Why Everyone Should Test Their Iron Metabolism

Quite a few people coming to see me tell me they are taking iron supplements for fatigue.  Have you been diagnosed with iron-deficiency anaemia or done any iron level tests? I ask. No, they reply, I just thought it would help me feel better. Taking iron supplements is a risky strategy because iron metabolism is more complex than you may think. You may do some serious damage if you don’t need them. This is like shooting in the dark when you don’t know what your biochemistry is doing. Getting it wrong can cause a lot of tissue damage and may even help to trigger a disease process like Alzheimer’s or cancer.

When iron metabolism goes wrong

There are two key players inside your body that directly influence your health for better or for worse: copper and iron. If you are chronically fatigued, you may be suffering from iron dysfunction, as well as infection and inflammation. It is important to realise that there is an enormous difference between the iron circulating in our blood versus the iron deposited in organs and tissues. Circulating iron is the ideal state for iron. When iron builds up in your tissues, it triggers stress, inflammation and tissue damage. Iron build-up in the brain is a contributing factor to neurological diseases like Alzheimer’s. Iron also feeds cancer cells.

Copper regulates iron

The mineral that helps iron get to where it has to go is copper. If copper is missing in action, iron gets stuck in your tissues and is less likely to show up in your blood. This can register as anaemia. Therefore, it is useful measuring iron stores (ferritin) as well as serum iron.  It is worth knowing that iron in the tissues can be up to ten times the amount of iron in the blood. Iron accumulation in tissues is caused by lack of bioavailable copper which in turn is caused by lack of the protein which transports copper round the body like a taxi - caeruloplasmin.  In short, if you don’t have access to the caeruloplasmin taxi that feeds copper to the energy-producing parts in the cells (mitochondria), the result is a general breakdown of energy.  

Copper researcher Morley Robbins likens this process to food preparation in a kitchen. The real action happens in the copper-directed “oxygen kitchen” of the mitochondria. Copper harnesses oxygen like a chef using ingredients to make a meal.  Iron is the transporter for the oxygen, like a waiter carrying the meals to the diners. Lack of copper and iron that you use for making energy results in lack of oxygen (hypoxia). This increases a substance known as Hypoxia Inducible factor-1 alpha (HIF-1 alpha) which ramps up inflammation, and that is always a bad thing.

The Fenton Reaction

This is why you should always test before supplementing with iron. If your test results indicate that this is the right thing to do, you should make sure that your glutathione status is robust enough to offset the pro-inflammatory and pro-oxidative effects of iron which turns on a chemical reaction in the body known as the Fenton reaction, which yields yet more oxidative stress. Glutathione is the body’s master antioxidant (think inflammation quencher) and I always prescribe this when repleting low iron levels.

Hereditary haemochromatosis

Hereditary haemochromatosis (HH) is an inherited condition where iron builds up in the tissues over the years and causes toxic damage to organs. It can be life threatening. It is a lot more common than I realised before I began seeing it in the clinic.  A lab director told me around 10% of the pollution may have HH. The condition is picked up on iron metabolism lab markers. In this case, it is essential to get iron down by phlebotomy to bring down the iron saturation level. Once again, I prescribe Glutathione plus N-Acetyl Cysteine (NAC) to protect the glutathione from being broken down for cysteine in cases where the patient is cysteine deficient.

What tests should everybody do? 

Not everybody has good discernment about how their body feels. They may be used to pushing through the pain. So I would advise everybody to access the simple and inexpensive blood tests below as part of a routine health check, especially if suffering from fatigue:

• Serum iron

• Ferritin

• Transferrin saturation

• Copper

• Caeruloplasmin

• Red cell magnesium

• Glutathione

If you would like to check your iron metabolism, please email the Good health Clinic on goodhealthclinic@outlook.com or ring on 07836 552936.