Feeling Tired And No One Knows Why?

By Dr. W. Gifford Jones

October 13, 2002

I'm so tired. Could it be that my blood is low? I can't count the number of times I've been asked this question. Sometimes the query is right on and iron is needed for anemia. But for patients suffering from "hemochromatosis" (iron overload), a prescription for iron is a death sentence. Now a genetic test identifies those with this disease.

Trosseau, a French physician, first described a patient with iron overload in 1865. At that time hemochromatosis was considered a rare disease. Now one and a half million North Americans carry this abnormal gene, about one in 250 people.

Hemochromatosis is most commonly seen in people of North European descent. Males are five times more likely to develop it than women. And men suffer the symptoms of iron overload at an earlier age.

But for years the great problem has been the failure to diagnose iron overload at an early stage. It's been aptly said that what one looks for one finds. The problem is that doctors failed to think about the possibility of this disease. It meant that patients visited several doctors before the diagnosis was made. And by this time organs had developed iron rust and were beyond repair.

Excess iron in the system can cause damage to many body organs. It can destroy the pancreas causing diabetes. Years ago hemochromatosis used to be called "bronze diabetes". Excess iron deposited in the skin caused a bronze pigmentation.

Too much iron can infiltrate the heart muscle resulting in congestive heart failure. It can penetrate joints triggering arthritis. Or it can destroy the liver causing cirrhosis and cancer. And if male gonads become rusty from excess iron hypogonadism results.

But with so many laboratory tests being done today how can doctors miss the diagnosis? Some physicians believe they're measuring iron when the order complete blood counts. But to detect iron overload doctors must check the blood level of serum ferritin.

Chronic unexplained fatigue is one of the most common symptoms of this disease. But iron overload should be suspected if there's depression, mood swings, a strange black-and-blue colour in the legs, loss of body hair or if liver enzymes are abnormal.

Arthritis is also a common problem involving the knuckle and first joints of the first two fingers. Men often notice a loss of sex drive or impotence. Women are more likely to have scantly periods or early menopause.

Our bodies contain about 4,000 milligrams (mg) of iron. Half of this is present in the hemoglobin in red blood cells which carry oxygen to tissues.

We all need iron to survive. Every day we consume 10 to 20 mg of iron in our diet. But we only require one mg. A little goes a long way. This same amount is lost daily from shedding cells from the surface of the skin, bowel and urinary tract.

"Intestinal balance" normally protects us from iron overload. The bowel absorbs what is needed and discards the rest in feces. This intestinal balance breaks down when patients inherit a faulty gene. The body absorbs more iron than the body needs. And unlike other nutritional substances iron in these patients has no way of being excreted from the body.

Trapped iron rusts out body organs. They become scarred, shrivelled and take on a brownish, rusty colour.

It's estimated that 98 percent of people with iron overload are not diagnosed. This is tragic as a serum ferritin blood test would pinpoint such cases. A genetic test would confirm the diagnosis and early treatment save lives.

Today the treatment of hemochromatosis may seem initially to be a return to medieval medicine. But the frequent removal of blood is the only way to rid the organs of excess iron. The rationale is simple. Removing blood also takes away iron. And as the blood level of iron decreases iron must be withdrawn from the body's organs to make new blood.

Today many North Americans take a daily multivitamin pill that contains iron. Since more people suffer from iron deficiency than iron overload it's not generally a problem. Bit if you're one in 250 with a defective gene taking vitamin pills that contain iron is hazardous.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod