In past blogs, I've talked about the symptoms and health problems that can occur when ferritin is below the optimal range of about 60 to 90. Here is a question from a male reader who experienced high ferritin.
Question: I have a ferritin now of 483, but when my problem was first found in 2007, it was at 1,768. My doctor recommended therapeutic phlebotomy (giving blood). I’ve had 7 pints of blood drawn, but now I am having symptoms of chronic fatigue, blurred vision, burning eyes, headaches, and problems focusing my thoughts. I have seen an optometrist, an ophthalmologist, a neurologist, and an ENT physician. I have had an MRI, blood tests, eye tests, sinus tests, and none of my doctors have been able to give me an answer. Could all of this be caused by the ferritin being so high for so long?
Dr. Vliet's Answer:
Ferritin levels this high are commonly caused by a genetic disorder called hereditary hemochromatosis. The gene for this disorder was identified in 1996, called C282Y.
Hemochromatosis affects both men and women and results from receiving a mutated C282Y gene from one or both parents.
Hemachromatosis is also called iron overload disorder, and it occurs when the daily absorption of iron from the intestines is greater than the amount needed to replace losses. Our body cannot increase iron excretion, so this means that if more is absorbed from our diet or supplements, it will accumulate in body tissues over time.
Excess iron deposits build up in various organs – the brain, joints, liver, testicles, and heart. Over time these deposits cause damage to the organs, leading to a variety of symptoms.
Women with hemochromatosis typically develop symptoms about 10 years later than men do, since women lose iron in menstrual blood each month and do not build up iron in the tissues as rapidly as men do.
Iron deposits in the heart damage the heart muscle and lead to heart failure or irregular rhythms, while iron deposits in the pancreas cause a decrease in insulin production and lead to diabetes.
Iron deposits in the liver cause liver damage (cirrhosis) and an increased risk of liver cancer. Iron deposits in the pituitary gland, testicles in men, or the ovaries in women lead to hypogonadism (low testosterone in men, low estradiol in women).
I suspect that there are several causes for the current problems you're having:
1. The elevated ferritin over time that has damaged various organs
2. Even though your ferritin is still too high, a very rapid decrease in ferritin from a very high level can cause fatigue, headaches, and vision changes.
3. If elevated ferritin over the years also damaged the pancreas, then some symptoms may be related to early diabetes or insulin resistance with blood sugar changes. This can be checked with fasting glucose, fasting insulin, two-hour postprandial glucose and insulin, and a hemoglobin A1C.
3. In addition, to some degree, I suspect that fatigue, headaches, difficulty thinking clearly may also be caused by low testosterone. Since this hormone is often overlooked in men as well as women, I think it would be helpful to check serum testosterone levels in the early morning to determine whether hypogonadism is causing some of your current problems.
The key to accurate diagnosis is getting the right tests done. Oftentimes, I find that these endocrine factors have not been adequately evaluated in either men or women.
Refer to the booklets on my website, www.herplace.com, for more information on what tests should be done to answer questions about the hormone causes of complex symptoms.
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