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Lurking pandemic - Hemochromatosis.

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    #92
    El_Dangeroso
    Users Awaiting Email Confirmation Posts: 5,620 ✭✭✭El_Dangeroso


    Tree wrote: »
    You can absorb a maximum of 3mg of iron a day afair, can't find the ref. It's been estimated a max of 10% of food iron can be absorbed. But the mechanism for transporting iron can be saturated, that's why teh 3mg ish max can happen. (there's active transport across the duodenal villi and even those cell can handle a certain amount of iron before they give up and slough off into the gut).

    Srai, SKS., Bomford, A. & McArdle, HJ. (2002) Iron transport across cell membranes: molecular understanding of duodenal and placental iron uptake. Best Practice & Research Clinical Haematology, 15, 243-259 might be the relevant link. Just had a look at a lit review i did last year.

    I can't get the fulltext of that paper, can you highlight where it says 10% was the max absorption, as everything else I've read says that's the average, with the body absorbing more if it needs more.

    http://bloodjournal.hematologylibrary.org/cgi/reprint/84/6/1697.pdf
    There are situations in which larger amounts of dietary
    iron are absorbed than can be attributed to the store-regula-
    tor. For example, phlebotomized subjects on a normal diet
    have been shown by balance studies to replace 3 to 4 mg of
    iron loss in addition to their excretory loss. 31, 32

    Even if 3mg iron a day is the saturation point in some people people but I don't see how absorbing more is a survival advantage? Unless of course the bacterial or parasitic hypothesis of haemochromatosis is true. Or possibly if a lot of blood loss was commonplace.

    The low-dietary iron theory just doesn't seem like a realistic explanation to me.


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    #93
    Tree
    Moderators, Science, Health & Environment Moderators Posts: 4,679 Mod ✭✭✭✭Tree


    you dont normally absorb at the saturation rate, you only aborb 1to2mg for losses. You only absorb at the maximal saturation rate if your regulation is gandered (haemochromatosis) or if you have higher than normal losses (bleeding/being female).

    There's no beneifit to absorbing excess as there is no excretory mechanisms to counteract the toxicity. So the absorbtion mechanism is generally tightly controlled.

    Also, that 10% is an estimate. It would vary w/ diet, but that's assuming 30mg of iron in the daily diet. Dont have time to be pulling information out of that ref, sorry.


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    #94
    El_Dangeroso
    Users Awaiting Email Confirmation Posts: 5,620 ✭✭✭El_Dangeroso


    Tree wrote: »
    you dont normally absorb at the saturation rate, you only aborb 1to2mg for losses. You only absorb at the maximal saturation rate if your regulation is gandered (haemochromatosis) or if you have higher than normal losses (bleeding/being female).

    There's no beneifit to absorbing excess as there is no excretory mechanisms to counteract the toxicity. So the absorbtion mechanism is generally tightly controlled.

    Also, that 10% is an estimate. It would vary w/ diet, but that's assuming 30mg of iron in the daily diet. Dont have time to be pulling information out of that ref, sorry.

    Yeah, but that's what I'm saying, the absorption method is tightly controlled in those without HC, so where's the evolutionary advantage to losing that tight regulation as is the case with HC? I'm not saying it can't be the case, these are all guesses after all, but I really doubt low dietary iron is the most parsimonious hypothesis given the facts we do know.


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    #95
    Worztron
    Registered Users Posts: 8,666 ✭✭✭Worztron


    If someone was a vegan or vegetarian and discovered that they had haemochromatosis, would that be advantageuos to them?

    Mitch Hedberg: "Rice is great if you're really hungry and want to eat two thousand of something."



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    #96
    Tar.Aldarion
    Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 60,082 Mod ✭✭✭✭Tar.Aldarion


    Worztron wrote: »
    If someone was a vegan or vegetarian and discovered that they had haemochromatosis, would that be advantageuos to them?

    My doctor suggested vegetarianism to me when I was diagnosed, I already was one. It would be since you may eat less iron than people that eat meat, then again a vegan or vegetarian could eat more iron, it just depends what they eat. In general I'd say it could turn out handy.


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    #97
    maninasia
    Registered Users Posts: 4,615 ✭✭✭maninasia


    taram wrote: »
    Out of curiosity, why? I'm a carrier, and I always have high iron when I donate blood, or have blood tests: I'm also a veggie who doesn't eat a particularly high in iron diet to begin with.


    I can see there are some people who are experts in this disease on here, they should be able to give a good idea as to effects on carriers. Why I say 'carriers' are the key is they usually outnumber full disease sufferers by a factor of 100s to 1000s of times (if it is the type of disease that needs two disease copies to express itself..like autosomal recessive diseases as opposed to autosomal dominant).

