Let’s Talk About Iron

Posted on May 8, 2019May 8, 2019 by Andrew Orr

Let’s talk about iron. After my recent post about me having haemochromatosis and the importance of regular venesection and proper screening, I thought we should talk more about iron.

We need to not only talk about high iron and genetic disorders, such as haemochromatosis, but also talk about iron deficiency and proper screening and management of that as well.

In this video post I talk high iron, low iron and everything in between. I also talk about genetics and auto-recessive genetic pathways and the parental mode of inheritance. This also goes for many other health conditions we see in people.

Please remember that early intervention, early screening, early treatments and early management is the key to any disease state.

Why Iron Deficiency and Anaemia Should Be Take More Seriously

Posted on December 11, 2018September 8, 2019 by Andrew Orr

One of the common things I am seeing in women of all ages is iron deficiency and anaemia. Many women have very low levels of iron and are unaware of the dangers this may pose to their short term, and long term health.

We are also seeing women being hospitalised and seek emergency help due to iron deficiency and anaemia and this highlights that there is inadequate management and detection of a very preventable condition. It also means that many women are not taking this matter seriously enough and often put off seeking screening and then aren’t having their iron levels managed properly.

I need to let all women know that having low iron can be very dangerous. It is something that should not be glossed over, or taken lightly. Iron deficiency can and does cause short term and long term health complications.

Iron deficiency can raise the risk of the following health conditions

Coronary heart disease
Stroke
Osteoporosis
Compromised immune system
Increased risk of infections
Tachycardia
Heart failure
Enlarged heart
Lung problems
Muscle aches and cramps
Restless leg syndrome
Delayed growth and development (mainly in children)

These are just some of the health issues that being low in iron can cause and it very important that we start educating all women and healthcare providers about the importance of iron.

What are the symptoms of Iron Deficiency and Anaemia?

Fatigue
Weakness
Dizziness
Fainting, or feeling of feeling faint
Pale skin
Breathless
Frequent headaches
Palpitations or racing heart
Easily irritated
Difficulty in concentrating
Cracked, or reddened tongue, sore tongue
Loss of appetite
Strange food cravings such as wanting to eat dirt, or clay
Cold hands and feet
Brittle nails
Hair loss
Tingling, or crawling feeling in the legs

Iron deficiency is a very common cause of fatigue and other health issues in women and men, but is more commonly seen in women. Iron deficiency is also the most common cause of anaemia.

What are the causes of Iron Deficiency and Anaemia?

Heavy menstrual bleeds
Endometriosis
Adenomyosis
Fibroids
Polyps
Coeliac disease
Inflammatory Bowel Disease
Stomach or intestinal ulcers
Pregnant and Breast Feeding Women
Certain Cancers
Vegetarians and Vegans
Eating disorders and food restriction
Girls going through puberty
Certain illnesses

Heavy menstrual bleeds and gynaecological condition’s such as Endometriosis, Adenomyosis, Fibroids and Polyps are some of the main causes of iron deficiency and anaemia in women. This is closely followed by dietary inadequacies and food and nutritional restriction.

Many women have undiagnosed gynaecological conditions which are the cause of their iron deficiency and anaemia. Some of these gynaecological conditions will require surgical interventions to be diagnosed properly.

How are Iron Deficiency and Anaemia Diagnosed?

Your healthcare provider can organise routine blood tests to test for iron deficiency and anaemia. These will include the following

Full Blood Count (FBC)
Iron Studies

These tests will provide the following information on :

The Total Iron level in your blood
Ferritin levels
Total iron-binding capacity (TIBC)
Iron saturations levels
The red blood cells size and colour (RBCs)
The white bloods cells (WBCs)
Haemoglobin
Hematocrit ( the percentage of blood volume that is made up of RBCs
Blood platelets

Other tests

There are other tests to check for the cause of iron deficiency and anaemia and these could include stool analysis (check for blood in stool), endoscopy and colonoscopy ( surgical intervention gastrointestinal bleeding) and laparoscopy (key hole surgery for gynaecological conditions)

Treatments for Iron Deficiency and Anaemia

Diet– A healthy diet that is rich in proteins, vegetable and iron rich foods is the best way to ensure your iron levels stay at optimum levels. A proper diet should include leans meats, seafood, nuts, seeds, healthy oils, green leafy vegetables and other coloured vegetables, and moderate fruit intake.

Supplements– Supplements will help to keep iron levels and vitamin B12 levels in optimum ranges. Iron supplements are very much needed if you are vegetarian, or vegan. There is now research to show that women who experience fatigue will benefit from supplemental iron, even if their iron levels and ferritin are within normal range. Those with heavy menstrual cycles, or those whom have inflammatory bowel issue should also be supplementing

NB- All iron supplements should be taken with vitamin C to help with absorption. Many iron supplements also cause constipation and therefore you should get a good one that does not interfere with your bowel habits and is more easily absorbed. Many of the mineral based iron products are not absorbed well and do cause gastrointestinal upset.

I always recommend a specific practitioner only brand to my patients because it is better absorbed, and it does not interfere with the bowel habits.

