Hemochromatosis is a fairly common genetic disease that causes iron to build up in the body. Knowing that you carry the genetic variants for hemochromatosis can literally add years to your life since you can prevent the buildup of iron through giving blood.
This is a personal cause for me, and getting the word out to as many people as possible is important because this is one bit of genetic information that can make a huge impact on the quality of life.
23andMe and AncestryDNA genetic data can tell you if you likely carry the genetic variant for hemochromatosis. Read on to find out how to check your data…
“Hereditary (genetic) hemochromatosis (HHC) an inherited disorder of abnormal iron metabolism. Individuals with hereditary hemochromatosis absorb too much dietary iron. Once absorbed, the body does not have an efficient way of excreting iron excesses. Over time, these excesses build a condition of iron overload, which is a toxic [sic] to cells. Glands and organs, including the liver, heart, pituitary, thyroid, pancreas, synovium (joints) and bone marrow burdened with excess iron cannot function properly. Symptoms develop and the disease progresses.” Iron Disorders Institute
Symptoms of building up iron can include
Hepcidin is the iron regulatory hormone produced by the liver. Hepcidin was discovered and named in 2000, and scientists have since figured out that it controls the regulation of iron in the body and responds to lipopolysaccharides to prevent iron-loving bacteria from reproducing rapidly. [ref]
“Hereditary hemochromatosis is caused by a deficiency of the iron-regulatory hormone hepcidin (Ganz and Nemeth, 2011). Hepcidin is a 25 amino acid peptide secreted by hepatocytes. It controls iron concentrations in extracellular fluid and blood plasma by regulating the amount of ferroportin, the sole known cellular iron exporter. Ferroportin transports absorbed, recycled or stored iron from tissues into plasma (Donovan et al., 2005). Hepcidin binding to ferroportin triggers its degradation, resulting in the decreased transfer of iron to plasma and consequently hypoferremia (Nemeth et al., 2004b). During infections or in response to injection of microbial molecules, hepcidin production is greatly enhanced (Armitage et al., 2011; Rodriguez et al., 2014), stimulated by inflammatory cytokines including IL-6 (Nemeth et al., 2004a; Rodriguez et al., 2014) and possibly activin B (Besson-Fournier et al., 2012). It has been proposed that hepcidin-mediated hypoferremia functions as a host defense mechanism that evolved to restrict iron availability for pathogen growth (Drakesmith and Prentice, 2012; Ganz, 2009) but this has never been demonstrated. Hepcidin was also reported to have direct bactericidal activity in vitro (Krause et al., 2000; Park et al., 2001), but the effect is seen only at unphysiologically high concentrations.” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296238/
The most common type of hemochromatosis is Type 1, or Classic, and is usually caused by variants in the HFE gene.
Check your genetic data for rs1800562 (23andMe v4, v5; AncestryDNA):
Check your genetic data for rs180073 (23andMe v4 only):
So you’ve checked your genetic data and found that you are heterozygous (one variant) for one of the HFE variants… While most of the official hemochromatosis sites will say that you are ‘just a carrier’, in actuality, it could be causing problems, just not to the extreme extent that being homozygous for the variant could cause.
Doctors and researchers seem to be focused (rightly so) on the long-term consequences such as liver failure and heart failure of extreme iron overload. But if you know that you are genetically susceptible to building up iron, you can take action to avoid the irritations that come with too much iron, such as random joint pain, fatigue, and/or abdominal pain.
Recent studies showing higher disease risk due to HFE variants:
Not everyone who is homozygous for the hemochromatosis variants will develop iron overload. Diet and lifestyle play a role in the rate at which iron accumulates. Additionally, there are other genes that play a role in ferritin levels and iron levels in the body. Some of these are listed below:
Rare genetic forms of hemochromatosis (mostly non-HFE):
Middle-aged men and menopausal women who are heterozygous or homozygous for any of the HFE variants, should, in my non-medical doctor opinion, go get their serum iron, TIBC, and ferritin levels checked or ask their doctor to test them. Ordering serum iron w/ TBIC and ferritin should give you enough information to know if you are storing too much iron. An inexpensive option if you want to order your own test is UltaLabs.
If you have slightly elevated iron levels, the simplest way to manage iron levels is to give blood! You will probably feel good, and you will definitely help out someone else with your blood donation. It is a win-win!
In addition to giving blood, natural and pharmaceutical iron chelators have been used to reduce iron levels in the body.[ref]
Quercetin, a flavonoid found in fruits and vegetables, has been studied for its iron chelating properties.[ref] A 2017 study on dendritic (immune system) cells found that quercetin “increase extracellular iron export, resulting in an overall decrease in the intracellular iron content and consequent diminished inflammatory abilities.” And a 2014 study on quercetin concluded: “Potentially, diets rich in polyphenols might be beneficial for patients groups at risk of iron loading by limiting the rate of intestinal iron absorption.” Foods high in quercetin include apples, dark cherries, tomatoes, capers, onions, and cranberries. Quercetin supplements including pure quercetin powder are also readily available.
Another flavonoid, rutin, has also been studied for its iron chelation properties.[ref] A 2014 study in rats found: “Rutin administration to iron-overloaded rats resulted in significant decrease in serum total iron, TIBC, Tf, TS%, ferritin levels…” Foods high in rutin include capers, black olives, buckwheat, asparagus, and berries. Rutin is also available as a supplement and in bulk powder.
Okra: A 2015 study found that okra “dramatically decreases intracellular iron levels in H63D cells compared to untreated cells”.[ref] Time to make some gumbo!
Dietary phenols such as EGC/G from green tea and grape seed extract also have been shown to inhibit iron uptake in the intestinal cells. [ref]
The jury is still out on curcumin. In a double-blind, placebo-controlled, randomized, cross-over study, curcumin was found to decrease hepcidin and increase ferritin.[ref] Other studies, though, refer to curcumin as a possible iron chelator.[ref]
Taurine, in a mouse model of hemochromatosis, was found to protect against liver damage from excess iron. The study is worth reading and looking into if you are worried about iron-induced liver damage.
Iron-fortified foods may, or may not, be a problem for those carrying the hemochromatosis genetic variants. In the US, white rice and refined wheat products are fortified with iron.
It hit me while researching all of this, that the bloodletters of yesteryear probably did some good for the minority of people who were overloaded with iron. Leeches to reduce blood and iron stores were probably effective against bacterial infections from iron-loving bacteria.
Fortification of iron into all wheat product in the US, which began in the 1940’s, is good for children and most women of childbearing age, but it adds to the iron overload burden for some men and older women. When looking at the forced fortification of foods with iron and folic acid, it really does seem that the policymakers are focused on the majority, at the expense of a minority who genetically are harmed by it. Since iron can takes decades to build up in the body, it may be that we are now seeing the consequences in the baby boomer generation.