Frequently asked questions about ovarian cancer screening 2

Frequently asked questions about screening for ovarian cancer

I have recently put up a post about ovarian cancer and as usual lots of people had question about the symptoms and also about proper screening. Just like many other serious health issues, there are lots of myths out there and why it is important to talk about the facts only.

Before I go into the frequently asked questions about screening for ovarian cancer, I do need to say this. If you do have bloating, or some of the other common symptoms of ovarian cancer, please don’t get all anxious and run off thinking you have ovarian cancer.

Many of these symptoms can be indicative of endometriosis and adenomyosis too. This is why it is important to talk to your healthcare practitioner, or specialist about any concerns you have around any of the symptoms you may be getting. Early intervention and detection is the key to any disease, and ovarian cancer is exactly the same. Either way it is worth seeing someone a specialist in this field.

If you do have any of the symptoms from my post on ovarian cancer, please talk to your healthcare practitioner about a referral to an expert, or specialist in this field and get assessed properly.

Frequently asked questions about ovarian cancer screening

This information covers screening for ovarian cancer i.e. the testing of women at population risk who have no symptoms that might be ovarian cancer. This information has been developed to support discussion with a woman about screening for ovarian cancer. Most of this can be found at the Australian Cancer Council (www.cancer.org.au)and the National Breast and Ovarian Cancer Centre (www.nbocc.org.au)

Is there a screening test for ovarian cancer?

No. There is currently no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or a combination of tests, to screen for ovarian cancer.

A Pap test does not detect ovarian cancer; it is only used to screen for cervical cancer.

What about the CA125 blood test?

CA125 is a protein found in the blood. It is known as a tumour or cancer marker. Increased levels of CA125 may indicate ovarian cancer. However, there are many other conditions that can affect CA125 levels such as ovulation, menstruation, endometriosis, benign ovarian cysts, liver or kidney disease, and other cancers such as breast or lung cancer.

If CA125 levels are not raised, this does not completely rule out ovarian cancer, as about 50% of women with early-stage ovarian cancer have normal CA125 levels.

For these reasons, the CA125 test alone should not be used as a screening test for ovarian cancer. It can be used in the assessment of symptoms that may be ovarian cancer.

Can an ultrasound be used as a screening test?

A transvaginal ultrasound (TVUS) gives the best picture of the ovaries but while able to detect the presence of ovarian disease, a TVUS cannot distinguish between benign and malignant disease.

For this reason, transvaginal ultrasound should not be used as a screening test for ovarian cancer.

What if a woman decides she still wishes to have a CA125 blood test or ultrasound?

She should be informed that if either a CA125 or an ultrasound test is abnormal, it may be necessary to repeat the test, or to undertake further tests, which may include surgery to investigate the abnormal result.

The discovery and investigation of abnormal findings can result in unnecessary anxiety and the investigations can carry significant risks.

Final word

I hope this explains a few of the fact around screening for ovarian cancer and helps people understand why some perceived screening methods are not reliable. For more information, you should always talk to your healthcare practitioner, or specialist, and never ever diagnose yourself based on some stupid google search. Always see a qualified healthcare professional for all your healthcare advice. Your life could depend on it.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Women’s Health Experts

The link between endometriosis and cancer

The Link Between Endometriosis & Cancer

One of the most common questions that I get asked from women with endometriosis is “Is there a link between endometriosis and cancer?”

There has been many research papers on this and there is some evidence to suggest that women with endometriosis may have a higher risk of certain cancers such as endometrial cancer and also ovarian cancer.

We all know that Endometriosis is a debilitating disease, but many people don’t realise the possible future implications of this disease, mixed with our highly inflammatory diets and lifestyle. Unfortunately it is a recipe for any inflammatory disease, and for expression of cancer cells.

There have been many reputable studies to date showing the link between inflammation and cancer and endometriosis is definitely an inflammatory disease that needs proper management otherwise some studies are now suggesting it could be a precursor to certain cancers.

This isn’t meant to scare anyone either. It is just to help people realise the possible implications of this disease and to be more proactive around getting yourself and your body healthier and also being properly managed by a qualified health professional. When it come to cancerous states, prevention is key and early intervention is also.

Better education is needed

Given that, we need to really take this disease more seriously than many people with the disease and many in the medical community probably realise. Prevention is always the key to any disease and even though endometriosis cannot be prevented, early intervention and ongoing management of the disease is crucial. This is why I think all young girls should be educated about what a proper menstrual cycle should be like and that period pain is not normal. There also needs to be proper education about diet and lifestyle interventions with inflammatory diseases, such as endometriosis, and how it also needs a multimodality approach to be managed properly.

Endometriosis is like cancer in many ways

Endometriosis, like cancer, is characterised by cell invasion and unrestrained growth. Furthermore, endometriosis and cancer are similar in other aspects, such as the development of new blood vessels and a decrease in the number of cells undergoing apoptosis. In spite of these similarities, endometriosis is not considered a malignant disorder.

The possibility that endometriosis could, however, transform and become cancer has been debated in the literature since 1925. Mutations in the certain genes have been implicated in the cause of endometriosis and in the progression to cancer of the ovary (Swiersz 2006). There is also data to support that ovarian endometriosis could have the potential for malignant transformation. Epidemiologic and genetic studies support this notion. It seems that endometriosis is associated with specific types of ovarian cancer (endometrioid and clear cell) (Vlahos et al, 2010). The relationship between endometriosis and ovarian cancer is an intriguing and still poorly investigated issue. Specifically, histological findings indicate a definitive association between endometriosis and endometrioid/clear cell carcinoma of the ovary (Parihar & Mirge 2009).

Women with endometriosis may be more prone to certain cancers

There are recent studies which have shown that mutations in the certain genes found were identified in 20% of endometrial carcinomas and 20.6% of solitary endometrial cysts, played a part in the development of ovarian cancers. In addition to cancerous transformation at the site of endometriosis, there is recent evidence to indicate that having endometriosis itself may increase a woman’s risk of developing non-Hodgkin’s lymphoma, malignant melanoma, and breast cancer (Swiersz 2014).

Women with endometriosis appear to be more likely to develop certain types of cancer. Brinton, PhD, Chief of the Hormonal and Reproductive Epidemiology branch at the National Cancer Institute has studied the long-term effects of endometriosis, which led her to Sweden about 20 years ago. Using the country’s national inpatient register, she identified more than 20,000 women who had been hospitalised for endometriosis.

After an average follow-up of more than 11 years, the risk for cancer among these women was elevated by 90% for ovarian cancer, 40% for hematopoietic cancer (primarily non-Hodgkin’s lymphoma), and 30% for breast cancer. Having a longer history of endometriosis and being diagnosed at a young age were both associated with increased ovarian cancer risk (Brinton et al, 1997).

Farr Nezhat, MD, Chief of Gynecologic Minimally Invasive Surgery and Robotics at St. Luke’s and Roosevelt Hospitals in New York City and Professor of Obstetrics and Gynecology at Columbia University, spoke on the pathogenesis of endometriosis and ovarian cancer. According to a 2000 study of women with ovarian cancer by Hiroyuki Yoshikawa and colleagues, endometriosis was present in 39% of the women with clear cell tumours and 21% of those with endometrial tumours. The studies clearly suggest that Endometriosis may be the precursor of clear cell, or endometrial ovarian cancer (Yoshikawa et al, 2000).

Inflammation and Estrogens are a big factor in many cancers

If you combine inflammation with oestrogen as with both endometriosis and ovarian or uterine cancers, it’s going to be a vicious circle, as the 2 diseases share numerous other characteristics. For example, both are related to early menstrual cycles and late menopause, infertility, and inability to fall pregnant. Any factors that relieve or offer protection against both conditions need to be explored, including dietary and lifestyle changes etc.

Some authors also suggest that there is an also increased risks of colon cancer, ovarian cancer, thyroid cancer non-Hodgkin’s lymphoma and malignant melanoma in women with endometriosis when compared with the general population (Brinton et al, 2005).

Proper management and early intervention is crucial

If you do have patients with endometriosis you do need to take into consideration the future implications of this disease, not only the pain and turmoil it causes on the way, but also the future possibility that endometriosis could also lead to cervical cancer, ovarian cancer, or many of the other cancers that can be found in the body.

There are certain medications, both natural based and medical that can great assist in the treatments and management of endometriosis and microscopic endometriosis implants. These do need to be explored and we now have the Royal College of Obstetricians and Gynaecologists recommending diet and lifestyle changes and to use complementary medicine such and Chinese Herbal Medicine and Acupuncture for the the management and treatment of endometriosis. This is recommended alongside medical interventions and it does get back to a multimodality approach is the key factor in proper management of this disease.

Diet and lifestyle changes are crucial in cancer prevention

There have been numerous studies showing the benefits of a low inflammatory based diet and reduction in lifestyle factors such as stress. These things are also crucial in any inflammatory disease and certainly in cancer prevention.

Anyone with endometriosis does need to be following anti-inflammatory diet, with reduced refined foods and increased whole foods. This is something I promote whole-heartedly and see great results with on a daily basis. It is also part of my PACE- Diet and Lifestyle program. PACE meaning (Paleo/Primal Ancestral Clean Eating) .

This style of diet is very much like the mediterranean diet which is now shown to be one of the best diets in the world to help with cancer prevention and reduction of cardiovascular disease. It is something that has been shown to assist with inflammatory diseases such as endometriosis. This can be done alongside supplements such as omega 3 oils and antioxidants that also offer protection and prevention against inflammatory diseases too. You should also talk to a qualified healthcare professional about diet and lifestyle interventions and supplementation.

See an Endometriosis Expert

Hope that helps everyone to understand why it is so important to really make some proactive changes if you do have endometriosis. You really need to explore as many options as you can when trying to manage this disease and halt its progression. It is also important to see an endometriosis expert and not try and manage this disease yourself. You just should not be doing this and it is not effective management. Always see an appropriately trained healthcare professional who is trained in endometriosis and other disease states in women. We don’t want to see it end up as cancer later on and this is why it is so important to make sure you are being appropriately managed now.

Final Word

If you do need help with endometriosis, and the associated symptoms of endometriosis, give my friendly staff a call and find out how I can help you. Always remember that early intervention is the key and being managed properly is also crucial.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The Endometriosis Experts

Cervical Cancer stages

Cervical Cancer Awareness

Cervical cancer awareness is something all women need to know about and why proper screening for women is so important. It is so important that we bring awareness to cervical cancer, just as we do to many other cancers such as breast cancer and ovarian cancer.

Cervical cancer remains a significant cause of death, from cancer in women worldwide. In clinic I see so many women with the early, intermediate and sometimes advanced stages of cervical cancer. It isn’t good and many women with early detection on cancer cells aren’t being proactive in follow up consults, or have little idea just how significant these results are to their future health and possible length of their life.

Our increasing understanding of the relationship between HPV infection, pre-invasive and invasive disease of the cervix, the introduction of population screening programs using Pap smear testing, the availability of HPV vaccines, and the introduction of testing for high-risk HPV DNA types have changed the burden of disease in developed countries but even so, cervical cancer remains a significant problem in developing countries.

The Statistics of Cervical Cancer

World wide, cervical cancer is the fourth most common cancer in women, and the 7th most common overall.

In 2012, there were approximately 528 000 new cases of cervical cancer, and there were 266 000 deaths as a result of cervical cancer. In 2015, there were 857 new cases of cervical cancer diagnosed in Australia. In 2019, it is estimated that 951 new cases of cervical cancer will be diagnosed in Australia. In 2019, it is estimated that the risk of a female being diagnosed with cervical cancer by her 85th birthday will be 1 in 494.

The majority of cases (approximately 85%) and deaths (87%) occur in less developed regions.

In Australia a report by the AIHW “Gynecological Cancers in Australia: an overview” showed the following statistics regarding cervical cancer.
-there were 951 cases of cervical cancer, accounting for 1.4% of all gynaecological cancers

– cervical cancer was the 14th most commonly diagnosed cancer in females

– the estimated number of deaths from cervical cancer was 256

– approximately 70% of cervical cancers were diagnosed in women under the age of 60 years

– the risk of being diagnosed with cervical cancer by the age of 85 years was 1 in 494.

HPV and cervical cancer

HPV (Human Papilloma Virus) is a major cause of cervical cancer and why we need to get the safe sex message out there. In a study of almost of 1000 cases of cervical cancer worldwide, the prevalence of HPV infection was 99.7%.

Screening and regular checkup are also needed in the overall prevention and early intervention of this disease. Large population based studies have shown that screening via gynaecological examinations and Cytologic (Pap smear),may decrease cancer incidence and mortality by more than 80%.

The current screening recommendations are:

Routine screening with Pap smears use to be carried out every two years for women who have no symptoms or history suggestive of cervical pathology. Since 2017, the pap test has been done away with and that has now changed to the new cervical screening test.

All women who have ever been sexually active should start having Pap smears between the ages of 18 and 20 years, or one or two years after first having sexual intercourse, whichever is later. In some cases, it may be appropriate to start screening before 18 years of age.

Pap smears may cease at the age of 70 years for women who have had two normal Pap smears within the last five years. Women over 70 years who have never had a Pap smear, or who request a Pap smear, should be screened.

