Iron is essential for hundreds of biological functions including DNA synthesis, oxygen transport and the use of energy. About 6% of the human body is iron and 25% of it is stored as ferritin.1 Iron is used in every living thing. Plants, animals, bacteria and even cancer cells would not survive without iron.
Plants use it to make chlorophyll, while animals and humans need it to make hemoglobin in order to transport oxygen and carbon dioxide.2 Your body recycles iron from red blood cells, and you can absorb it from your food. A common symptom of iron deficiency is anemia.3 However, anemia is not always present with iron deficiency in children.
Since it is needed for cognitive development and to establish normal behavioral patterns, deficiency in children may present as poor school performance. There is limited evidence that using supplementation can improve the damage done by deficiency in young children.
However, what many people don’t realize is that iron overload is more common than iron deficiency, and that it can trigger significant health problems, including cancer and death. Your body has a limited ability to excrete iron, so it can build up in your pancreas, liver and heart.
Too Much Iron Affects Joints and Metabolism
Since iron is found throughout your body, an abundance can create significant health conditions in multiple systems. In one study,4 researchers found that excess iron in individuals with metabolic syndrome affected their blood pressure and other markers of cardiovascular risk, as well as glycemic control.
The researchers engaged 64 individuals who had a diagnosis of metabolic syndrome. They were randomly assigned to one of two groups. In the first, participants gave blood at the beginning of the study and after four weeks. The amount of blood removed was dependent on each individual’s iron levels.
The researchers were looking for a change in systolic blood pressure and insulin sensitivity, as well as hemoglobin A1c, plasma glucose, heart rate and blood lipids. They found a significant reduction in systolic blood pressure in the group who gave blood at the beginning and end of the study.
There was no significant effect on insulin sensitivity, but the participants who gave blood had lower blood glucose levels, hemoglobin A1c and heart rate.
In another study5 scientists evaluated the result of removing blood in individuals who had chronic gout. They enrolled 12 people with hyperuricemia and removed some of their blood over a period of 28 months in order to maintain their body at the lowest amount of iron stores possible, without inducing anemia.
During the study, they saw that participants had a marked reduction in the number and severity of gout attacks. Removing blood was found to be safe and beneficial.
Overload Is More Common Than Deficiency
Iron is also a common nutritional supplement. Since it’s added to many multivitamins and mineral supplements, it’s easy to get too much. Many processed foods are also fortified with iron. For instance, two servings of fortified breakfast cereal may provide you with as much as 44 mg,6 bringing you dangerously close to the upper tolerance limit of 45 mg for adults.
This is well over the recommended daily allowance, which is 8 mg for men and 18 mg for premenopausal women.7 Since the body excretes only small amounts, nearly all adult men and postmenopausal women are at risk for overload and many doctors don’t appreciate the importance of checking for it. Women, who lose blood regularly during their menstrual period, do not have the same risk.
Another factor contributing to the possibility of iron overload is hemochromatosis.8 This is one of the most prevalent genetic conditions in Americans. It impairs the body’s iron regulation, which means that those who have it tend to absorb higher amounts than normal.
It takes two inherited copies of the genetic mutation, one from your mother and one from your father, to cause the disease. Results from one study were used to estimate that 40% to 70% of those with the defective genes develop clinical evidence of iron overload.9
Another common cause of iron excess is the regular consumption of alcohol.10 This increases the amount of iron you absorb from your diet. In other words, if you drink alcohol with foods high in iron, you will likely absorb more than you need.
Other contributors may include cooking in iron pots and pans, eating processed foods, drinking well water that’s high in iron and using multiple vitamins and mineral supplements together.
Severe Blood Shortages Another Consequence of COVID-19
Blood donation is one of the easiest ways to reduce your ferritin level and iron overload. It promotes your good health and may save the life of someone else. Unfortunately, the American Red Cross had to cancel nearly 2,700 blood drives across the country when people began practicing social distancing due to regulations related to SARS-CoV-2.11
This led to severe shortages and has resulted in 86,000 fewer donations. The Red Cross collects blood at various permanent locations and during blood drives at workplaces, college campuses and schools.
More than 80% of the blood they collect comes from blood drives. While they’re adding donation slots to improve opportunities to give, blood availability remains low. Chris Hrouda, president of the Red Cross Biomedical Services, voiced concerns over the shortage to a reporter with the Press Herald:12
“In our experience, the American public comes together to support those in need during times of shortage and that support is needed now more than ever during this unprecedented public health crisis. Unfortunately, when people stop donating blood, it forces doctors to make hard choices about patient care, which is why we need those who are healthy and well to roll up a sleeve and give the gift of life.
We know that people want to help, but they may be hesitant to visit a blood drive during this time. We want to assure the public that blood donation is a safe process, and we have put additional precautions in place at our blood drives and donation centers to protect all who come out.”
To donate, you only need a blood donor card, a driver’s license or two forms of identification. People who are at least 17, weigh at least 110 pounds and are in generally good health are eligible.
