Low Iron Levels

[Mito]

While ferritin can vary due to those factors, I don't understand why he would suggest TSAT is superior. It's a calculation that depends on Serum Iron and TIBC. Serum Iron can be affected by eating, so I don't see how it can be considered more accurate.

Quoting Masterjohn: "So let’s compare ferritin and transferrin saturation here. In terms of sensitivity, the reason that ferritin increases in response to too much iron status is because on a mechanistic level, elevated transferrin saturation communicates through HFE to hepcidin to downregulate iron absorption and to increase storage of iron and ferritin. So transferrin saturation is much more sensitive than ferritin is because transferrin saturation is the cause of ferritin elevating in response to too much iron, and that’s consistent with my own story where my transferrin saturation was going out of the reference range while my ferritin was way, way, way within it. In fact, when ferritin is used to diagnose hemochromatosis, then it may be the case that they won’t recommend that you get a liver biopsy until your ferritin reaches 1000 nanograms per milliliter, and you could probably catch all of those people with hemochromatosis if you just screened everyone who has transferrin saturation over 45%.

So monitoring your transferrin saturation is like putting a smoke detector in your house or in your apartment, and waiting for ferritin to get that high is like waiting for a text message from the firemen who arrived late to put out the fire after your house burned down. "

 

[tankasnowgod]

In fact, when ferritin is used to diagnose hemochromatosis, then it may be the case that they won’t recommend that you get a liver biopsy until your ferritin reaches 1000 nanograms per milliliter, and you could probably catch all of those people with hemochromatosis if you just screened everyone who has transferrin saturation over 45%.

So monitoring your transferrin saturation is like putting a smoke detector in your house or in your apartment, and waiting for ferritin to get that high is like waiting for a text message from the firemen who arrived late to put out the fire after your house burned down. "

Well, the bigger question is....... why would doctors let ferritin get that high? 1000ng/ml is widely accepted as critical. If your ferritin is that high or higher, weekly (and even bi-weekly) phlebotomies are started, cause there is dramatic increase in the risk of serious and permanent liver damage. Again, many iron researchers suggest that the ferritin range is too high to begin with, and the highest range I've seen is 30-400. The 1000ng/ml is more than double the top of that lab range.

So why would TSAT be superior? Why not treat everyone in the ferritin range of 400-1000 with less aggressive phlebotomies, like semi-monthly or monthly? Why not treat everyone in the "high normal" category of 200-400 with monthly phlebotomies? Blood donation is incredibly safe for vast majority of people with ferritin that high. And then, you wouldn't have to risk the liver biopsy, which is far more risky than blood donation.

I like Chris Masterjohn, but I just don't understand his reasoning on this one.

 

[Mito]

So why would TSAT be superior? Why not treat everyone in the ferritin range of 400-1000 with less aggressive phlebotomies, like semi-monthly or monthly? Why not treat everyone in the "high normal" category of 200-400 with monthly phlebotomies? Blood donation is incredibly safe for vast majority of people with ferritin that high. And then, you wouldn't have to risk the liver biopsy, which is far more risky than blood donation.

I like Chris Masterjohn, but I just don't understand his reasoning on this one.

One reason might be because you need to measure inflammation and oxidative stress to put ferritin in context? "But ferritin is harder to interpret because it’s affected by oxidative stress and inflammation in addition to iron status. And high CRP could be raising ferritin and contributing to anemia by shifting iron away from its proper roles and into storage in ferritin. Although it’s harder to test for oxidative stress than to just test CRP for inflammation, oxidative stress must also be considered. And when considering oxidative stress, you have to consider the possibility that supplements designed to protect against oxidative stress like sulforaphane and milk thistle and green tea extract and resveratrol could actually be upregulating ferritin, which again complicates the interpretation of ferritin and can even make you anemic if you don’t have enough iron to be storing all that ferritin without taking it away from hemoglobin synthesis."

 

[Regina]

Chris Masterjohn is at high risk for hemochromatosis (his story here https://chrismasterjohnphd.com/2017/01/27/need-manage-iron-status/) and he recommends targeting ferritin between 60 and 140 nanograms per milliliter. He prefers to monitor transferrin saturation since its a more sensitive iron marker and ferritin can vary due to other factors like infections and inflammation.

Thx for your thoughts Mito. I do have HFE heterozygous, fwiw. (100% northern europeans who typically die young of heart disease).
I still think my blood results are parodoxical. Transferrin saturation was only 7%. But ferritin was a creepy 3.5.

 

[tankasnowgod]

One reason might be because you need to measure inflammation and oxidative stress to put ferritin in context? "But ferritin is harder to interpret because it’s affected by oxidative stress and inflammation in addition to iron status. And high CRP could be raising ferritin and contributing to anemia by shifting iron away from its proper roles and into storage in ferritin. Although it’s harder to test for oxidative stress than to just test CRP for inflammation, oxidative stress must also be considered. And when considering oxidative stress, you have to consider the possibility that supplements designed to protect against oxidative stress like sulforaphane and milk thistle and green tea extract and resveratrol could actually be upregulating ferritin, which again complicates the interpretation of ferritin and can even make you anemic if you don’t have enough iron to be storing all that ferritin without taking it away from hemoglobin synthesis."

Well, high iron levels would increase oxidative stress, as iron is the most potent pro-oxidant in the body. Also, there are many anemias that can happen even when body iron stores are high. Some, like Sickle Cell and Thalassimia even contribute to iron accumulation. Deficiencies of certain B vitamins, like B6, B12, and Folate can also be the causes of anemia, and are easily corrected. He could be right, but I still think he's making this unnecessarily complicated.

And at the same time, I don't know how much these other factors could affect ferritin. The studies I've seen suggest something like a 50-100 point increase during times of sickness and infection. Still, even taking that into account, a reading over 300 would still indicated excess body iron stores.

 

[tankasnowgod]

Thx for your thoughts Mito. I do have HFE heterozygous, fwiw. (100% northern europeans who typically die young of heart disease).
I still think my blood results are parodoxical. Transferrin saturation was only 7%. But ferritin was a creepy 3.5.

Hey, I got the one of the Heterozygous mutations too! I got the super rare combo of H65D and S63C. That really makes your blood results seem odd.

Unless you've been overbled, or been doing a lot of blood donations along with a really low iron diet.

 

[Regina]

Hey, I got the one of the Heterozygous mutations too! I got the super rare combo of H65D and S63C. That really makes your blood results seem odd.

Unless you've been overbled, or been doing a lot of blood donations along with a really low iron diet.

Just eating a Peaty diet following 4 years on Perfect Health Diet. I admit that I wasn't eating liver AND piling on the aspirin, vitamin E and recent trial of succinic acid. But I always eat a lot of shellfish, an ocassional skirt steak, lamb chops, pork shoulder. But a big shift toward dairy and eggs. But eggs are big on Perfect Health Diet. So I think the 5 yrs of no grains, tons of eggs, new shift toward dairy.

The endotoxin concerns me for aikido going forward.
Bowel Toxins Accelerate Aging – Functional Performance Systems (FPS)

I would love to figure out how to stave this off.

 

[tankasnowgod]

Just eating a Peaty diet following 4 years on Perfect Health Diet. I admit that I wasn't eating liver AND piling on the aspirin, vitamin E and recent trial of succinic acid. But I always eat a lot of shellfish, an ocassional skirt steak, lamb chops, pork shoulder. But a big shift toward dairy and eggs. But eggs are big on Perfect Health Diet. So I think the 5 yrs of no grains, tons of eggs, new shift toward dairy.

The endotoxin concerns me for aikido going forward.
Bowel Toxins Accelerate Aging – Functional Performance Systems (FPS)

I would love to figure out how to stave this off.

Yeah, you could potentially get iron pretty low with just diet alone. Dr. Fachinni demonstrated that with this study- http://www.healtheiron.com/Websites...oSlow_Progression_of_Diabetic_Nephropathy.pdf

 

[dbh25]

When you get an iron panel, do you go fasted, or does it make a difference?

 

[Regina]

I'm afraid the complications are over my head. I'm trying to understand the h. pylori piece. And this study also mentions heat shock proteins.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC280902/pdf/iai00018-0436.pdf

 

[Mito]

Well, high iron levels would increase oxidative stress, as iron is the most potent pro-oxidant in the body.

I think he believes it's the free iron that's dangerous (I think Peat has said the same) and a pro-oxidant. When iron is bound to the ferritin protein, ferritin can protect against free iron. Therefore ferritin should be seen as an antioxidant.