This policy applies to women with no symptoms and normal Pap smear results who should be screened. To find out more about the cervical screening test, you should talk you your healthcare practitioner, or specialist. You can also find out more information about cervical cancer screening at  Cancer Australia

National screening and education about regular screening, has had a significant impact on the reduction of cervical cancer and deaths caused by this disease

HPV Vaccination

Please note that HPV vaccinated women would still require cervical screening as the HPV vaccine does not protect against all the types of HPV that cause cervical cancer. Until any changes are implemented women should continue to have two yearly Pap tests.

Symptoms of Cervical Cancer

Abnormal vaginal bleeding is the most common symptom of invasive cancer of the cervix. This may include bleeding after sex, bleeding in-between periods, or post-menopausal bleeding.

Cervical cancer is often asymptomatic until quite advanced in women who are not sexually active.

Other symptoms may include:

  • Pelvic pain
  • Bowel or bladder symptoms due to pelvic pressure
  • Symptoms from a fistula (leaking urine or faeces vaginally)

Cervical cancer is preventable

Cervical cancer remains an important preventable cause of cancer in women both in Australia and worldwide. Even with the advent of vaccines, it is very important to remember that participation in regular screening is still necessary and a key part of reducing the incidence and deaths from cervical cancer.

Avoiding risk factors and increasing protective factors will help prevent many forms of cancer

The following risk factors increase the risk of cervical cancer:
1. HPV infection
2. Smoking (even social smoking, or 1-2 per day)
3. DES (diethylstilbestrol) Exposure – A man made estrogen
4. Poor diet
5. Being Overweight
6. Lack of exercise
7. High number of full-term pregnancies
8. Long term use of oral contraceptives

The following protective factors decrease the risk of cervical cancer:
1. Preventing HPV infection
2. Cervical Cancer Screening (pap smears & new HPV screen)
3. Diet (decreasing highly refined foods)
4. Exercise
5. Weight Loss
6. Quitting smoking

Avoiding risk factors and increasing protective factors does help prevent cancers and we all need to look at avoiding the risk factors and increasing more of the protective factors. If you are worried about your risks, you should talk to your healthcare professional about how you might lower your risk of cervical cancer.

Final Word

In practice I see so many women presenting with various stages of this disease and end up not being pro-active around the treatment of the disease. So many take this disease and precancerous cells too lightly. It can kill if not treated properly and therefore it is important to follow up with proper screening, treatments and interventions of cervical cancer.

Let’s bring more awareness to cervical cancer and let’s bring more awareness to prevention and hopefully a cure.

Regards
Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

Untitled design 10

Breast Cancer Awareness

Breast cancer awareness is something that everyone should know about. Mankind has known breast cancer since ancient times. In 460 B.C. Hippocrates explained breast cancer as a disease caused by an excess of black bile, or “Melancholia”. He named the condition ‘Karkinos’- (Cancer)- the Greek word for crab and the astrological constellation. This was because the tumor seemed to have tentacles which reached out into the surrounding breast tissue, resembling the legs of a crab.

The history of Breast Cancer

This theory of Hippocrates held for many centuries until 1680, when the French physician Francois de la Boe Sylvius suggested that Breast Cancer developed from an increase in the disruptions of the acidity of local lymphatic fluids.

There were many theories that followed including celibacy causing breast cancer, too much rigorous sex causing disruption to the local lymph drainage and thus causing breast cancer and others linking breast cancer to mental disorder-the melancholia references again.

In 1757 Dr Henri Le Dran was the first person to suggest that the surgical removal of the tumor was the most effective treatment, provided all the lymph nodes in the armpits were removed. This must have been a horrific prospect prior to anaesthetic and proper sterilised surgical procedures. The survival rates were appalling, due to immediate death post surgery from the high infection rates. It wasn’t until 1976 that advancement in radiation and chemotherapy actually took place. This really isn’t that long ago and the first mammogram trails showing reduction of breast cancer due to early screening, where only initiated in 1989. To think that in such a short spam of time, we now have this as a routine screening tool that can save lives.

It wasn’t until 1994 that scientist have isolated the first of the genetic mutations associated with breast cancer and these genetic screening for the gene mutations and being predisposed to breast cancer. This screen has led to Angelina Jolie having a double mastectomy when testing revealed she had the BRCA1 gene mutation which predisposed her to both ovarian and breast cancer. It was estimated that Jolie had an 87% risk of breast cancer and a 50% risk of ovarian cancer. Jolie’s mother died at 59 from the disease in 2007.

