Ippodrom47
Member
- Joined
- Jun 7, 2021
- Messages
- 208
It's always assumed that iron overload can be diagnosed as high transferrin saturation or/and ferritin. If both are normal, then your symptoms must be causes by something else. However, this seems not to be the case. The following study
pubmed.ncbi.nlm.nih.gov
discusses several cases of iron overload in relation to psychiatric illness. One of the cases is:
Case 6
Mr. F, a 36 year old male, presented with a 16 year history of chronic anxiety and premature ejaculation (less than five seconds). Counselling had been given by both a psychologist and psychiatrist for one and a half years prior to presenting. Amitryptalline had had some success but was discontinued because of weight gain. A physical examination revealed bilateral varicoceles and facial redness. His TSI was 37% and his urine DFO challenge was 4.9 mg iron per 24 hours. He was given 10 mg/kg 1Mof DFO twice a week for ten weeks. Within four weeks the anxiety had significantly decreased and intercourse was estimated to have increased to two to three minutes but the varicoceles persisted. His TSI was reduced to 33% and his urine iron level to 0.8mg per 24 hours. When last seen nine months after DFO therapy he was well, but has not been seen in six months.
His ferritin was 109 pre-treatment and 49 post-treatment. Even the initial value is normal. However, he had iron overload confirmed by the urine DFO challenge, and showed a marked improvement with iron chelation therapy, as well as a 6-fold reduction in urine iron, meaning there was indeed iron overload in his system.
The question is, why both transferrin saturation and ferritin were perfectly normal despite him having obvious iron overload confirmed by the 24-hour urine analysis and treatment results?
If the excess iron is not floating in the serum or stored as ferritin, where can it be coming from? WTF, in other words?
P.S. Another case from the study:
Case 2
Mr. B, a 23 year old male, presented with a ten year history of anxiety, fatigue, light headedness, orchalgia and tinnitus. Several otolaryngology and urological evaluations failed to explain the tinnitus and orchalgia. He was then seen by a psychiatrist who attempted to control the symptoms with medications, all of which were stopped by the patient because of not feeling well on them. Laboratory evaluation revealed persistently elevated TSls, with an average of 58%. A DFO challenge was positive at 2.7 mg of iron per 24 hour urine. He was treated with 10 mg/kg 1Mof DFO twice a week for eight weeks at the end of which time his TSI was normal at 36% and his urine was normal at 0.8 mg per 24 hours. His orchalgia, tinnitus and dizziness totally cleared and his anxiety and fatigue became significantly less. He has been off DFO for 21 months and remains well.
His serum ferritin levels were 140 and 80 pre- and post-treatment respectively. Sure, his saturation was slightly elevated, but not so much as to cause such symptoms, as many sources and doctors would have us believe.
Iron overload and psychiatric illness - PubMed
Seven patients with varying psychiatric disorders were found to have iron overload as manifested by abnormal serum ferritin, transferrin saturation index (TSI), or excessive urinary iron. All possible sources of secondary iron overload were ruled out. The patients were treated with the specific...
pubmed.ncbi.nlm.nih.gov
Case 6
Mr. F, a 36 year old male, presented with a 16 year history of chronic anxiety and premature ejaculation (less than five seconds). Counselling had been given by both a psychologist and psychiatrist for one and a half years prior to presenting. Amitryptalline had had some success but was discontinued because of weight gain. A physical examination revealed bilateral varicoceles and facial redness. His TSI was 37% and his urine DFO challenge was 4.9 mg iron per 24 hours. He was given 10 mg/kg 1Mof DFO twice a week for ten weeks. Within four weeks the anxiety had significantly decreased and intercourse was estimated to have increased to two to three minutes but the varicoceles persisted. His TSI was reduced to 33% and his urine iron level to 0.8mg per 24 hours. When last seen nine months after DFO therapy he was well, but has not been seen in six months.
His ferritin was 109 pre-treatment and 49 post-treatment. Even the initial value is normal. However, he had iron overload confirmed by the urine DFO challenge, and showed a marked improvement with iron chelation therapy, as well as a 6-fold reduction in urine iron, meaning there was indeed iron overload in his system.
The question is, why both transferrin saturation and ferritin were perfectly normal despite him having obvious iron overload confirmed by the 24-hour urine analysis and treatment results?
If the excess iron is not floating in the serum or stored as ferritin, where can it be coming from? WTF, in other words?
P.S. Another case from the study:
Case 2
Mr. B, a 23 year old male, presented with a ten year history of anxiety, fatigue, light headedness, orchalgia and tinnitus. Several otolaryngology and urological evaluations failed to explain the tinnitus and orchalgia. He was then seen by a psychiatrist who attempted to control the symptoms with medications, all of which were stopped by the patient because of not feeling well on them. Laboratory evaluation revealed persistently elevated TSls, with an average of 58%. A DFO challenge was positive at 2.7 mg of iron per 24 hour urine. He was treated with 10 mg/kg 1Mof DFO twice a week for eight weeks at the end of which time his TSI was normal at 36% and his urine was normal at 0.8 mg per 24 hours. His orchalgia, tinnitus and dizziness totally cleared and his anxiety and fatigue became significantly less. He has been off DFO for 21 months and remains well.
His serum ferritin levels were 140 and 80 pre- and post-treatment respectively. Sure, his saturation was slightly elevated, but not so much as to cause such symptoms, as many sources and doctors would have us believe.
