Is Iron the New Cholesterol?

Is Iron the New Cholesterol?

One thing I’ve realized being in this game for so long is that
if you’re convinced that meat truly is deadly, you’re not going
to stop looking for reasons why. They’ve tried blaming just about
every part of meat over the years, including the protein itself,
the saturated fat, the cholesterol, the methionine, the char on
BBQ, and even the obscure compounds like TMAO or Neu5gc. The latest
component of meat they’ve zeroed in on is iron—the essential
mineral responsible for energy production and a host of other vital
functions.

The experts’ track record with all the other “evil meat
components” has many of my readers skeptical, so they asked me to
weigh in on iron.

Iron is an essential mineral, integral in the production of
energy and the creation of blood cells. If pregnant women don’t
get it, they can’t deliver oxygen and nutrients to their growing
babies. If kids don’t get it, they shortchange their mental and
physical development. If adults don’t get it, their basic
day-to-day physiological function falls apart. Without adequate
iron, our antioxidant defenses, our immunity, and our metabolic
function all suffer. Hell, most countries even mandate the
fortification of refined flour with large amounts of iron to
prevent these tragedies.

Iron also has a dark side. A large body
of observational
evidence
 links elevated iron levels to diseases
and disease states
 like type 2
diabetes
heart
disease
insulin
resistance
inflammation,
Alzheimer’s disease, hypertension, fatty liver, hypothyroidism,
arthritis, and cancer. You
name it, it’s probably linked to elevated iron. And as
much as I’d like to, I can’t dismiss these connections as
non-causal.

For one, iron is inherently reactionary: The
very same proclivity for electron exchange that makes iron so
integral in biochemical reactions that address stress and support
health means it can also create
free radicals
 that damage DNA, cells, blood
lipids
, and increase stress and harm health.

Two, there’s a little something called hereditary
hemochromatosis.

Hereditary hemochromatosis is a genetic condition increasing a
person’s absorption and retention of dietary iron. This has
benefits in certain contexts—carriers have a natural resistance
to the bubonic plague, as one effect of hemochromatosis is to
render white immune cells iron-deficient and thus resistant to the
plague virus which feeds on iron—but it’s mostly negative in
today’s relatively plague-free world. Most of the hemochromatosis
literature focuses on homozygotes (carriers of two copies of the
gene) and specific “iron
overload-related diseases
,” which include cirrhosis, liver
fibrosis, liver cancer, elevated liver enzymes,
“physician-diagnosed symptomatic hemochromatosis,” or finger
arthritis. Those are bad conditions to have, to be sure, but
that’s not even a complete list. Homozygous carriers of the
mutation also have greater
risks
 for diabetes, arthritis, fatigue, liver disease, and
frailty and muscle loss. They’re more likely to experience
neurodegenerative diseases like Parkinson’s and Alzheimer’s.
Even heterozygous carriers (those who carry just one copy of the
variant) have an elevated risk of
iron overload compared to the general population.

Okay, okay. But couldn’t it be that the
hemochromatosis gene is increasing disease risk through another,
non-iron route?
Perhaps high iron is just a marker of
disease, not a cause. After all, most genes are pleiotropic—they
have more than one effect.

Probably not. The most reliable treatment for hereditary
hemochromatosis is phlebotomy. Literally removing iron from the
body by draining blood is the first (and often only necessary) line
of defense against hereditary iron overload. And it works really
well.

Besides, phlebotomy may also be beneficial in people
without clinical iron overload or hemochromatosis. 
It’s
the most effective way to reduce iron stores and tends
to increase insulin
sensitivity
. In insulin resistant men with fatty liver, blood
donation normalized insulin
sensitivity and liver enzymes. In meat eaters, blood
donation reduced
ferritin levels to match those of lacto-ovo-vegetarians and
improved insulin sensitivity
. One study even
tested the effect of randomized phlebotomy on cancer incidence.
After four and a half years, those subjects placed in the
phlebotomy group lived longer, had less cancer, and had lower
ferritin levels than the subjects who didn’t donate blood.

I can’t argue with the research, but the idea that a primary
component of a food we’ve been eating for millions of years and
to which we may even owe much of our brainpower—the iron in
meat—still rankles. Is iron truly inherently “bad,”
or is there anything about our modern environment that makes it
so?