Since Angelina Jolies decision, there was a surge in enquiries around genetic testing and medical evaluation as to breast cancer risks across all parts of the world.

Breast cancer remains the most common malignancy in women, comprising 18% of all female cancers and there is 1 million cases of breast cancer diagnosed worldwide. Most women will know someone who has had the diagnosis, based on these figures.

Despite all the testing and screening it is estimated that about 40% of women have never discussed their risk factors with there doctor, or health care practitioner.

So what can you do to reduce your risks?

The first thing anyone can do is check yourself for any noticeable signs of changes to the breast. You can also have a routine breast examination at your doctor.

Next is regular mammogram, or ultrasound screening, followed by biopsy if anything suspicious is found. Screening for genetic predisposition is another tool that should be used by all women too. About 10% of breast cancer in developed countries is due to genetic predisposition. Certain populations of people have higher genetic risk factors with the Ashkenazi Jewish population having the highest risk factors and well as risk factors for some rare genetic diseases.

The good thing with early screening and detection is that we have now seen in increase in survival rates with the increase between 72-89%.

There are also other risk factors that people need to take into consideration. Women who have their menstrual cycle too early and those who go into menopause later in life are at increase risk of developing breast cancer. Having a baby later in life also increases the risk factor for cancer. Having a baby after 35 years old doubles the risk, while having children earlier reduces the risk. Breast-feeding also reduced the risk of breast cancer too.

Obesity and lifestyle factors increasing breast cancer risks

Obesity and increased alcohol intake also increases a woman’s risk and doubles the chances of having breast cancer. Obesity doubles a woman’s risk factors in postmenopausal women and increased alcohol intake (3-6 standard drinks per day) also doubles the risk factors.

Women on the combined pill also have in increased risk of breast cancer, while progesterone only options do not increase the risk.

Lifestyle modifications

Since there is compelling evidence alcohol and obesity increase the risk of breast cancer, women do need to reduce their alcohol intake and also aim to keep their weight within a healthy range.

This is why we all need to be looking at anti-inflammatory based diets, free from inflammatory wheat grains, excess refined soy products, alcohol, refined foods and refined sugars. These highly inflammatory based foods all lead to excess blood sugars, which in turn spike insulin product. This then causes interference to hormone metabolism (namely estrogens) and also causes the body to store fats and stops the burning of fats, again interfering with estrogen metabolism. This is turns causes inflammation, which is he cause of many of our disease states and leading causes of death.

This is why I always promote a Primal based, low inflammatory, clean eating diet. This is the basis for my PACE-Diet and Lifestyle program (Paleo/Primal Ancestral Clean Eating) that I promote to my patients. This style of diet promotes leans meats, fresh fruits, nuts, seeds, good fats, fresh vegetables and salads, clean water etc. This is very similar to the famous Mediterranean diet, which has to date never been scrutinized and has lot of research behind it. Eating this way will not only make you healthier for it, but will be reducing your risk factors around any inflammatory disease state. Just remember that 90% of breast cancers come from non-hereditary factors related to lifestyle and the way we eat in the modern world.

Early detection and awareness is vital

It is well known that early detection and treatment is vital to survival rates in women with breast cancer. It is so important to regularly check for lumps and bumps and talk to your doctor about regular screening. If you have hereditary risks then talk to your healthcare provider, or specialist about genetic screening for breast cancer.

Let’s all raise awareness for breast cancer and support more research into finding a cure for this disease that affects millions of women world wide each year.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

Cancers in women 1

Bringing Awareness To Cancers In Women

Over the next week I am going to focus on a very serious subject – Cancers in women.

Having recently focusses on the awareness of endometriosis and adenemyosis, I thought I should bring some awareness to the topic of cancers in women as a whole. This isn’t to scare people either. It is to bring awareness to a very serious topic and to help people understand the importance of early intervention and changes to diet and lifestyle can greatly reduce the risks of this horrible disease.

With cancer rates increasing I am going to focus on the cancers that affect the female reproductive system and impact of reproductive health. This will also include those cancers that increase after menopause too. Whenever I talk about fertility and reproduction, it is referring to the stage in life when women are fertile and are of reproductive age. Menopause is also including because that still comes under the reproductive system.

Cancer has been around a long time

Humankind has been dealing with the impact of cancer and malignancy for its entire history and the first clear description of any cancer is found in the Ebers Papyrus, dating from nearly 3500 years ago. The cancer was very accurate described by the Egyptian writer and what was described was in fact breast cancer. Chinese Medicine has texts dating back for further than that, describing the different forms of cancers and their treatments. Modern medicine does tend to only reference Greek, Egyptian and Roman text.

