. After two weeks of supplementation, the studies should be repeated. Further supplementation depends on levels at that point. I advise anyone to avoid letting iron levels reach values above the midpoint of the reference range. Once acceptable levels of iron have been achieved, supplementation should be stopped, and iron levels monitored every three to six months until they remain stable. If they will not stabilize, a through examination is called for.
Flavonoids in vegetables—and especially tea—bind to iron in tissues, protecting them from iron-induced free-radical damage. In fact, heavy tea consumption can cause iron deficiency, especially in premenopausal women. This may explain, in part, how flavonoids protect against cancer and other degenerative diseases, especially heart attack and strokes. Quercetin, rutin, hesperidin, and curcumin are especially powerful iron-chelating flavonoids, and all can be purchased from health food stores and suppliers.
It is important to note that Vitamin C can actually overcome the blocking effect of flavonoids by dramatically increasing iron absorption, and the amount that will increase absorption is quite small. For this reason, I advise taking vitamin C on an empty stomach. Usually, cells lining the intestinal wall regulate iron absorption. Large doses of iron are less well absorbed than smaller doses, especially under conditions of iron depletion. Also, animal proteins enhance the absorption of iron. This is why iron from meat, especially red meats, is much better absorbed than from vegetables.
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