Subject: Iron: The double edged sword

From: [email-masked] (Michael Traub)
Date: Thu, 31 Mar 1994 13:58:13 GMT

>From Good Medicine vol 1, no 1, Winter 1993: "Iron: the Double Edged Sword"

In  his  new  book,  Iron  Balance,  Dr.  Randall Lauffer turns upside down
everything   we   thought  we  knew  about  iron.  Dr.  Lauffer  points  to
increasing  evidence  that Americans get into trouble with iron not usually
by  getting  too little, but more commonly from getting too much. Iron is a
catalyst  in  chemical  reactions  that damage the heart, cause cancer, and
accelerate  the  aging  process.  In  this interview, Dr. Lauffer describes
how  to  find  out  if  you are iron overloaded or iron deficient, and what
foods keep iron levels in control.

Barnard:  It  is  surprising  to  learn that iron may present serious risks
for  many  people.  We  tend to think of iron only as a healthful nutrient,
and the more the better.

Lauffer:  Scientific  discoveries  are  coming  out  every  day showing new
roles  that  iron  plays in many common diseases, and that has been turning
a  lot  of  heads  in  the scientific community. We are coming to recognize
that  there  has  perhaps  been  an  overemphasis on iron deficiency in the
past.  Worldwide,  iron  deficiency  is  a  major  problem,  especially  in
populations  that  are  malnourished.  However, in the well-fed populations
of  the  Western  world  Europe  and  the  United States in particular iron
deficiency  is  increasingly  rare,  and  is  mainly  observed  in  certain
sub-groups  such  as  pregnant  women  and children. The prevalence of iron
deficiency   in   developing   countries,   however,  attracted  scientists
attention,  and  they  saw  a  great opportunity to cure a major problem by
providing  iron  in  common foods. And they focused on it at the expense of
focusing  on  the  possibility  that  some  people  in our own country were
overloaded with iron.
  
Of  course,  there  is  a  second  reason  why  iron  deficiency  has  been
overemphasized;  its  because  not  only scientists are involved. There are
also  commercial  interests:  the  vitamin manufacturers with products like
Geritol,  food  companies  making  cereals  and breads fortified with extra
iron,  as  well as the food lobbies, such as the beef lobby. In general, as
you  age,  you  accumulate iron in your body. Your body is really a sort of
dead  end  for iron. Theres no way to get rid of it in a regulated fashion.
We  can  always  get  rid of extra sodium if you eat too many potato chips.
But  with  iron,  there's  really no way to get rid of it. It stays in your
body.

Barnard: What dangers are there from having too much iron in the body?

