The Irony of Iron

By | March 12, 2016
The irony of iron overload

Time for phlebotomy to shed some excess iron

You can have too much of a good thing.  I know this to be true beyond the occasional food or beverage indulgence.  Today’s topic is too much iron.

Yesterday, I had my third phlebotomy after my stem cell transplant.  Sitting in that chair in the infusion center triggers so many memories.  My first visit to the infusion center was six and a half years ago. My blood was so thick that we had to withdraw blood to prevent a stroke or another clot. I remember the blood would clot in the tube on the way to the collection bag. They had to use a large needle (I called it the fire hose) so the blood would flow out of my arm.  Too many red blood cells (aka, erythrocytes or RBCs).

Flash forward to three years ago.  My bone marrow reached “spent phase” due to the Polycythemia Vera (overproduction of red cells) and couldn’t produce enough red blood cells to sustain life. The red cells carry hemoglobin, a protein that carries oxygen from the lungs to the rest of the body and then returns carbon dioxide to the lungs so it can be exhaled. I started receiving transfusions of donated RBCs. That was the beginning of 18 months of transfusions of leuko-reduced, irradiated red blood cells and almost a year of transfusions of washed platelets.  If you are a blood donor, I thank you!

Why the phlebotomies now?  Acquired hemochromatosis.  All that lovely hemoglobin that kept me alive also carries more iron than my body can adequately use and process. So the excess iron circulates and settles into certain organs (i.e., liver, spleen, heart, skin).  Excess iron eventually damages the organs.

The measure for iron is Ferritin. Ferritin is a protein that binds to iron. Most (but not all) iron stored in the body is bound to ferritin.

In case you wondered, the “standard range” (according to the lab that does my tests – it varies by region and lab) for Ferritin is 10.0 – 291.0 ng/mL.  Mine was over 4,000 ng/mL for quite awhile.  It is now down to 2406 ng/mL so I’ve got some more to go. They say each phlebotomy reduces the ferritin count by 30-50 ng/mL.

 

I know people who struggle with low iron.

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