When these Greek physicians first cut the surface of a breast cancer, it did in fact resemble a crab, because of it solid central body, with extensions into the surrounding tissue resembling legs.

The ancient Greek word for crab is “Karkinos” which in Latin is translated into ‘cancer’- as in the astrological sign. This term was then extended into all cancers and malignancies, not just breast cancer.

Genetic, hereditary and hormonal links to cancer

It is believed that cancer is predominantly caused by a failure in the regulation of genes which govern cell growth and differentiation. Malignant change is most typically the result of a cascade of changes in a number of genes.

These changes in genes can be bought on by hereditary genetic genetic changes, while others may be the incorporation of foreign viral DNA, or a compound that may act as the primary trigger for malignant change. Some cancers and malignancies are also caused by hormonal stimulation both internally and by injection, or ingestion of hormones from an outside source (Drugs, Hormone Replacement etc).

Diet and lifestyle links to cancer

Other cancers are plain and simply caused by the highly inflammatory foods we eat and the lifestyle we live. Obesity and being overweight increases our cancer risks and there are no many studies proving these links. Having excess fat stores, eating highly processed foods, high GI foods and over 3-4 glasses of alcohol per week can increase your cancer risks exponentially. This why we all need to adopt a clean eating approach to foods and look at eating less refined foods and more whole foods.

The incidence of cancers in women is highest in developing western countries and lowest in countries such as Africa and Asia. The difference has more to do with diet than it does genetics. Since there is compelling evidence that alcohol, highly refined foods and obesity increase the risk of cancers in women (and men) I will be focusing greatly on the need for us all to look at changing our diets to not only help in the prevention of certain cancers, but to also help prevention of other disease states that are leading causes of our lives being cut short.

The most common cancer in women

Since breast cancer remains the most common malignancy in women, comprising of 18% of all female cancers, most women will know someone who has had this diagnosis.

I’ll focus on breast cancer firstly and then go into the other cancers so that we can all be educated about how we can prevent these disease states from increasing. If you have any questions, or topics you want discussed around this topic, please let me know

Take care and remember prevention is better than cure. Always talk to your doctor, or healthcare practitioner about cancer risks and always seek early intervention if you find any lumps and bumps that were not there before.

Hope you the topics help you all. If I can save just one person with this information, then I am happy. Lets try and save more than one, so please like and share to spread the word.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

serious complications of low iron

The Serious Health Complications Of Low Iron

In the last couple of weeks I have been talking about the serious complications of people not having their health managed properly. It seems to be a big issue and with my latest post, the issue of unmanaged, or undiagnosed low iron is also becoming a very serious issue indeed. So for this post I will be talking about the serious health complications of low iron.

Two thirds of body iron is present in circulating red blood cells known as haemoglobin. Each gram of haemoglobin contains about 4gms of iron and each ml of blood lost from the body results in a loss of about half a milligram of iron.

Bleeding is the most common cause of iron deficiency.  This could be from either a diagnosed, or undiagnosed gynaecological issues (endometriosis, adenomyosis, fibroids, polyps, other) or it could be from a parasite infection. It could also be from bleeding as part of a gastrointestinal issue, or part of inflammatory bowel diseases (IBS, Crohn’s Coeliac disease).

There could be other reasons for blood loss in the body, or reduction of iron and many of these conditions, and the conditions above, can go unrecognised and then cause iron deficiency anaemia. Some of these issues can be very serious, or even fatal.

Excessive menstrual losses are often overlooked with many women. This is something that should not happen and should be part of the questioning with any low iron status. The problem is, unless the menstrual flow changes, patients typically do not seek medical attention for heavy menstrual bleeding. Sometimes when a healthcare practitioner asks, these patients generally report that their menses are normal. It may be normal to them, but we need to educate women that heavy blood loss is not normal and can lead to anaemia.

Because of the marked differences among women with regard to menstrual blood loss (10-250 mL per menses), patients meed to be asked about their menstrual history and about a specific history of bleeding, blood flow, abnormal bleeding in between cycles,  clots, cramps, and the use of multiple tampons and pads. These are very important questions to ask and sadly many women are not being asked these questions, or having further questioning about their menstrual, or overall health, including dietary intake etc.

What is iron deficiency anemia?

Anaemia occurs when you have a decreased level of haemoglobin in your red blood cells (RBCs). Haemoglobin is the protein in your red blood cells that is responsible for carrying oxygen to your tissues.