Lauffer:  Iron  is  a  key component of the free radical theory of disease.
This  was  discovered  some  time  ago, and more and more evidence is being
laid  down  in  support of it. Basically, the theory is this: Oxygen, which
of  course  is  good  for you, is used in burning the body's fuel, that is,
the  foods  that  we  eat.  But  oxygen  also  can  be converted into toxic
by-products.  Now,  most  of  these  toxic  by-products  are  pretty  mild.
However,  in  the  presence of iron, and also, in some cases, copper, these
mildly  toxic  forms  of  oxygen  are converted into much more toxic forms.
And  wherever  they are produced, they can damage the tissue that surrounds
them.   This   is   true   in   heart   disease.   The  leading  theory  of
atherosclerosis   involves   free   radical  damage  to  the  bad  form  of
cholesterol  thats  floating  around  in  your  blood.  LDL, or low density
lipoprotein,  is  oxidized  by free radicals. And then certain cells in the
artery  itself  and  the artery wall begin sucking up this damaged LDL. And
this  begins  what we call atherosclerotic plaque development. But the most
important  role  for  iron  is  that  excess iron in the heart creates more
damage  when  a  heart  attack  actually  occurs. The same type of chemical
reaction  that  oxidizes  LDL can also damage the heart cells directly. For
example,  when  you  have a heart attack, you have diminished oxygen supply
to  the  heart.  Then,  when  you have either coronary bypass surgery, or a
procedure,  such  as  angioplasty,  where the artery is opened up and blood
flow  resumes,  more  oxygen  is  quickly perfused into the heart, and this
generates  more  damaging  oxygen free radicals. And the more iron present,
the  more  damage occurs in the process. And we are now following a Finnish
study,  which  was  recently  released in a major cardiology journal, which
shows  that  men  who  have  higher  iron  levels  are predisposed to heart
attacks.  We  don't  have  enormous  evidence  that  excess iron will cause
atherosclerosis  directly.  We do believe, however, that the combination of
high  cholesterol  levels  which  are  common  in Western cultures and high
iron  and/or  copper  levels  can  contribute  to this process. People have
wondered  for  years why men are predisposed to certain diseases from which
women  seem  to  be  protected. For heart disease, it is not that women are
totally  protected;  they seem to be protected only prior to menopause. The
conventional  medical  view  is  that  it  is  all  hormonal,  that in some
mysterious  way,  womens  hormones  protect  them  during the child bearing
years.  And  there's  been no clear mechanism proposed as to how that would
actually  work.  For example, the effects of estrogen on cholesterol levels
are  really  quite  ridiculously small to ever be a mechanism for this. The
changes  in  iron  metabolism,  however,  are  dramatic, and appear to be a
much  more  sensible  explanation  for the difference in incidence of heart
disease  in  men  and  women.  The  iron levels match exactly the mortality
rates  of  heart  disease  in  men and women. Men get very high iron levels
early  in  life, say twenty years old, whereas women's iron levels are held
down  by  the  natural  loss  of iron through menstruation. As soon as that
ceases,  however,  their  iron levels bound up quickly to that of men, and,
at the same time, the incidence of heart disease increases.

Barnard:  Luckily,  the  same  kind  of diet that lowers cholesterol levels
also lowers iron.

Lauffer:  Exactly.  It  makes  sense to look to many of the Asian cultures,
where  heart  attacks are of much lower prevalence, and at the type of diet
they  eat,  and  try  to  mimic that. Its very simple. In fact, the biggest
contributor  to  both  high  iron  and  high  cholesterol  levels  is  meat
consumption.  Meat  is  a one-two punch: it contains a certain form of iron
that  is  very  rapidly  and easily absorbed. And it contains saturated fat
and  cholesterol.  So every bite of meat is contributing to two problems in
the  body,  both  of which lead to heart disease and possibly other chronic
diseases  that  are common in Western meat-eating cultures. The theory that
even  moderately  elevated  iron  levels  may  be a risk factor for disease
is  new  to  many  people.  And  even  though most studies are finding that
animal  fat  seems  to  be  the  culprit, this cannot be separated from the
amount of iron that you get from meat as well.

Barnard:  Let  me  ask you about two other areas: one is general aging, and
the  other  is the effect on the brain: Alzheimer's disease and Parkinson's
disease in particular. Is there a role for iron in those areas?

Lauffer:  Well,  it is difficult to say that if you have higher iron levels
that  you  will  appear  to  look  older,  that  you'll have more wrinkles,
grayer  hair,  those  studies simply have not been done. What we can say is
that  the  leading  theory  of  aging,  which  involves  free  radicals, is
definitely  involved  in at least some of the aging effects, and iron has a
central  role  in  this process. In Parkinson's disease, that's the shaking
palsy  disease  you  see  often  in  elderly  people, the part of the brain
thats  damaged  is also highly iron overloaded. So perhaps this is a cause,
or  at  least  a  triggering factor for the death of those brain cells that
causes  Parkinson's  disease.  In  Alzheimer's, we don't have nearly enough
information.  There  are some provocative studies coming out of England and
Canada  showing,  first  of all, that excess aluminum in the drinking water
seems  to  be  associated  with  a  higher incidence of Alzheimer's. In the
brain,  it  is  possible  that  aluminum  might  kick  iron out of the safe
storage  sites,  and  allow  iron  to  sort  of  roam around and cause free
radical  damage.  So  we  are  concerned  about  the  combination  of  high
aluminum and high iron.

