The problem of elevated iron levels in men

elevated iron levels

Let’s start with women and children first – women and children have more issues with low iron levels. About 17% of premenopausal women and 10% of children in the U.S. population are considered iron deficient.

But men are different. Men can have just the opposite of iron levels that are too high due to a genetic condition called Hemochromatosis. Also known as iron overload, this hereditary disorder causes too much iron to be absorbed during digestion of food. This excess iron will be stored in your organs, especially the liver, heart, and pancreas. As iron levels gradually build up over time, certain symptoms can appear and can lead to life-threatening conditions such as liver disease, heart problems, and diabetes.

Symptoms of hemochromatosis in men

While hereditary hemochromatosis is present at birth, most men don’t experience signs until later in life – usually between the ages of 30 and 60. Any man, who has an immediate family member (grandfather, father, brother) with hemochromatosis, should ask their doctor about genetic tests to determine if they have inherited the gene.

The most common symptoms men can experience with hemochromatosis are:

  • Fatigue
  • Joint pain
  • Weakness
  • Weight loss
  • Stomach pains
  • Skin bronzed like a suntan – visible in 70% of people with symptoms

Over time, more serious conditions may develop such as arthritis, cirrhosis and/or enlargement of the liver, diabetes, heart disease or pancreatitis.

There are a couple of other significant symptoms associated with hemochromatosis affecting men that may get overlooked:

Usually thought of as a women’s disease, men can and do get osteoporosis. Not only can men develop brittle bones, but a man with genetic hemochromatosis is significantly at risk for this disease. A 2005 study looked at men with hereditary hemochromatosis of an average age of 47 years old. Each man had two copies of the HFE gene and they also had normal markers (normal vitamin D and normal parathyroid hormone levels) for things that impact bone loss. What the study found was that 78.9% of these men had osteopenia and 34.2% had osteoporosis.

Men with genetic iron overload should have their bone mineral density tested to keep check on their bone health.

  • Loss of libido

A common symptom of men with iron overload is sexual dysfunction in the form of loss of libido, shrinkage of testicles, and erectile dysfunction. It is estimated that up to 45% of men with symptomatic hemochromatosis have sexual dysfunction symptoms.

Iron overload may affect sex drive in men if the pituitary gland becomes overloaded with iron. The pituitary gland, considered the “master gland” of the body, “talks” to all other glands telling them what to do.  An improperly functioning pituitary gland can lead to the male sex hormones not working correctly, increasing the risk of  hypogonadism, reduction of testosterone, and issues with sexual functioning.

Diagnosing hemochromatosis

Since many symptoms overlap with symptoms of other conditions, hemochromatosis can be difficult to diagnosis.  If suspected, a person should be referred to a hepatologist or cardiologist.  Two blood tests that can detect and diagnosis the condition includes:

  • Serum transferrin saturation which measures the amount of iron bound to transferrin.
  • Serum ferritin. This blood test measures the amount of iron the body has stored.  Serum ferritin levels help diagnosis and follow the patient during treatment.

Treatment of hemochromatosis

Treatment goals for hemochromatosis include the following:

  • Reduce the amount of iron in the body returning it to normal levels
  • Prevent or delay organ damage
  • Treat complications of the disease
  • Maintain a normal level of iron in the body

Treatments for managing hemochromatosis are:

  • Therapeutic phlebotomyA procedure that is similar to donating blood that removes blood and iron from the body. Depending on circumstances, a person may have to do this as frequently as once a week or every 2-4 months.
  • Iron chelation therapy This uses medicine to remove excess iron from the body and is a good option for people who can’t have routine blood removal.
  • Dietary changes – Changes in a person’s diet can help such as avoid taking iron pills or multivitamins with iron, limiting the intake of vitamin C as this vitamin helps the body absorb iron from food; avoiding uncooked fish and shellfish as they can contain bacteria causing infections in people with hemochromatosis; and limiting alcohol as it can increase the risk of liver disease.
The problem of elevated iron levels in men
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Dr. David Samadi

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Dr. David Samadi