Iron deficiency anaemia is the most common type of anaemia that women present with, and it occurs when your body doesn’t have enough iron. Your body needs iron to make haemoglobin. When there isn’t enough iron in your blood stream, the rest of your body can’t get the amount of oxygen it needs. Today in a recent post I talked about iron being like trucks, or the transporters of oxygen around the body.

While iron deficiency may be common, many people don’t know they have iron deficiency anemia. It’s possible to experience the symptoms for years without ever having it diagnosed, or the cause of the iron deficiency diagnosed either. It is a very serious issue that needs some serious attention.

In women of childbearing age, the most common cause of iron deficiency anemia is a loss of iron in the blood due to heavy menstruation or pregnancy. A poor diet or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anemia. Women who adopt a vegan diet will also be prone to being iron deficient and vitamin B12 deficient.

Disruption to the microbiome and leaky gut syndrome can also cause iron deficient anaemia too.

One of the best ways to treat the condition is through iron infusion, and also with iron supplements, or changes to diet. We also need to make sure the cause of the iron deficiency is addressed as well.

Symptoms of iron deficiency anaemia

The symptoms of iron deficiency anaemia can be mild at first, and some people may not even notice them. Many people are completely unaware that they may be low in iron, or are actually iron deficient.

The symptoms of moderate to severe iron deficiency anaemia include:

  • general fatigue
  • weakness
  • pale skin
  • Bruising easy
  • shortness of breath
  • Palpitations
  • dizziness
  • Strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  • Tingling or crawling feeling in the legs
  • Tongue swelling or soreness
  • Cold hands and feet
  • Tachycardia
  • Brittle nails
  • Headaches and migraines
  • Sore joints
  • Brain fog and lack of concentration.

The serious complications of unmanaged iron deficiency.

Undiagnosed, or unmanaged iron-deficiency may cause the following severe complications:

  • Heart problems.If you do not have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your body. When your heart has to work harder, this can lead to several conditions: irregular heartbeats called arrhythmias, a heart murmur, an enlarged heart, or even heart failure.
    Severe anemia due to any cause may produce hypoxemia and enhance the occurrence of coronary insufficiency and myocardial ischemia.
  • Increased risk of infections- Research has shown that iron deficiency anaemia can affect your immune system (the body’s natural defence system), making you more susceptible to illness and infection.
  • Motor or cognitivedevelopment delays- This mainly occurs in children. Children deficient in iron may exhibit behavioral disturbances.
  • Behaviour issues and mood disorders- Behavioral disturbances may manifest as an attention deficit disorder, or mood disorder such as : Depression Unipolar depressive disorder, Bipolar disorder, Anxiety disorder, Autism spectrum disorder, Attention-deficit/hyperactivity disorder, Tic disorder, Delayed development and other some other psychiatric issues.
  • Pregnancy complications- Iron deficiency can lead to preterm delivery or giving birth to a baby with low birth weight.
    The neurologic damage to an iron-deficient foetus results in permanent neurologic injury and typically does not resolve on its own, or by supplementation.
  • Chronic Health Conditions worsened- In people with chronic conditions, iron-deficiency anaemia can make their condition worse or result in treatments not working as well.
  • Dysphagia (Difficulty swallowing)- This may occur with foods due to abnormal muscle and nerve control. This could result in choking. It can also lead to throat cancers.
  • Atrophic gastritis – This occurs in iron deficiency with progressive loss of acid secretion, and causes inflammation of the gastric mucosa with loss of the gastric glandular cells and replacement by intestinal-type epithelium, and fibrous tissue
  • Tiredness- As iron deficiency anaemia can leave you tired and lethargic (lacking in energy), you may be less productive and active at work. Your ability to stay awake and focus can be reduced, and you may not feel able to exercise regularly.
  • Fainting– Low iron can cause fainting and this could be dangerous in many situations, especially at work places, or working on machinery, or driving a car.
  • Cold Intolerance– Cold intolerance develops in one fifth of patients with chronic iron deficiency anaemia and is manifested by neurologic pain, vasomotor disturbances, or numbness and tingling.
  • Issues with Brain and Optic Nerve– Rarely, severe iron deficiency anaemia is associated with papilledema (optic disc swelling), increased intracranial pressure, and the clinical picture of pseudotumor cerebri. These manifestations are all corrected with iron therapy.
  • Migraines– Research has now shown that there are certain types of migraines caused by iron deficiency
  • Death – Caused by some of the issues mentioned above

The importance of proper management

Hopefully now everyone can see why iron is so important and that people with iron deficiency need to see their healthcare practitioner for proper help and proper management .  Iron deficiency anemia isn’t something to self-diagnose or treat. It needs to be diagnosed, treated and managed properly. In many cases an iron infusion is the best and quickest way to get iron levels back up. Have a read of my post about iron infusions. Click here

Iron infusions are the quickest way of getting iron levels back up

In the case of low, or severely low iron, supplements just are not enough. They take too long to get levels up and the damage to your body in waiting too long can also be serious.  Always see your healthcare practitioner, or specialist, for a diagnosis rather than trying to manage low iron on your own, or just taking iron supplements on your own. Overloading the body with too much iron can be dangerous too, because excess iron accumulation can damage your liver and cause other complications.

Final Word

This is why everyone needs to be managed by a properly trained healthcare professional with any health issue, especially low iron. If your practitioner is not able to assist you, please make sure you get a second or third opinion. Some practitioners may not be well versed in the serious complications of low iron, or know much about iron infusions etc.

If you do need help with managing the symptoms of low iron, you can call my friendly staff and find out how I can assist you. For more information please call +61 07 38328369 or email info@drandreworr.com.au

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicince

-Master of Reproductive Medicine

-Women’s and Men’s Health Advocate

 

 

When a Hysterectomy Should Be Considered

When A Hysterectomy Should Be Considered

Many times I have talked about “Why a hysterectomy does not cure endometriosis” and so I have decided to talk about “When a hysterectomy should be considered”

Now, before you go any further, I need people to sit back, listen objectively and also take the personal out of this. This is a very personal topic and yes, I am a man and a male healthcare practitioner all in one, with over 20 years experience in helping women with women’s health conditions and being a voice for them also. But regardless, this topic does need to be talked about. Any negative comments, or rudeness will get the delete button immediately. Constructive discussion is always welcome.

The long and short of it is this. There are times when a hysterectomy should be considered (lack of quality of life, cancers etc) and we need to be able to give women the facts so that they can make informed choices, and also not be judged for those choices either. The fact is that for some conditions, women actually get their life back after having a hysterectomy and I talk about all of this and more in this video blog.

 

Kath Mazzella interview

Gynaecological Cancers & Gynaecological Awareness with Kath Mazzella

I’m sharing a video link up with Kath Mazzella (OAM) about her journey with being a gynaecological cancer survivor and her passion for now helping women with better understanding of gynaecological, sexual and mental health conditions.
 
Kath Mazzella OAM is a Gynaecological cancer survivor. Kath is now so passionate about creating change in relation to the level of awareness of Gynaecological, Sexual and related Mental Health challenges and to break down the barriers and stigmas associated.
After her gynaecological cancer surgery Kath discovered how little women knew and talked about conditions “down there”, and how many women were suffering in silence. This empowered Kath to go on a journey … a journey that her partner Tony had no choice initially but to go on with her. Now he has stepped up to stand beside her and promote this very worthwhile and necessary message, extending it beyond just the women, but also to the men that surround their worlds. After all, when one woman suffers, all those in her world suffer with her.
Kath and Tony together are powerful advocates for women challenged by gynaecological, sexual and related mental health conditions, personally inspiring women (and a few men also), arguing for institutional and social change that delivers better awareness, prevention, treatment and support.
Kath and Tony are inspirational public speakers and Kath is the founder of the International Gynaecological Awareness Day.
Most recently, Kath was awarded the Jeannie Ferris Cancer Australia Gynaecological Cancers Award, which she handed to Tony upon acceptance, stating that he deserved the award for his patience in supporting her through all the years of her campaigning.
 
In 2012, Kath received the prestigious WA Senior of the Year Award and the Beyond Blue category award, finally having the link between Mental Health and Gynaecological and Sexual health recognised.
 
In 2009 Kath was awarded an Order of Australia Medal for her service of the community through raising the profile of Gynaecological health; was inducted into the 100 Women WA Hall of Fame and also was an inductee to the Hall of Fame – Our Bodies Ourselves Women’s Health Heroes, Boston, US. Kath was shortlisted for the Centre for Women in Leadership Award; and Most Inspiring Woman of the Year – Momentum Women’s Forum. Kath was also presented with the Zonta International “Woman of Achievement Award” for Western Australia and received an Executive Women’s Forum Woman of the Year award, both in 2005.
 
Have a listen to our video link up and don’t forget to get behind the gynaecological awareness day on September 10.