Barnard: What role does iron play in cancer?  

Lauffer:  We  have  had  evidence  for a long time that high iron levels do
increase  the  risk  of  cancer,  and  there are two reasons: first of all,
irons  role  in  free  radical damage is important in cancer. Cancer arises
when  the  blueprint for the cell the DNA is damaged. Second, iron is known
to  be  a  key catalyst for this process, one of the best catalysts you can
imagine.  So  it  seems  funny  that the body could exist safely with iron,
oxygen,  and  DNA as components, with a lot of fat around as well. The body
tries  to  safely sequester iron away in the cell and keep it away from the
DNA.  However,  free  radical  damage  still  occurs.  The body repairs the
damage  as  best  it  can,  but  it cant sometimes repair every little nick
that  occurs.  And  so, the more of these nicks you get, the greater chance
you  have  of  getting  cancer.  Iron has another role in cancer: iron is a
key  ingredient  for  cell  division. If the cell doesn't have iron around,
it  simply  does not divide. So if you can restrict the amount of iron to a
cancer  cell,  it  actually  slows  down  cancer growth. People with higher
amounts  of  iron  have plenty of iron to supply growing cancer cells. This
is  also  true  of  infectious  cells, such as bacteria or yeast, and it is
thought   that   people   with   higher  iron  levels  are  susceptible  to
infections,   not  just  cancer.  There  are  several  studies  in  foreign
countries  and  one  very  large  study  in  this  country with over 10,000
people  examined.  For men especially, it was clear that higher iron levels
were   associated   with  increased  risk  for  certain  forms  of  cancer.
Iron-overload  victims  have  an  increased  cancer  risk.  For  example, a
person  with  inherited  iron-overload  has  200  times  the  risk of liver
cancer compared to a normal person.

Barnard:  I  wanted  to  ask  you about this genetic tendency to accumulate
iron in the body. Can you tell me about that problem?

Lauffer:   Hemochromatosis,   the   heredity  form  of  iron  overload,  is
extremely   common  in  this  country.  Many  physicians  are  unaware  how
prevalent  this  disease  is.  There  are  over  a  million  people in this
country  who  have the genes for this disease that they have inherited from
their  family,  and  very  few  have  been diagnosed. When you get a lot of
excess  iron  in  your body, it begins to masquerade as other diseases. You
get  diabetes;  you get congestive heart failure, due to the destruction of
the  heart  muscle over time; you get arthritis. Often the doctor will want
to  treat  that one disease rather than see it as part of a larger picture.
The  treatment,  actually,  is  for  that  person to donate a pint of blood
every  week  for  a  year or so, and get rid of all that iron. Thats really
the  cure  for these patients, and its miraculous what happens. They can be
completely  cured  by  continuing  to donate blood at some level, initially
frequently, and then later they can just donate occasionally.

Barnard: How does one test for iron overload or iron deficiency?

Lauffer:  The  iron  tests  that  have  been  used  in  the  past  are very
non-specific,  and  don't  really  tell  us  how much excess iron is stored
away  in  the  body. There are three tests which are much better. The first
is  serum  iron. Its worthless alone, because it varies throughout the day.
You  have  to  combine  it  with  a  second  test called total iron-binding
capacity,  or  TIBC. You take the serum iron and divide it by the TIBC, and
what  you  get  is the percentage of the iron-binding capacity in the blood
which  is  saturated.  The third test is called serum ferritin, and it will
tell  you  how much excess iron you have stored away in your body. If thats
high,  you  might  want  to reduce that iron level, just as when you have a
high  cholesterol  level.  And  you  can  do that through dietary means and
other changes in your behavior.

Barnard:  Many  people  may not get tested at all, but may take iron simply
because they feel tired and assume they are low on iron.