Iron Infusion– Sometimes when iron gets too low, supplements just will not be enough to get iron levels up to where they should be quick enough. This is where iron infusions can be very effective. Please see my post on when you need to use and iron infusion. (Click here)

Treating the underlying cause of bleeding

Supplements will not help if the cause of the iron deficiency and anaemia is from excessive bleeding. It may help a little, but it will not be enough. Even iron infusions will only be short lasting if you don’t treat the underlying cause of the bleeding issue. Extreme cases may even need a transfusion to get iron levels and blood levels back up to optimum. This is why it is important to screen for underlying gynaecological conditions that can cause heavy and excessive bleeding.

If you are getting low in iron if means there is something wrong and there is a deficiency that needs to be addressed. Please do not take iron deficiency lightly and always be prompt to find the causes and restore optimum levels of iron in the body.

Prevention is a must

Prevention is always the best way to treat any health condition and this goes for iron deficiency as well. Ensuring you eat a healthy diet with iron rich diet is a great start. As said before, vegetarians and vegans are going to have to supplement and work really hard with their diet to ensure they get adequate iron. Even then it can still be hard as plant based foods just do not have the iron levels that meats, eggs and seafood’s have.

Make sure you also have lots of vitamin C in your diet to help with iron absorption and it is a good idea to supplement with vitamin C to ensure you get the right daily intake.

Final Word

If you do think you might be low in iron or have anaemia, please make sure you talk to your doctor, or your healthcare practitioner. Please do not supplement with iron without checking your levels first. Having too much iron can be dangerous and you also need to make sure you do not have hereditary high iron (haemochromatosis), which can present with the same symptoms as low iron.

If you are found to be low in iron, then please make sure you take prompt action to restore your iron levels and also make sure you are screened as to why you are low in iron in the first place.

Iron deficiency and Anaemia can be very serious and should never be taken lightly. Please always consult with your doctor, specialist, or healthcare practitioner for the most effective ways to keep your iron levels in healthy ranges.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

Von Willebrand Disease

Posted on August 20, 2018September 7, 2019 by Andrew Orr

Von Willebrand Disease (VWD) is the most common inherited bleeding disorder diagnosed in women with heavy abnormal uterine bleeding, due to a coagulation defect.

Women with this disease may also have some tendency to bruising/nosebleeds in childhood but it will be when they get there first period that deficiency in von Willebrand factor – an essential protein required for both normal platelet function and as a co-factor to Factor VIII in the clotting cascade, most frequently presents.

A parent with VWD has a 50 per cent chance of passing the affected gene on to each child. VWD can affect both men and women. Sometimes genes mutate or change and can skip generations. Sometimes a child may have VWD but there was no family history of the condition. This means that VWD can occur in any family.

Women with this condition will present with excessive or prolonged bleeding with all other investigations normal (e.g. structural abnormalities are excluded). The diagnosis of Von Willebrand’s disease is by means of a coagulation screen and vWF antigen testing.

History behind Von Willebrand’s disease

Von Willebrand’s disease is named after Dr Erik Adolf von Willebrand, a Finnish paediatrician. In 1924, a 5-year-old girl was brought to the hospital in Helsinki where von Willebrand worked. He diagnosed her with a bleedingdisorder which he recognised was different from the haemophilia which was initially suspected. He subsequently assessed 66 members of her family and in 1926 first described the disease and its inheritance.

Von Willebrand’s disease is the commonest coagulation defect in humans-but is also seen in dogs (notably Doberman Pinschers),and more rarely in swine, cattle, horses, and cats.

Symptoms of Von Willebrand’s Disease

Many people with the disease do not have any symptoms. Those who do may find that they:

have lots of nosebleeds
bruise easily
have heavy menstrual (period) flow
bleed excessively from the mouth.
The presence in your menstrual flow of blood clots greater than 1 inch (2.5 centimeters) in diameter
The need to change your menstrual pad or tampon more often than hourly
The need to use double sanitary protection to control menstrual flow
Symptoms of anemia, including tiredness, fatigue or shortness of breath

There are three main types of VWD:

Type 1
Type 2
Type 3.

These can be broken down into further categories. The most common are types 2A and 2B.

Complications of von Willebrand disease may include:

Anaemia– Women who experience heavy menstrual bleeding are more at risk of iron deficiency anaemia.
Swelling and pain-If abnormal bleeding occurs in the joints or soft tissue, swelling and severe pain can result.
Death from bleeding –Rarely, someone with Von Willebrand’s Disease may experience uncontrolled bleeding that can be life-threatening and needs emergency medical attention.

There are hormones and other medications that can help with the acute bleeding that can present with VWD.

Although Von Willebrand’s Disease is the most common pathology, other bleeding disorders including thrombocytopaenia and haemophilias should be considered. Consultation with a haematologist should be considered when a coagulation defect is diagnosed, or when the history suggests a clotting disorder. The main aim is to to manage the underlying disease but to also help with effective menstrual regulation (usually with combined contraceptive pills).

Regards

Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned