STTM page High Iron graphic

Having low iron is far more common for hypothyroid or Hashimoto’s patients due to their low stomach acid situation (or less common, having h-pylori bacteria or gluten damage). I’ve found myself with low iron several times over the years due to the former. But some have HIGH iron! Below are causes of high iron you can explore! ~Janie, hypothyroid patient and creator of this patient-to-patient site

High iron occasionally shows up on one’s lab results!

How do I know when it’s high?? For women, we’ve noted frequently that if the serum iron is several points and more higher than 110, that’s a clue. For men, it appears that if it’s several points and more above the 140’s, that’s a clue. More clues explained below.

HIGH IRON REASON ONE: a methylation problem, i.e. the MTHFR MUTATION (the most common reason we see)

It’s been noted before that the MTHFR mutation was the most common reason for having high iron in some thyroid patients.

Though MTHFR looks like an acronym for a dirty word (lol), it actually stands for the mouthful “methylenetetrahydrofolate reductase”, representing the MTHFR enzyme. When working correctly, this enzyme works with the folate vitamins (B9, folic acid), breaking it down from 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, which in turn helps with breaking down certain metals like iron.

Thus, if your MTHFR gene has a mutation and that mutation is now expressing itself, your labs can look like this: higher than optimal serum iron and % saturation, a low ferritin….and a higher in the range TIBC. It’s the latter high TIBC that especially gives away the problem, as with true high iron, the TIBC should be lower in the range, not higher. In a range of 250-450, for example, a rising TIBC would mean inching towards 350 or higher.

But here’s the kicker–if your iron is high due to the MTHFR mutation, you are in a low iron state! Why? Your body is unable to break it down for use! 

The solution?? Patients first confirm it via testing (23andme.com, for one), then they start treating that mutation to enable the iron to be broken down for use eventually–may take a few months, say some.  Here is a good introductory summary, and after reading it all to have an understanding, move on over to MTHFR forums for feedback: www.stopthethyroidmadness.com/mthfr

P.S. There are other methylation genes that could be causing additional problems.  They include, but are not limited to, CBS, MAO-A, COMT, MTRR, MTR, APOE, NAT 1 and 2, etc, etc.

HIGH IRON REASON TWO (less common, but it can be there): HEMOCHROMATOSIS

Hemochromatosis is a genetic condition caused by a mutation in the gene called HFE, and can also be found in C282Y and H63D.  Many people have seen it being passed down in their families. Research states that it’s mostly found in people of Northern European descent.1  It causes your body to absorb far too much iron, even just from your diet! Medically, it’s also called “HFE-associated Hereditary Hemochromatosis”.

Says the Iron Institute: Over time, these excesses build to a condition of iron overload, which is a toxic to cells, plus glands and organs, including the liver, heart, pituitary, thyroid, pancreas, synovium (joints) and bone marrow. They become burdened with excess iron and can’t function properly.  Symptoms develop and disease progresses.2

The clue you could have this is two-fold: a) knowing that your ancestors have had it is one clue. But some may not know. So the other clue is if ALL THREE of the following are high: serum iron, % saturation and ferritin.  And the TIBC, an indirect measure of the iron-carrying protein transferrin, will be lower in the range when all three of the former are too high. To know for sure,  you can do it yourself via 23andme.com The latter will tell you your genetics all over the place, not just this particular mutation!

What do people with this expressed mutation do? They avoid high iron foods and Vitamin C (Vit. C increases the absorption of iron) as well as give blood, aka a phlebotomy. If you have hemochromatosis, your doctor will guide you on the latter–work with him or her! Common is giving blood every few months; some might be able to go longer.

Via Mayo: “In hereditary hemochromatosis, serum iron is usually above 150 mcg/dL and percent saturation exceeds 60%. In advanced iron overload states, the percent saturation often exceeds 90%.”

If your ferritin is not high while the other two are, you may be #1, which is far more common.

OTHER RARE POTENTIAL CAUSES

Just to cover all bases, these are three more less common conditions that might result in having high iron…

  1. Dysmetabolic Iron Overload Syndrome (DIOS): This term has been used in a few places, including a study written by the European Association for the Study of the Liver.6  The study states it’s “detected in about one third of patients with nonalcoholic fatty liver disease (NAFLD) and the metabolic syndrome.” i.e. insulin resistance may also play a role in this for some.
  2. Hemolytic anemia: Simply put, this condition means one’s red blood cells expire faster than your bone marrow can replace them!  Literature shows different causes, ranging from toxins, genetics, certain infections, etc.  At first, states Wiki, your body can make RBC’s faster to compensate for the abnormally fast loss of RBC’s, but anemic symptoms eventually set in.3  It’s the compensation that may at first make iron levels look high. One’s skin may look yellow with this condition and urine may darken.3  This is definitely something you should work with your doctor about if you suspect it.
  3. Sideroblastic anemia: This inherited or acquired disorder (or sometimes of unknown origin) is where one’s body has available iron, but it’s not being unified with hemoglobin.4 The latter carries oxygen in the blood. As a result, one’s iron can go high, and/or the liver can be negatively affected or enlarged. It’s said to be observed more in males than females. Testing for this is done via “staining of the red blood cells”– they are looking for what are called ringed sideroblasts”.5  Also work with your doctor if you suspect this.

Other: there’s a good list of less common conditions that can cause iron overload on page two of this information: http://www.esh.org/files/doc/IRON2009_CAP.25(584-605).pdf

Please don’t let all the above more rare conditions confuse you totally. We seriously see high iron mostly with the MTHFR mutation than the others. So at least explore that thoroughly. If you suspect any of the others, though, including the other methylation gene mutations, work with your doctor.

  1. https://ghr.nlm.nih.gov/condition/hereditary-hemochromatosis#statistics
  2. http://www.irondisorders.org/hemochromatosis
  3. https://en.wikipedia.org/wiki/Hemolytic_anemia
  4. https://rarediseases.org/rare-diseases/anemias-sideroblastic/
  5. http://www.haematologica.org/content/96/6/789
  6. https://www.ncbi.nlm.nih.gov/pubmed/21718726

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