The Iron Elephant – The Dangers of Iron Overload

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The Iron Elephant – What you should know about the dangers of excess body iron (Vida Publishing Inc.) – is a book written by journalist Roberta Crawford which was first brought to my attention via‘s discussion board. As it happens, one of the members was suffering from extreme fatigue and joint problems related to an autoimmune condition that was not responding neither to vitamin C or dietary measures. In fact, she was getting progressively worse.  A blood test analysis revealed high ferritin levels which rang a bell of high iron stores. Furthermore, there was a history of hemochromatosis within the family. This prompted much research and learning which was carried throughout the thread Hemochromatosis and Autoimmune Conditions.

Slowly but surely, the picture of iron overload toxicity began to emerge and the final pieces of the puzzle fell into place. Several people who were having trouble recovering their health on a diet that was basically bulletproof were found to have iron overload.

The healing diet which is a gluten and dairy free ketogenic diet with moderate intake of protein and plenty of animal fats does not work as it should be as long as there is excess iron in the body.

Iron overload may affect any organ in the body and may include symptoms such as fatigue, depression, arthritis, irregular heart beat, high blood sugar and/or diabetes, shortness of breath, swelling of the abdomen and legs, jaundice, loss of sexual drive, premature menopause, loss of body hair, shriveling of the testicles, hypothyroidism, and redness of the palms of the hands.  A suntan that does not fade in winter may or may not be present.

The excess iron oxidizes in your body and can literally rust your organs leading to diseases such as cancer, thrombosis, cirrhosis, arthritis and so forth.

The Iron Elephant describes the bitter journey of many people who suffered needlessly from iron’s toxicity effects. It is a warning for the rest of us who might be unaware of a silent iron overload. Let’s have a closer look to the key concepts and warnings.

Iron 101


Only about 10% of the iron in food is available for absorption. Once you absorb iron, it has no exit from the body except by blood loss. Iron is not excreted. Once allowed into the body, it takes up stubborn residence.

The red blood cell is born in the bone marrow and lives for about one 120 days. When the red cell breaks down, it releases iron, to be recycled into new cells. Only about 1 mg a day is lost in finger nails, dead skin cells and other detritus, and this is the loss that needs to be made up from food.

Many people are secretly, unknowingly storing too much iron every day because of an iron metabolism imbalance. They are unable to keep from absorbing unneeded iron. Iron is so abundant and ubiquitous that you just can’t simply formulate an iron-free diet.


Celtic Curse


As many as 32 million Americans (one in eight people of Northern European ancestry) may be carriers of genetic hemochromatosis  also known as iron overload disease or iron storage disease. Hereditary hemochromatosis (HH) has been dubbed the “Celtic Curse” and it is the most common genetic disease in the USA. Researchers believe that HH originated at least 40,000 years ago in the area we now know as Ireland with a single ancestor whose genes mutated to over-absorb iron from what was then a very poor iron diet and famine conditions.  Nowadays, descendants of these ancestors absorb too much iron until it reaches toxic levels.

Geoffrey Block, MD, an hepatologist, states,

“the appearance of the HFE gene mutation [for HH] occurred somewhere from 40,000-60,000 years ago. Human DNA goes back to somewhere between 120,000-200,000 years ago. The ethnogenetic source for the C282Y (HFE) mutation arose in the Celtic ’empire’. Most people think that Celtic means Ireland, however, the Celts of 40-60,000 years ago covered Ireland to just west of Moscow, north to the upper reaches of Scandinavia, south into Spain and Portugal, and south east across the Italian peninsula and north of Greece and Turkey/Iraq.”

But any ethnic group can also have the mutations even though it is more infrequent (i.e. Asian or Jewish). In fact, the single gene carrier estimate for the abnormality runs into the 650 million people world-wide, more than half a billion people. Needless to say, that a heck of a lot of people. The tragic thing that to this day in 2013, many people are having a hard time to get their doctors to order iron testing, let alone interpret them correctly once they are done. Excess iron has no way to leave the body but by bleeding. When the body is storing excess iron, then it must be unloaded in order to avoid injury. It is already too late when the damage is done. When iron is the underlying factor, no amount of testing, no method of treatment will do a person any lasting good unless the iron is removed. Excessive iron may be the cause of arthritis, hypothyroidism, diabetes, cirrhosis, cardiomyopathy, chronic fatigue and much more.

Each person’s unique metabolism will result in varying degrees of damage due to iron overload.


Untreated Iron Overload Can Give You Cancer


Excess iron storage in the liver is carcinogenic for primary liver cancer. If cirrhosis had not developed due to iron burden, and treatment is adequate, liver cancer rarely develops. Early detection is essential.

Among the most important concepts reported in The Iron Elephant was the one where it was speculated that, contrary to all accepted belief, in Hodgkin’s disease or leprosy, the white blood cells (leucocytes) are not diminished, but are simply trapped in areas other than where they belong and that iron proved to be the trapping agent.

Iron depresses the immune system. Tumors require iron for survival. Due to a tumor’s iron sequestration phenomenon, when there is a finding of iron deficiency, one must search for cancer. Iron might be sequestered by the tumor itself and therefore not available for blood formation.

Dry weight of iron in breast cancers are threefold greater than that of normal breast tissue. Nearly 90% of those with metastasizing breast cancer have elevated serum ferritin – marker of iron storage.

In both infection and malignancy iron is shifted to storage tissues. The severity of cancer is related to displacement of iron. Levels of iron go back to normal if a person recovers. This is why it is very important to screen for iron markers. If they are low, it is essential to investigate for cancer or infection.

Inhalation can be another form of iron entry into the body, raising the risk of cancer. Workers in iron mines develop bronchial cancer five to ten times the rate of the general population. Lung cancer can be nearly 8 times higher than expected in patients with hemochromatosis. Other cancers recorded are pancreas, stomach, rectum, gallbladder, bladder, prostate, colon and brain among others.

People with iron overload provide a favorable environment for cancer growth.


Untreated Iron Overload Can Give You Arthritis


Sore or stiff fingers with affection of the index and middle finger is typical of iron overload. However it can vary depending on overuse and straining. Do test for iron load if it hurts when someone shakes your hand and the pain lingers. Other joints that may get affected include knees, hips, jaw, shoulder. The most frequently affected are the hands and wrists and weight-bearing joints such as knees. Joint pain is not always present.

Dupuytren’s contracture – which is a proliferative connective tissue disorder which involves the palmar fascia of the hand – is sometimes seen. In severe cases, the hand takes the form of a claw. When something similar happens in other parts of the body – cheek, stomach, arm – it is called panniculitis. The tissues seem to fasten to the underlying connective tissue leaving an impression, like a dimple.

Along with arthritis, there might be acute synovitis with subsequent inflammation of the tendons. But the most common feature of iron overload is chondrocalcinosis also known as pseudo-gout.

Arthritis is one of the most difficult symptoms to improve. Furthermore, iron promotes the growth of microorganisms, which can further contribute to the inflammation associated with arthritis.


Untreated Iron Overload Can Give You Heart Disease


Traces of iron greatly increase rhythm irregularities following heart attacks. Furthermore, chelating iron greatly decreases rhythm irregularities following heart attacks.  Even iron levels long regarded as within range, may have deleterious effects in the heart. As we will see, within range may already be too toxic. Normal iron load levels have been set to high and should be redefined in view of iron’s toxicity.

Abnormalities such as atrial ectopic heart beats, atrial fibrillation, incomplete right bundle branch (long regarded as a normal variation in the electrocardiogram), low voltage and enlarged heart is seen more often in those with iron overload. Heart failure incidence increases in iron storage diseases.

Supplementing with Vitamin C might be dangerous. Vitamin C binds with iron and moves it around where it might end in the heart muscle. Vitamin C taken with iron increases absorption of the iron.

Iron in the heart is a poison related with arrhythmias and heart damage.


Untreated Iron Overload Can Give You Cirrhosis


The primary target organ for iron is usually the liver, which becomes overloaded and damaged. The liver can either become enlarged or atrophied. Liver enzymes that never get normalized is indicative of iron overload.

Whenever cirrhosis is suspected, iron should be checked. Cirrhosis is a consequence of chronic liver disease where replacement of liver tissue by fibrosis, scar tissue and regenerative nodules leads to loss of liver function. Liver dysfunction leads to all kinds of problems including mental confusion. When you have a sluggish liver, you have more problems in metabolizing even healthy foods such as protein and fat.


Untreated Iron Overload Can Give You Diabetes


Diabetes that is difficult to manage and/or that appears at an earlier age than expected is indicative of iron overload. Severity depends upon the amount of iron load and whether diabetes is discovered early or late in the course of iron accumulation. Improvement might be expected if iron is unloaded promptly.

Blood sugar levels are very difficult to regulate when the underlying cause of pancreas damage is excess iron.


Untreated Iron Overload Can Impair Your Immune System


The body has mechanisms to withhold iron from invading microorganisms, but when there is iron overload, this ability is seriously impaired. Everyone with depressed immune function should check their iron load levels. People are much more susceptible to infections at times of high iron elevation. Low iron body stores reduce mortality due to certain infectious diseases.

One thing that is easily forgotten is that many anemias are in themselves iron loading anemias. For instance, thalassemia and sideroblastic anemia among others. The worst thing in this case is to reach out for iron supplementation. That will do nothing to correct the underlying problems and will only worsen things. Patients with rheumatoid arthritis may have anemia as a body mechanism to withhold the iron in order to defend the body against arthritis.

The only anemia that improves after iron supplementation is iron deficiency anemia, and you can’t diagnose it based on hemoglobin levels alone. Iron stores must be checked.


Untreated Iron Overload Can Make You Very Tired


Hypothyroidism can be a complication of iron overload and people with chronic fatigue syndrome should be screened for iron load levels.

It is ironic that excess iron may be the underlying cause of pallor, weight loss and fatigue. In fact, up to 25% of those diagnosed with hemochromatosis might be anemic.


Laboratory Screening


Ferritin is an ubiquitous intracellular protein that stores iron and releases it in a controlled fashion. The amount of ferritin stored reflects the amount of iron stored.

There is a specific iron-binding protein called transferrin which holds and controls iron transit. Transferrin binds to iron and delivers it to wherever it is needed.

The concentration of iron per se in blood plasma is about one hundred micrograms per one deciliter. Serum iron (SI) normal values goes from 50 to 160 depending on the lab. Serum iron above 150 must be followed up with transferrin saturation and ferritin levels.

The blood plasma contains enough transferrin to combine with about 300 micrograms of iron per deciliter. This is called Total Iron Binding Capacity (TIBC). When the concentration of iron is one hundred micrograms, the transferrin is about one-third saturation.

You obtain the percentage of transferrin saturation by dividing serum iron by TIBC and multiplying by 100 percent. It’s the proportion of these two numbers that is significant. You’re looking for a normal range of 25-35%.

If you have elevated transferrin iron saturation percentage greater than 45% with an accompanying elevated serum ferritin, iron overload is present and bloodletting/phlebotomy should be commenced. Blood-work should be done in fasting and after drinking enough water for hydration.

Iron levels fluctuate from day to day and from hour to hour. When transferrin saturation persists over 45% and ferritin is above 150, then you have iron overload.

It is important to keep in mind that people who might be gene carriers or relatives of someone diagnosed with hemochromatosis, may test “normal” and later proved to have a considerable iron load at a later examination. There is a variable rate of iron accumulation within families.

In the absence of symptoms and with blood tests that show normal levels, the relatives nevertheless can sometimes be diagnosed after persistent checking. Liver tests had confirmed a diagnosis, even after blood tests were normal.

The doctors on the Board of Directors of The American Hemochromatosis Society state that transferrin saturation percentage greater than 40% and serum ferritin greater than 150ng/mL could indicate clinical iron overload/iron storage in the body and treatment with phlebotomy (bloodletting) should be considered regardless of DNA test results.

Some researchers suggest that ferritin should fall between 20-80 ng/ml, with an ideal range being 40-60 ng/ml. If you are above those levels, but less than 150, consider donating at the blood bank. You can only benefit and at the same time, your blood will potentially go to someone who needs it more.

