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TIRED BLOOD? MAYBE YOU'RE LUCKY



In an attention-grabbing study published in the journal Circulation, excess iron has been directly linked to cardiovascular disease, and may even be a stronger risk factor than cholesterol, blood pressure levels, or even diabetes. This is especially ironic (pardon the pun), because iron has long been thought by the traditional medical community to be the one mineral that is a supplemental must (FDA-approved iron preparations represent one of the largest product categories in the Physicians' Desk Reference). Legislators have even gone so far as to coerce by law the addition of iron to grains and cereals. Yet if the relationship of iron to heart disease is true-and this is consistent with the free-radical theory of disease and aging as well as over 1,000 papers in the scientific literature-the complicity of the bureaucrats to maintain the "iron curtain" in the face of strong evidence to the contrary is scandalous.

The new study led by Dr. Jukka T. Salonen, involving l,931 men, was conducted over a 5-year period in Eastern Finland, where coronary heart disease has among the highest incidences in the world. At the beginning of the study the men were aged 42, 48, 54, or 60 years and were free of heart disease. They were followed for an average of 3 years, during which time 51 men suffered heart attacks. For every 1% increase in serum ferritin, the form in which iron is stored in the body, the scientists found a 4% increase in the risk of a heart attack.

SOLID SUPPORT

"The study represents the first direct empirical evidence in support of…the conjecture that stored iron promotes [heart disease]," wrote Dr. Jerome L. Sullivan of the Medical University of South Carolina in Charleston in an editorial Circulation.2 According to Sullivan the study solidly supports his 1981 hypothesis that stored iron is a strong risk factor for coronary heart disease, and the causal relationship is stronger than any other except smoking.

The men in the study with serum ferritin values of more than 200 micro-grams per liter had 2.2 times the heart attack risk of those with lower ferritin values, after adjustment for other risk factors, and their mean daily intake of iron was 19 mg (RDA = 18 mg). While Durk Pearson and Sandy Shaw have long warned the public about the harmful free-radical-promoting aspects of iron and have meticulously kept it out of their formulations, many doctors and the FDA haven't investigated the connection, perhaps because of their bias against nutrient supplements and their ignorance about free radicals.

A Wall Street Journal article earlier this year honed in on a wide variety of diseases, including cancer, for which iron has been implicated as a villain.3 Health surveys indicate that iron-deficiency anemia turns out to be massively over-diagnosed-it is indeed quite rare-and the inherited disease hemochromatosis, which can cause fatal iron overload, is far more common, affecting an estimated 1.4 million Americans. Other iron overload diseases mentioned were arthritis, heart disease, and premature wrinkling. And the problems are made worse as iron accumulates with age and as we are bombarded with more legally mandated iron from breakfast cereals and other foods.

AUTO-OXIDATION PROMOTER

The common cause of many of these problems stems from iron's catalytic action as an auto-oxidation promoter. It is possible to successfully defend oneself from unavoidable iron toxicity through dietary supplemental antioxidants, which can help to quench destructive free radicals, and through natural fruit acid chelators, which can help to remove iron and other toxic metals from the body. But if someone is taking large daily supplemental amounts of iron preparations, antioxidants and natural chelators may be inadequate to the task. The Journal reported that there is even an Iron Over-load Diseases Association in Florida, which has won liability lawsuits for injury and even death resulting from irresponsible medical prescribers of iron preparations.

According to Dr. Sullivan, there is little evidence to support the theory that "iron-poor blood" reduces the energy level of women. 'Women lose their iron stores through menstruating for a large part of their adult lives, and they outlive men," Sullivan said. "Nobody has been able to demonstrate that a person who is iron-depleted has any problems with energy." Dr. Randall Lauffer, a Harvard Medical School assistant professor, said patients should demand that their doctors test their iron levels. Lauffer has formed a related biomedical commercial venture and published a book a year ago which links excess iron with cancer, heart disease, and arthritis. He is of the opinion that the enrichment of grains and cereals with iron is "a bizarre chapter in American nutritional science" and thinks that the idea of iron supplementation should be redefined, particularly for premenopausal women.

"TRIED AND TRUE"

One can reasonably conclude that politics has no business in health pronouncements and that this situation would be far less damaging if unpoliticized science were the source of health advisories. Yet the Associated Press ran a story quoting some scientists (government grant recipients?), doctors, and dietitians (both government licensed) who still maintain that the recent study is not reason enough to stop taking the allowances of iron recommended by the National Research Council.

Said Dr. Richard Caso, cardiologist at Saddleback Memorial Medical Center in Laguna Hills, Calif, '"We have to maintain a certain suspicion of any study that comes down the pike. We can't be too quick to embrace new studies. We have to stick with the tried and true." Eleanor Huang, registered dietician and Orange Coast College instructor, still believes that most people have more reason to worry about iron deficiencies than excesses. "Iron deficiency is a pretty widespread problem," she said. "I would say, don't be scared by this study. I would not advocate a drastic change in diet. People should continue to try and get the iron they need."

Dr. Henry Ginsberg, head of the division of preventive medicine and nutrition at Columbia University's College of Physicians and Surgeons, stressed that much more research needs to be done and then went far beyond the data by suggesting that Americans quit taking unnecessary dietary supplements.8 Dr. Mary Ann Malloy, who served on a heart association committee looking at women and heart disease, said the study brought into question the "more is better" approach to vitamins and minerals, as if studies of vitamins C, E, and beta carotene didn't exist.

Whether defenders of a dying paradigm are truly ignorant or ignore the evidence because they are financially inclined to do so is a moot point. The problem is compounded by the fact that government, particularly the FDA, has tried to monopolize nutritional truth. In fact, many of the scientists who originally were involved in creating the RDAs have now recanted and agree that they are almost meaningless as guides to optimal nutrition.

  1. Salonen JT et al. High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation. 1992;86:803-81
  2. Sullivan JL. Stored iron and ischemic heart disease. Circulation. 1992;86:1036-1037.
  3. Stipp D. Is Popeye doomed? Some experts sound warnings about ingesting too much iron. Wall Street Journal. January 17, 1992:B1.
  4. Most anemias are NOT caused by iron deficiency but by inadequate vitamin B-12 or folic acid.
  5. Excess iron intake is also thought to decrease one's resistance to bacterial disease because iron is a nutrient necessary for the growth of bacteria.
  6. Selvin BW. Doctors: don't alter iron intake they say more studies needed before link to heart is proved. Newsday. September 9, 1992:19.
  7. Anon. Don't stop taking iron, doctors, dieticians say. Chicago Tribune. September 10,1992:16(C).
  8. Bolt JA. Study links iron in blood to heart disease. Oregonian. September 9, 1992:A07.


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