Possible Modern Influences On Iron Levels Less Bleeding

One factor is that we don’t shed as much blood as before. Most
men engage in far fewer bouts of direct violent conflict. Most
people have fewer parasites feasting on their blood. And when’s
the last time you exchanged blood oaths with anyone? We have fewer
opportunities to bleed, in other words. That’s why regular
phlebotomy can be such a useful tool for men (and some women) with
too much iron in their bodies—it emulates all the bloodletting we
used to do in a controlled, safe fashion.

Less Intense Activity

We use iron to generate energy. The more physical activity in
which we engage, the more iron we utilize. This is usually couched
in warnings for
female athletes engaged in intense training
, but it can also
explain the beneficial effects of exercise in people with iron
overload. There are even cases of “mild exercise” causing iron
deficiency, so everything that increases energy
expenditure—walking, gardening, hiking—will at least subtly
reduce iron stores. More activity, less iron sitting around idle
getting into trouble.

Too Many Seed Oils

I strongly suspect that the unprecedented dissemination of
high-omega-6 seed oils throughout our food systems, our body fat,
and our cellular membranes are exacerbating—if not causing—the
relationship between excess iron and various diseases. Take the
supposedly ironclad (pun intended) relationship between heme iron
and colon cancer, which is mediated by iron’s peroxidative
alteration of fatty acids in the colon. In animal studies that seek
to show this relationship, you can’t get the colon cancer to
“take” unless you feed the animal high-PUFA oils along with
their heme iron. In one studyfeeding
heme iron to rats promoted colon cancer only when fed alongside
high-PUFA safflower oil
. Feeding MUFA-rich and far more
oxidatively-stable olive
oil
 alongside the heme prevented the colon carcinogenesis.
In another paper,
only mice consuming fish oil-based and safflower oil-based diets
exhibited carcinogenic fecal peroxides after eating heme iron; a
coconut oil-based group of mice had no negative reaction to
heme.

Among a cohort of US
nurses
, where PUFA intake
is around 7% of calories and comes from seed oil
, iron intake
has moderate links to colon cancer. Among a cohort of
Swedish women
, where PUFA intake is under 5% of calories with
greater
proportion coming from fish
, the association is far
weaker.

What To Do About All This?

First, men and postmenopausal women should figure out their
hemochromatosis status
. Both men and women with hereditary
hemochromatosis have elevated risks of iron overload-related
diseases, but they are much higher for men. (Premenopausal women
have a handy built-in mechanism for shedding excess
iron—menstruation.) Modern men and older women, with our absence
of intestinal parasites and our lower tendency to engage in bloody
hand-to-hand fighting, have few opportunities to shed iron. Your
doctor will be able to order the test, or you can go through a
genetic testing service and look for positive hits
on C282Y and H63D.

Do it earlier rather than later. Studies
indicate
that one of the biggest predictors of whether someone with genetic
iron overload develops liver cancer is their age at diagnosis of
hemochromatosis. Those who wait risk incurring more damage.

Even if you’re negative for hereditary
hemochromatosis, you can still have iron overload
.
Determine this by asking your doctor for a ferritin test. According
to the Mayo Clinic, for men, the
ferritin reference range is 24 to 336 ng/ml, and for women, it is
11 to 307
. That is a wide range, and levels that your doctor
would probably classify as technically normal have been associated
with insulin resistance, atherosclerosis, and reduced telomere
length
(a marker of aging).

From what I can tell, levels approaching 200 ng/ml in men should
definitely be classified as “high.” And lower may be even
better. In one study, egg-and-dairy-eating vegetarian men had
ferritin levels of 35 ng/ml and better insulin sensitivity than
meat-eating men with ferritin levels of 72 ng/ml. After donating
enough blood to hit 35 ng/ml, the meat eaters insulin sensitivity
improved.

Dr. F. S. Facchini has used blood donation to induce “near
iron deficiency”—the lowest body iron store that allows normal
red blood cell production—in his gout patients,
clearing them of gout attacks for as long as they maintained
it
. His patients at high risk for heart disease also
saw major benefits
from hitting very low ferritin levels (“to
levels commonly seen in premenopausal females”), including
increased HDL and lower blood pressure, even if they started with
normal ferritin.