As for the person who inspired all this research, here is a recent report:

“[Our] daughter with the serious problems who has been prescribed regular phlebotomies has made enormous improvements over the past few weeks.  She decants about a pint every two weeks.  Obviously, if someone was really HIGH they would need to get it down as quickly as possible, but this schedule seems to work after she did two in rapid succession.
It really is amazing to see how her energy/mood has improved and her inflammation has quieted down with just getting rid of some blood.”

Those who can’t donate blood and/or are having problems getting a phlebotomy prescription, opt for decanting iron through oral EDTA chelation and/or activated charcoal. Here is an interesting testimonial about the later one:

“Just an update for the data pool – After giving two pints of blood and drinking activated charcoal on average of every few days for the past 2 months (some days I’d drink it some days I would not), my Ferritin level dropped to 55 from 197, so I think the activated charcoal really played a part since giving a pint of blood should only drop it about 50 points from what I understand, so if the drop were just from the pints of blood, the reading should have been around 97.  Of course there could be other factors at play of which I am unaware. Serum iron level dropped to 70, though that doesn’t tell us much.

Unfortunately, this doctor I had didn’t do either of the binding capacity tests so I have no idea of the saturation, logically, it should have improved (I think).  So, I’m going to continue to give blood as often as the red cross allows me to and I think that should manage it.  All my other blood tests were normal and she did an abdominal ultrasound to make sure I didn’t have liver enlargement or anything and that all looked normal as well.  I did have one liver hemangioma, a benign mass but she said that’s no big deal.”

So, if anyone can’t do EDTA or doesn’t want to do EDTA, activated charcoal certainly appears to be an alternative.

For more information on this topic visit the Iron Disorders Institute and read The Iron Elephant – What you should know about the dangers of excess body iron.

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  1. mary wier  July 27, 2014

    Dear HM My husband developed type 2 in 1997 and along with it came severe anemia with ferritin around 10 and hg at 10 and transferrin high, our blood doctor worked with him 3 years and never found a cause, husband was treated for h. pylori—-the doctor prescribed b 12 and iron supplements ongoing to fix the anemia, which it did. My husband has been stable with the type 2 with diet and supplements. Then we went gluten free 3 years ago as an experiment. We have experienced some detox where we are tired, irritable, etc. Then we found that our gluten free bread, crackers and cookies were worse than gluten, inflaming the body so we quit them.
    My husband has been on the b 12 and iron all along and his last check up showed a rise in glucose and hga1c and also an unusual rise in ferritin, it was 88 and the folate was at the top of the range, 25.00—I did not find this out until I picked up the lab work at the office and I do know that my husband has never had a ferritin over 30 or a folate over 7, so I took him off the iron and folic acid supplements, feeling that going gluten free was enabling the supplements to be absorbed better, too much so, I am just wondering if the gluten free eating and the continuing iron and folic supplements may have created the rise in glucose and hga1c! We are going to new blood doctor next week to investigate. Do you have any feedback for this?? Thanks from Mary in Chattanooga TN.

    • Gabriela Segura, MD  July 29, 2014

      Hello Mary,

      The gluten-free industry is atrocious. For the most part it is loaded in sugar and most of them still use gluten containing foods in their “gluten-free” products. Corn, rice, in fact… ALL grains count as gluten loaded with sugar. The best way to get a hold of these issues is through a low carb diet, like a ketogenic diet or a paleo diet restricted in carbs and free of ALL grains and/or agricultural products. See “Keto-adapted” by maria emmerich, or my article on the ketogenic diet in the main page, or “Primal Body Primal Mind” by Nora Gedgaudas. A diet free in anti-nutrients will likely rise nutrient levels in the body, including iron. I am seeing people with iron overload only in those predisposed to it and/or with the genetic susceptibility. Your husband is still on a good range. It is problematic when transferrin is over 30% and ferritin above 100 or so. Best!

  2. Tim  August 8, 2014

    This article does seem slightly at odds with your recommendation of the ketogenic diet. Most ketogenic diets seem to be pretty reliant on red meat, an obvious source of iron. As the diet is pretty restrictive already, trying to do a Ketogenic diet while keeping red meat to a minimum would make it even more difficult to do.

    • Gabriela Segura, MD  August 9, 2014

      Hello Tim!

