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What Causes Iron Levels To Be High?

Are you wondering what causes iron levels to be high?  Maybe you were told you have high iron and you don't really know what that means.  There are different ways to measure iron.  So in addition to discussing what causes high iron we want to look at the various test that can look at iron levels. 


If you are curious about the causes of high iron and some of the things you should be thinking about when this comes up in your health, keep reading we are gonna get into the details.

What causes too much iron or iron levels to be high? First let's define a little bit more on what we mean by iron levels.  There are a few different tests that can refer to iron and iron levels.  One way we can measure iron is through a serum iron test.  This is the kind of iron that is free floating (bound to transferrin) around in your blood.  While it is bound, it's more free and ready to be used.  We also have another form of iron referred to as stored iron. This test is called ferritin.  

Then there is one other way that is more of a surrogate marker for iron.  This is hemoglobin.  Hemoglobin is not actually iron but it contains iron.  Hemoglobin is a molecule that helps your body transport oxygen and in order to make hemoglobin, your body will require iron.  So iron is a core part of that hemoglobin. Because of this hemoglobin makes up the bulk of the iron in your body.  Often times when people refer to your iron levels, they are referring to  hemoglobin.  The terms, iron and hemoglobin are sometimes used interchangeably. 

They are not the same and should not be used interchangeably.  While the levels of hemoglobin, serum iron and ferritin often correlate, the don't always.  For instance, it is possible to have a normal hemoglobin and high ferritin.  It is also possible to have high hemoglobin and low ferritin. So let's look at what cause iron level to be high in more detail. 


What Is Too Much Iron?

For this article, we will exclude hemoglobin from the conversation of too much iron.  What we will include and are specifically referring to is high serum iron and high ferritin.  In particular, we want to look at the ferritin.  It is important to note that normal ferritin levels differ for males and females.  The ferritin reference range for females starts at about eleven and goes up to two hundred and thirty.  The reference range for males starts at about twenty five and goes up to about five hundred.  Males have a very broad reference range for ferritin. 

When we talk about high iron levels there are two ways to think about this.  There is extremely high iron like 30% above the normal range and then there is something above what is considered an optimal range.  We will discuss both of these.  For a female a ferritin well above two hundred, let's say two hundred to three hundred is very high.  Something in the high one hundreds and low two hundreds would be suboptimal.  There are a few things you should be thinking about when you have these levels.  We will discuss it below. 

For a male if they have a ferritin that's well above five hundred, like six hundred to seven hundred, this is extremely high.  Even when their ferritin is in the three hundred to four hundred range, this is suboptimal and on the high range.  Now let's look at what might be causing these high iron levels.


What Causes High Iron Levels?

michael-schaffler-mRTJ1jpH8XQ-unsplashOne of the things that can cause high iron levels is called hemochromatosis.  Hemochromatosis is the disease state caused by high iron.  It occurs due to a genetic abnormality if increased  iron absorption through the digestive tract.  When that happens your body tends to accumulate more iron.  For females this problem tends to not show up early in life, if they are having normal menstrual cycles.  It still can happen, but it is more common after they go through the menopause or stop mensuration.  Women can still have the genetics of hemochromatosis but because they have menses their iron levels do not get high. 

For this reason it is more common for men to get hemochromatosis diagnosis.  In men this can show up in their mid twenties or late thirties.  It does take a while for the iron to build up.  Anything over four hundred is considered problematic . These higher levels usually occur when you have hemochromatosis.  Sometimes this will not show up right away.  So if you are still pretty young you have to keep checking your ferritin periodically over the years. Since it is genetic, you may have a family member with this as well. 

When the high numbers show up depends on several different things, like your specific genetics, your diet, etc.  For instance, there are several different gene alterations that will cause iron to absorb at increased rates.  If you are doing any kind of blood donations this will mitigate the risk for both males and females . However you should not just rush out and start doing blood donations (more on this below).  Your diet will also play a big role too. 

For dietary sources of iron only certain foods are going to be a significant source of iron. The main source of iron in our diets is called heme iron.  The heme iron is coming from hemoglobin in the blood of animals.  If you are eating animal products, you are getting some iron from this.  If you are not eating animal products, then you might be getting a little bit of iron.  The potential for any dietary source of iron to raise your ferritin or serum iron will depend on how well you absorb it.  With plant sources, it is unlikely you will get high iron because there is not a lot of iron in these.

So far we talked about two main causes of high iron, high dietary consumption of high iron foods and hemochromatosis genetic alterations that favor iron absorption.  You don't have to have a diagnosis of hemochromatosis for this to be a cause of high iron. Some people only have minor genetics that favor this.  The diagnosis of hemochromatosis is done by a hematologist or blood specialist and they do this after looking at really high ferritin and transferrin.  If these are both high usually they will do genetic test to confirm the genetics for increased iron absorption. There are different combinations you can have to get that diagnosis.  Some are more common than others.

The last reason that people can have high ferritin has to do with inflammation.  This phenomena is called an anemia of chronic disease.  In this case, the overall iron levels are not high.  What shows up is high is the ferritin.  What happens is your red blood cells actually come down and you become anemic.   When there is really high inflammation in your body, your body will sequester or store and shunt all of your iron into into ferritin.  So if you have a high ferritin and you don't know why, it's a very important that know this before you start donating blood.  You have to make sure that your hemoglobin is normal and also that you don't have inflammation because that could be a cause for high ferritin.  

Sometimes high iron alone can cause inflammation.  This means there are a few finer points that you need understand about iron.  As a result this is something you should be doing in conjunction with your doctor.  In summary the three main causes of high iron are:

  • High iron foods
  • Hemochromatosis or genetics favoring that
  • Anemia of chronic disease, chronic inflammation, or chronic infections

That should give you a better understanding of what causes iron levels to be high and maybe some things to discuss with your doctor on what the best steps will be.  If you have questions about anything resented here, please ask in the comment section below. To get a customized plan on your blood tests or high iron levels, click on the link below to get started. 


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