"Now, it’s also the case that free iron, when it’s not bound by a protein, can interact with hydrogen peroxide to produce the much more dangerous hydroxyl radical. And in the presence of free iron and hydrogen peroxide, you can have much more damage to the cell and to metabolism and to the structural components of your tissues than you would if you just had hydrogen peroxide or if you just had iron."

"Ferritin is unambiguously a good guy and ferritin should be seen in the context of our iron metabolism as an antioxidant. In fact, the same factors that increase our synthesis of glutathione and catalase and all the other antioxidant enzymes also increase ferritin because it’s considered part of the antioxidant defense system. The purpose of ferritin is to sequester iron in long-term storage to prevent free iron from being available to pathogens, for their own growth and to prevent free iron from causing oxidative stress."

Also, there are many anemias that can happen even when body iron stores are high. Some, like Sickle Cell and Thalassimia even contribute to iron accumulation. Deficiencies of certain B vitamins, like B6, B12, and Folate can also be the causes of anemia, and are easily corrected.

I think he agrees with that. He discussed it in the podcast.

 

[tankasnowgod]

When you get an iron panel, do you go fasted, or does it make a difference?

These days, I mostly just test ferritin, and it doesn't make a difference for that marker. Although with an iron panel that involves serum iron or TSAT, you should go fasted.

 

[tankasnowgod]

"Ferritin is unambiguously a good guy and ferritin should be seen in the context of our iron metabolism as an antioxidant. In fact, the same factors that increase our synthesis of glutathione and catalase and all the other antioxidant enzymes also increase ferritin because it’s considered part of the antioxidant defense system. The purpose of ferritin is to sequester iron in long-term storage to prevent free iron from being available to pathogens, for their own growth and to prevent free iron from causing oxidative stress."

I don't disagree with this. I certainly don't think ferritin itself is bad. It's a crucial component of the Iron Withholding Defense System. I still think ferritin is, overall, a better marker for body iron stores, and researchers like E.D. Weinberg agree. But similar to a high white blood cell count, high ferritin is a signal of another issue in the body. You wouldn't want to lower ferritin by impeding it's production, or the same with white blood cells. Or cholesterol, for that matter (although statins do exactly that).

The issue I still see with his claims is that Masterjohn seems to want to prioritize TSAT, instead of pointing out that ferritin values between 200-1000 can also be indicative of iron overload. Not treating someone whose ferritin is near 900 is just insane, and could really be considered criminal malpractice.

But truthfully, a full iron panel would be superior. If you know Hemoglobin, TSAT, and Ferriitn, better conclusions could be reached. An iron panel is cheap (Price is currently about $65 on Direct Labs), and is a simple blood test. It doesn't carry the potential dangers and complications of a liver biopsy.

 

[hiconscience]

drink more OJ! Vitamin C helps turn non-heme iron into the usable form our bodies need :)

 

[hiconscience]

I think certain micobes and viruses need iron(oxygen) to survive. So some parasitism may be involved. I know Lyme disease uses iron and if there isn't enough uses manganese. but this is just an example of hundreds and hundreds of different possibilities..
eat a wide variety of easily digestible foods and organic juices without pulp (hard to digest)
Best of luck to you

 

[dbh25]

These days, I mostly just test ferritin, and it doesn't make a difference for that marker. Although with an iron panel that involves serum iron or TSAT, you should go fasted.

Thanks TaNG

 

[tankasnowgod]

I think certain micobes and viruses need iron(oxygen) to survive.

Without a doubt. Iron is essential to all life, but it can be a great promoter of bacterial and viral growth. It was an experiment where iron completely inactivated antibiotics that spurred E.D. Weinberg's career researching iron initially.

 

[hiconscience]

thanks for the info tankasnowgod

 

[dbh25]

Normal range for ferritin is considered to be 30-200, at least on my latest lab work. Finally checked my ferritin, it was 17, now up to 28 two months later.

How did you feel, with ferritin at 17?

 

[Regina]

I think certain micobes and viruses need iron(oxygen) to survive. So some parasitism may be involved. I know Lyme disease uses iron and if there isn't enough uses manganese. but this is just an example of hundreds and hundreds of different possibilities..
eat a wide variety of easily digestible foods and organic juices without pulp (hard to digest)
Best of luck to you

Thx! :)