09/05/2012 12:16 pm ET Updated Nov 05, 2012

Iron: The Double-Edged Mineral

Too much or too little can be harmful to your health.

A heavy-duty mineral, iron is used to make red blood cells -- the oxygen transport system of the body. Once iron is absorbed into the bloodstream, it is stored in the ferritin molecule. Unless the iron is eliminated through blood loss as in the case of menstruation, childbirth, physical injury or blood donation, most of it remains in the body where it is stored.

Iron stores are known to rise with age, and for many years were considered harmless. But a landmark study in Finland published in the early 90s in the journal Circulation suggested that excessive iron stores in men rank right behind smoking as the most prevalent risk factor for cardiovascular disease. While more recent studies have found this theory to be inconclusive, the jury is still out.

Elevated ferritin levels may contribute to heart damage -- even after a heart attack -- by producing free radicals which attack cellular integrity. It now appears that menstruating women are protected from heart disease from the loss of iron-rich blood during the menses.

It is estimated that the average female who is menstruating is losing approximately 500 mg of ferritin per year. If elevated (over 150 ng/mL for women and 300 ng/mL for men according to many integrative physicians), ferritin becomes an increasingly harmful risk factor for heart disease. The higher the ferritin, the more the oxidation of LDL cholesterol.

Consistently high ferritin levels can reflect a condition called hemochromatosis -- an inherited disorder impacting about 1 out of every 200 to 300 Americans that causes the body to store excess iron in the tissues.

But often doctors fail to recognize iron overload because the symptoms are so similar to other more familiar diseases like cirrhosis, heart disease, cancer, and diabetes. Iron overload can also cause hair loss, fatigue, abdominal pain and even irritable bowel syndrome.

For those suffering from hemochromatosis or individuals testing above 150 ng/mL, consider reducing iron intake by cutting out red meat and monitoring supplemental iron intake especially in vitamins and fortified cereals. Cut down on vitamin C and red wine during meals, which are both helpful in the absorption of iron (I know, I know), and look for an iron-free multivitamin.

On the other side of the coin, if the ferritin levels are below 30 ng/mL, this can be an indication for anemia -- a condition in which the blood cannot carry sufficient oxygenation required for optimum health. You can also be anemic if your red blood cells are low in hemoglobin, or if you are just low on red blood cells. Adult anemia is usually caused by an iron, folic acid, and/or B12 deficiency. Your body cannot properly manufacture hemoglobin without these critical nutrients.

It may also seem puzzling that after the age of 50, anemia rises sharply -- similar to iron overload. In this case, however, adults with iron deficiency are bleeding somewhere and are "wasting" iron. These conditions include ulcers, colitis, precancerous polyps, or even colon cancer. Poor digestion and malabsorption (think lack of hydrochloric acid) are also huge factors, as well as alcohol abuse. Other causes of anemia are chronic inflammation, kidney disease, and low testosterone in both men and women. Symptoms of low iron are somewhat similar to those of excess: fatigue, lifeless hair with cold hands, and cold feet.

To know the true state of your iron levels, at your next blood test, have your physician order a ferritin test, first and foremost. In addition, get a CBC or complete blood count. A normal red blood cell or erythrocyte reading will be between 4.2 to 5.4 million cells/mcL for women and 4.7 to 6.1 million cells/mcL for men.

Low hemoglobin (Hb) would be under 12 g/dL for women and 14 g/dL for men. Larger than normal RBCs indicate a B12 and/or a folate deficiency, whereas small red blood cells suggest iron deficiency or sometimes lead poisoning.

If you are suffering from anemia, it is imperative that you shore up your digestion. Make sure you are taking sufficient digestive enzymes and especially an HCL supplement which helps in the absorption of all acid-based minerals, including iron. Take a high quality multivitamin with up to 18 mg of iron daily (the RDA for menstruating women). Sometimes the addition of B12 (make sure it is the methylated B12 for complete utilization) and folic acid is necessary. Additional digestive enzymes derived from plants are also important to take because they assist with both digestion and absorption.

Remember, iron overload and anemia are just symptoms -- not diseases. Understanding the causes, along with the cures, are the best pathways to better health and longer life.

(Please note: All values and measurement increments may vary between different laboratories. Talk to your healthcare practitioner about the meaning of your specific test results.)

For more by Ann Louise Gittleman, Ph.D., CNS, click here.

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