    In some inherited genetic diseases carriers show no effect whatsoever but in many inherited genetic diseases carriers will have a slightly different 'expression than the normal population but not enough to cause serious disease.

    Autosomal Recessive (need two defective copies for the disease to appear)
    Autosomal Dominant (only one copy of the gene can cause the disease to appear)
    http://en.wikipedia.org/wiki/Dominance_(genetics)#Dominant_and_recessive_genetic_diseases_in_humans

    Every genetic disease is different and it's hard to generalise, this one is complicated again because the ill effects don't turn up until you are older and already reproduced, so that is why I said it is also possible it is simply a 'founder effect', an unlucky coincidence of timing and nature. Since an estimated 33% of the population in Ireland are supposed to be carriers I think it was simply introduced extremely early in the gene pool in Ireland.

    Just thinking of the top of my head there may be a way to very roughly test this theory, if more people in the West of Ireland have this disease than the rest of the country.


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    #98
    BostonB
    Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    Worztron wrote: »
    Is it practically impossible for someone with haemochromatosis to become anaemic?

    I know someonw who is a carrier, and a tendancy to be anaemic.


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    #99
    Tar.Aldarion
    Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 60,082 Mod ✭✭✭✭Tar.Aldarion


    BostonB wrote: »
    I know someonw who is a carrier, and a tendancy to be anaemic.

    My mother carries it and has to take iron injections a lot etc


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    #100
    Worztron
    Registered Users Posts: 8,666 ✭✭✭Worztron


    BostonB wrote: »
    I know someonw who is a carrier, and a tendancy to be anaemic.

    But they are only carriers and don't have haemochromatosis, therefore they wont suffer from iron overload.

    Mitch Hedberg: "Rice is great if you're really hungry and want to eat two thousand of something."



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    #101
    BostonB
    Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    From what I've read it would be unusual but not impossible. Any carriers I know have their iron monitored.


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    #102
    Bottle_of_Smoke
    Registered Users Posts: 9,770 ✭✭✭Bottle_of_Smoke


    Worztron wrote: »
    Is it practically impossible for someone with haemochromatosis to become anaemic?

    Typicially yes. Obviously if they were being starved or given an iron free diet or some other mad reason it might be possible but if you were eating enough or a bit less food than neccesary it would be quite a challenge to become anaemic with haemo


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    #103
    Worztron
    Registered Users Posts: 8,666 ✭✭✭Worztron


    I went to get tested yesterday. I went to my doctor after a 12 hour fast. I'd though he would do the blood test (my father has a different doctor but took the blood test for him) but he gave me a form to take to the hospital. He wrote on the form for other tests such as Glucose, Lipids, LFTs, FBC, etc. He said that it was not for the haemochromatosis that I had to fast for but the other tests. When I got to the hospital, the nurse said they could not test for haemochromatosis because it is a hereditary condition (WTF? I don't see why that should matter). The nurse was very nice though and she is just following 'guidelines' from the incredibly stupid HSE. She took the blood tests for the other things.
    Now I need to go back to the doctor to tell him what the HSE should have informed him about. No wonder the so called health service is in tatters.
    I do feel sorry for the nurses as they do work extremely hard. Shame on Mary Harney.

    Mitch Hedberg: "Rice is great if you're really hungry and want to eat two thousand of something."



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    #104
    Tar.Aldarion
    Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 60,082 Mod ✭✭✭✭Tar.Aldarion


    Then where are you supposed to get tested? i did in some medical centre place, who also did all the other tests.


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    #105
    BostonB
    Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    I thought they did it though a blood test. Its probably a specific test outside the normal routine though. I can't remember.


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    #106
    Tar.Aldarion
    Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 60,082 Mod ✭✭✭✭Tar.Aldarion


    there are blood tests and DNA tests I think. Not usually part of the routine but people should have it tested really, as it is fairly common


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    #107
    huggs2
    Registered Users Posts: 471 ✭✭huggs2


    Tar.Aldarion wrote: »
    there are blood tests and DNA tests I think. Not usually part of the routine but people should have it tested really, as it is fairly common

    There are 2 blood tests that are needed to make a diagnosis of haemochromatosis, these are Serum ferritin which measures the level of iron in your blood and also Serum transferrin saturation which should be less than 45%.When i was diagnosed at age 58 i had a saturation level of 98% and serum ferritin of 2580.( should be approx. 50 to 250 i think)


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    #108
    Tar.Aldarion
    Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 60,082 Mod ✭✭✭✭Tar.Aldarion


    Very high! This is why people should be tested at an early age, I was diagnosed as a teenager and can keep an eye on it.


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    #109
    Worztron
    Registered Users Posts: 8,666 ✭✭✭Worztron


    Tar.Aldarion wrote: »
    Then where are you supposed to get tested? i did in some medical centre place, who also did all the other tests.

    I will have to back to my doctor and tell him that he must take the blood sample and arrange it with Dublin (the only place they will test it is up in Crumlin). We have a totally inefficient health service.

    Mitch Hedberg: "Rice is great if you're really hungry and want to eat two thousand of something."



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    #110
    BostonB
    Closed Accounts Posts: 18,056 ✭✭✭✭BostonB


    I thought I was tested Blanch. But can't remember now. I doubt my GP did it.


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    #111
    Worztron
    Registered Users Posts: 8,666 ✭✭✭Worztron


    I got blood taken on Tuesday the 8th March for Glucose, Lipids, LFTs, FBC, etc. Is it okay if I get blood taken today for haemochromatosis? And thanks to huggs2 I now know that 2 tests are required.

    Mitch Hedberg: "Rice is great if you're really hungry and want to eat two thousand of something."



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    #112
    huggs2
    Registered Users Posts: 471 ✭✭huggs2


    Worztron wrote: »
    I got blood taken on Tuesday the 8th March for Glucose, Lipids, LFTs, FBC, etc. Is it okay if I get blood taken today for haemochromatosis? And thanks to huggs2 I now know that 2 tests are required.
    '

    Alot of you questions can be answered here.

    http://www.mayoclinic.com/health/hemochromatosis/DS00455

    see "Preparing for your appointment" in your case.


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    #113
    huber
    Registered Users Posts: 54 ✭✭huber


    I've just started having blood taken as I've been recently diagnosed with Haemochromotosis, I've had 5 lots taken off in last 2 months, but now after blood test I've been told that I have to get a prescription and go on folic acid replacement tablets for 3 months. Anyone know why this is? Am I now anaemic?


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    #114
    sam34
    Closed Accounts Posts: 8,073 ✭✭✭sam34


    huber we don't allow discussion of personal medical situations here. you should ask your doctor for advice.


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    #115
    cnarf
    Registered Users Posts: 10 ✭cnarf


    You have had a lot of blood taken. Folic Acid is needed for the production of new red blood cells which will also use some of your excess iron. Keeping your red cell count up makes it safer to continue giving blood and reduce your iron concentration.


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    #116
    tyview
    Registered Users Posts: 210 ✭✭tyview


    My mothers parents both have haemochromatosis, my grandmother died from it at 67 after self medicating for what she though was anaemia. My mother is one of 9, all of whom except her have it. I haven't met my biological father so I don't know if there is any history on his side. I get regulare bloods done for hypothyroidism and last week asked for my iron etc to be done too. The nurse rang me back today to say that my iron levels are normal (last yr they were below normal), my ferritin was normal (last yr below normal) and my transferin was high (last yr normal).

    With the history, I'm considering getting the test for it but I was wondering how much it cost and where it can be done? (the nurse wasnt sure)


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    #117
    Chuck Stone
    Closed Accounts Posts: 13,030 ✭✭✭✭Chuck Stone


    My Dad was diagnosed and treated for this recently.

    Think I'll get a blood test just to be on the safe side.


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    #118
    FD1973
    Registered Users Posts: 17 ✭FD1973


    Anybody have any idea on costs regarding the genetic test? I have to get it done on advice from my GP due to two sets of blood samples testing resulting in high iron content. He told me the costs are 'considerable'.....


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    #119
    huggs2
    Registered Users Posts: 471 ✭✭huggs2


    FD1973 wrote: »
    Anybody have any idea on costs regarding the genetic test? I have to get it done on advice from my GP due to two sets of blood samples testing resulting in high iron content. He told me the costs are 'considerable'.....
    When my doctor found i had high readings i was refereed to a consultant (gastroenterologist) where he decided i needed to have a gene test and this was free to me. There are a lot of things to consider when going for a test so you do need to have a discussion with your consultant.You don't mention you age or readings or sex.


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    #120
    locum-motion
    Registered Users Posts: 5,143 ✭✭✭locum-motion


    FD1973 wrote: »
    ... He told me the costs are 'considerable'.....


    I find that surprising. When I was diagnosed, I was told that Haemochromatosis care is free in Ireland. I've never been asked for a cent.


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    #121
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    locum-motion wrote: »
    I find that surprising. When I was diagnosed, I was told that Haemochromatosis care is free in Ireland. I've never been asked for a cent.

    +1 Apart from GP's fee's if you are a private patient the care and testing is free. Certainly my experience of the blood testing (in North County Dublin) is that there is no great cost involved.


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