What seems safe is to stay on the low end of
normal—say, from 50-150 ng/ml—as long as no symptoms of low
iron arise.

As for women? Higher levels don’t seem to correlate
with the same health issues in women. Lucky.

Now, say you have high iron, whether it’s hereditary
hemochromatosis or just high normal ferritin levels….

What Should You Do About High Iron Levels? Donate Blood

The quickest, safest way that also does the most social good (if
you care about that sort of thing) is to donate blood. When you
donate blood, your body must upregulate hemoglobin production to
replace the lost blood. That requires iron, which is taken from
body stores.

Don’t Manage Iron Overload With Diet

By that I mean stuff like:

  • Don’t give up red meat.
  • Don’t stop eating liver every week.
  • Keep eating oysters.
  • Don’t religiously adhere to reverse-kosher (only eating meat
    in the presence of dairy to inhibit iron absorption).

If you make dietary iron the focal point, you’ll miss out on
all the
incredible nutrients iron-rich foods
like red meat and liver
can offer. Besides, you’ll run yourself ragged following even
more food restrictive rules that increase the chance of other
nutrient deficiencies.

Don’t Manage an Iron Overload That Doesn’t Exist

I’ve seen people go down the rabbit hole of iron obsession
without actually confirming they even had too much iron. They
started giving blood (even self-administered), trying to reduce
iron absorption by pairing dairy and calcium with their iron-rich
foods, avoiding iron-rich foods—totally blind. Iron is an
important nutrient. Deficiency is real. Anemia is no joke. Get
tested before you start messing around with iron.

Follow a Healthy Primal Eating Plan

Whether it’s keto, low-carb, moderate-carb, or even
vegetarian, going Primal will mitigate many of the potential
effects of high iron by:

  • Avoiding Seed Oils and Excess Omega-6
    Fats. 
    Seed oils almost certainly make the “iron
    overload problem” worse, and may even be responsible for its
    negative effects and link to various diseases.
  • Including Phytonutrient-rich Fruits, Vegetables, Herbs,
    Teas, and Coffee. 
    Polyphenols both inhibit iron
    absorption and reduce the oxidative interaction between iron and
    lipids.

So to sum up, get tested and be aware of the iron issue, but
don’t let it rule you. It’s iron overload, not overlord.

Take care, everyone. What do you think of iron? Ever get tested?
Ever give blood? See any benefits?

Let me know down below!

References:

Tamosauskaite J, Atkins JL, Pilling LC, et al. Hereditary
Hemochromatosis Associations with Frailty, Sarcopenia and Chronic
Pain: Evidence from 200,975 Older UK Biobank Participants
. J
Gerontol A Biol Sci Med Sci. 2019;

Burke W, Imperatore G, Mcdonnell SM, Baron RC, Khoury MJ.
Contribution
of different HFE genotypes to iron overload disease: a pooled
analysis
. Genet Med. 2000;2(5):271-7.

Allen KJ, Gurrin LC, Constantine CC, et al. Iron-overload-related
disease in HFE hereditary hemochromatosis
. N Engl J Med.
2008;358(3):221-30.

Nowak A, Giger RS, Krayenbuehl PA. Higher age at
diagnosis of hemochromatosis is the strongest predictor of the
occurrence of hepatocellular carcinoma in the Swiss hemochromatosis
cohort: A prospective longitudinal observational study
.
Medicine (Baltimore). 2018;97(42):e12886.

Larsson SC, Rafter J, Holmberg L, Bergkvist L, Wolk A. Red meat consumption
and risk of cancers of the proximal colon, distal colon and rectum:
the Swedish Mammography Cohort
. Int J Cancer.
2005;113(5):829-34.

Liu B, Sun Y, Xu G, et al. Association between
Body Iron Status and Leukocyte Telomere Length, a Biomarker of
Biological Aging, in a Nationally Representative Sample of US
Adults
. J Acad Nutr Diet. 2018;

The post Is
Iron the New Cholesterol?
appeared first on Mark’s Daily Apple.

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