Why Too Much Iron Can Be Dangerous
At the cellular level, iron can react with hydrogen peroxide in the inner mitochondrial membrane.13 This is a normal part of cellular aerobic respiration. However, excess iron catalyzes the formation of too many damaging hydroxyl free radicals from peroxide.
This is one pathway that can accelerate chronic disease. In addition, research14 also shows that excessive iron promotes apoptosis and ferroptosis in cardiomyocytes. Ferroptosis is cell death that is dependent on and regulated by iron.15 The cardiomyocytes generate and control contractions. Apoptosis is programmed cell death of diseased and worn-out cells.
Too much iron can impair your heart function through mitochondrial abnormalities and the death of muscle cells in your heart. Iron overload is also a concern in Alzheimer’s disease.16 The buildup of iron increases oxidative stress, which has a “rusting effect” in your brain, commonly found in Alzheimer’s patients.17
Other researchers suggest that iron in the cerebrospinal fluid is strongly correlated with Alzheimer’s and a particular risk allele, APOE-ε4.18 Thus far, conventional treatment has been focused on clearing amyloid proteins in the brain. While the approach appeared logical, there has been limited success.
Evidence now suggests reducing excess iron may be an effective way of slowing or preventing Alzheimer’s disease. Read more about this in “How Excess Iron Raises Your Risk for Alzheimer’s.”
GGT: A Predictor of Iron Toxicity and Mortality
A second measurable factor with an impact on iron toxicity and mortality is gamma glutamyl transpeptidase, sometimes called gamma-glutamyl transferase (GGT). This is a liver enzyme involved in the metabolism of glutathione and the transport of amino acids and peptides.19 In this video interview with Gerry Koenig we discuss GGT, the value of measuring GGT and why it’s so important to your health.
GGT can be used as a screening marker for excess free iron, liver damage and as an indicator of your risk of sudden cardiac death and chronic kidney disease.20 In recent years, researchers have discovered GGT interacts with iron. Low levels tend to be protective against high levels of ferritin.
This means, if your GGT is low, you have some protection even when your ferritin levels are a little higher than ideal. However, when both serum ferritin and GGT are high it represents an increased risk of chronic health problems and early death. Even when ferritin levels are low, an elevated GGT needs to be addressed.
While the test is often used as a marker for alcohol-related liver disease, the predictive value also applies to diabetes, metabolic syndrome, cardiovascular disease and all-cause mortality.21 GGT may also be used as an early marker for atherosclerosis, arterial stiffness, gestational diabetes and a variety of liver diseases, including viral hepatitis.
Test Iron and GGT Levels and Reduce Them to Normal
As with many lab tests, the normal ranges will vary between laboratories and are often far from ideal and the normal ranges used for GGT may not be adequate to prevent disease. As I’ve shared before, the range of ideal to “normal” GGT can be wide. Koenig’s suggestions, which are in the ranges of what Mayo Clinic suggests,22 are below:
| Ideal GGT Level, units per liter (U/L) | Average level, above which risk for chronic disease increases significantly | “Normal” GGT Levels | |
|---|---|---|---|
Men | < 16 U/L | 25 U/L | Up to 70 U/L |
Women | < 9 U/L | 18 U/L | Up to 45 U/L |
To determine your healthy ranges, you’ll need both your ferritin and GGT levels tested. According to Koenig, women who have a GGT level above 30 units per liter (U/L) have a higher risk of cancer and autoimmune disease. While other tests have a broad range between what’s healthy and what’s risky, the range for GGT between health and disease is in the single digits.23
“Part of it is dependent on body weight,” Koenig says. “Strangely enough, the most recent indications are that people who are too thin (whatever their level of GGT is), it could be harmful if [their GGT is] relatively high. For instance, for a thin woman with a GGT … in the range of the second quartile, which is going to be generally 14 to 18 today it can be dangerous if she’s expecting to have children and has a very low BMI.”
Ideal ferritin levels for adult men and non-menstruating women is between 30 nanograms per milliliter (ng/ml) to 60 ng/ml. Some labs use a normal range of 200 to 300 ng/ml, which is far too high for optimal health. Ideally, I believe you don’t want to drop below 20 ng/ml or above 80 ng/ml.
As demonstrated in the research studies above, it’s easy to lower your iron levels by donating blood to two or three times a year. In the past, that is how I maintained ferritin levels below 100 ng/ml.
However, once I started a comprehensive detoxification strategy using near and far infrared sauna, my ferritin levels continued to drop without giving blood. An effective detoxification program can also lower GGT levels.
GGT is inversely related to glutathione. This means as your GGT level rises, your glutathione goes down, which is one way an elevated GGT can harm your health. You also can lower your GGT levels by reducing or eliminating alcohol, carefully considering your protein intake and raising the amount of fruits and vegetables you eat.
However, by elevating glutathione, you lower your GGT. The amino acid cysteine plays an important role in the production of glutathione and can be found in whey protein, poultry and eggs. Red meat and alcohol will raise your GGT levels.24
Certain medications can also raise your GGT. Speak with your pharmacist to determine if any over-the-counter medication or prescription drugs you are taking may have an impact and confer with your doctor to see if you can stop or switch to something else.