Lauffer:  But  there  are  many  causes  of fatigue, and the old wives tale
that  you  need  more  iron, more red meat or liver to boost your iron-poor
blood,  is  largely  false.  Anemia  is  not the most likely cause. You can
have   a   virus,   you   can   have   depression  or  other  psychological
disturbances,  or  there  could  be other dietary deficiencies or diseases.
Geritol's  ads  in  the  1950s  and 60s, said things like, If you're tired,
take  iron.  It'll  not  only  make  you  feel  better,  it'll improve your
marriage  and  sex  life.  Basically,  scientists  could  not  justify  the
recommendation   for   iron   in  the  presence  of  fatigue.  The  Geritol
advertisements,   which  were  viewed  as  illegal  by  the  Federal  Trade
Commission,  buttressed  the  myth  that  iron is only a good thing, and we
should get more.

Barnard:  In  addition  to  moving from meat to a diet with more fruits and
vegetables,  what  other  suggestions  do  you  have regarding the foods we
should be eating?

Lauffer:  I  recommend  the  inclusion  of  foods in your diet that inhibit
iron  absorption  in  the  gut.  Whole  grains  and  certain  beans  have a
substance  called  phytic  acid,  which  binds iron very tightly in the gut
and  doesn't  allow  it to get in. There are suggestions that diets high in
fiber  can  reduce  colon  cancer.  Its not necessarily just the fiber, the
kind  of  undigested portion of the food, but its this other substance, the
phytic  acid,  that  prevents  iron  from  getting in, and it also prevents
iron  from  causing  free radical reactions inside the colon. It may be the
phytic acid content in these foods thats preventing colon cancer.

Barnard:  Now,  if  people  are  building  their  diet  from grains, beans,
vegetables,  and  fruits, are they going to become iron deficient?

Lauffer:  Absolutely  not. There are many studies in vegetarian populations
where   the   iron  levels  are  lower  than  they  are  in  a  meat-eating
population,  but  they're  certainly  adequate, more than adequate, in many
cases.  You  know, most men have 1,000 to 2,000 extra milligrams of iron in
their  bodies,  and  thats iron that they're not using. Its just waiting to
cause  trouble.  I  recommend instead that a safer level would be somewhere
around  100  to  400 milligrams. We have very little information to suggest
an  exact  range at the present time. However, this is exactly the range of
iron  levels  that  a  younger  woman would have, and since it appears that
younger  women  are protected from some diseases, a lot of us have begun to
recommend that level.

Barnard:  Should  we throw out our cast-iron pots and pans and dump out our
red  wine?  What  about other kinds of things that people who are concerned
about iron might be able to do?

Lauffer:  After  we  reduce meat and add phytic acid, everything else has a
minor  effect.  And  if  you  had to come out with a very short message, it
would  be  just  those first two items. However, yes, you can reduce use of
cast  iron  pots.  If  you also reduce the amount of alcohol you drink, not
only  will  you  absorb  less  iron from your foods, but there may be other
benefits  as  well,  since  alcohol  may  be an independent risk factor for
other diseases.
  
Also,  start  spotting foods that are high in iron. Look at your cereal box
and  see  how  much iron is in there; they often add iron to try to play up
the  fact  that  theyre  hitting  100  percent  of  the  Recommended  Daily
Allowance.  You  have to ask yourself, Do I really need that if I've got an
extra  1,000  milligrams of iron in my body already? Why do I need 18 extra
milligrams  in  the  morning?  The  most  important  message is that people
should  heed  the nutritional advice of reducing the amount of fat and meat
in  diet,  but  they  should begin to think that maybe this is not due just
to the fat content in their diet, but also iron.

For more info contact:	Physicians' Committee for Responsible Medicine
			P.O. Box 6322
			Washington, DC  20015
			(202) 686-2210

-- 
Michael Traub, [email-masked]   FAQ maintainer for rec.food.veg & VEGAN-L
 "I have no doubt that it is a part of the destiny of the human race,
 in its gradual improvement, to leave off eating animals" - Thoreau