      Iron has several sources and it is not intuitive to do a specific diet to get rid of iron. For practical purposes, this is nearly impossible. What is interesting is that iron overload issues is uncovered through paleo or ketogenic diets because people heal their gut and they suddenly absorb much needed nutrients from what they eat. The ketogenic diet is still very healing and learning about iron overload and genetic predispositions will help people deal with the various aspects of their health problems.

  3. Kate  August 21, 2014

    Dear Dr Segura,

    In your article about vitamine C you have mentioned that people with hemochromatosis and those who have other predispositions to excessive accumulation of iron in the body should be cautious when taking a decision to heal with high doses of vitamine C.

    However, in the article in the link below there is:

    “Of special interest in this case is vitamin C. The medical literature states that vitamin C supplementation should be avoided with iron overload diseases. Tissue damage due to peroxidation of membrane lipids has been detected after low-dose vitamin C supplementation.

    However, ferric iron is known to destroy vitamin C and iron overload patients are clearly severely deficient in vitamin C and other antioxidants. This may well be the main reason for their susceptibility to liver cirrhosis, diabetes, heart disease and cancer. I suspected that the cell membrane damage was not due to too much but too little Vitamin C”.

    What is more, Dr Ruselle Jaffe is of the opinion that the cause of the hemochromatosis is in fact lack of vitamin C…(1:07)

    Could you please comment on that issue? There are so many contradictory infos about iron overload and vitamine C that I feel a bit misguided…

    Thank you in advance,


    • Gabriela Segura, MD  August 21, 2014

      That is very interesting Kate, thank you for sharing! I think nobody knows for sure and sharing research on iron overload and vitamin C might help clarify things. The iron overload problem was uncovered when megadoses of vitamin C were tried and health issues continued to deteriorate regardless. You can read about it here:

      Hemochromatosis and Autoimmune Conditions,20265.0.html

      Although there could be many factors at play, it is certainly worth of keeping in mind, proceeding with caution. More research is needed and people can experiment and see if their symptoms get worse or not, but it is up to each individual to take that responsibility.

      The following update is interesting and suggests that people with iron overload could still benefit from vitamin C in case of severe viral infections and other debilitating diseases:

      Vitamin C – A cure for Ebola

  4. James Brookman  April 5, 2015

    This article seems like it is promoting an imbalanced “fear of iron.”

    First, there’s a mouse study that showed that iron’s lethal potential was entirely neutralized by vitamin E. “Vitamin E is protective against iron toxicity and iron-induced hepatic vitamin E depletion in mice.”

    Further, multiple studies show iron’s potential benefit to protect against Parkinson’s –
    Reduce HIV progression –
    Reduce risk of colorectal cancer – and

    Then, iron deficiency is somewhat common in older age as one study showed that immune deficiency in older women is associated with iron deficiency.
    As well, a NEJM study showed that where high body stores of iron were not associated with death from heart attacks, low iron stores were.
    Higher transferrin-saturation levels were not associated with an increased risk of coronary heart disease or myocardial infarction. On the contrary, the results indicate that there may be an inverse association of iron stores with overall mortality and with mortality from cardiovascular causes.”

    There is another more positive side to the iron coin.

  5. Eddie G.  August 8, 2015

    I donated blood yesterday to see if I could bring my ferritin level down. How long should I wait before retesting my ferritin levels? Thanks

    • Gabriela Segura, MD  August 16, 2015

      You can wait one more week and retest. Hope it was not such a terrible experience!

      • Eddie G.  August 24, 2015

        Hi Doctor, It wasn’t such a bad experience. I can’t believe I waited so long to donate blood. I don’t know why, but I felt drained yet relaxed after the procedure. Normally I have trouble sleeping, but that nice I sleep well. I usually can only sleep until 4 am, but the night after I donated blood, I slept until 7am. That is a rarity. Thank you for replying.

  6. Jansen  August 28, 2015

    Dear Dr Segura,

    Just a question regarding metabolic iron disorder.
    I am always feeling tired, weak and I feel joint cracking and eczema which I never had my entire life.
    I had a blood test the first week of June
    Ferritin 384 range 25-336
    Iron 132 range 59-158
    TIBC 377 range 250-425
    iron sat 35% range 20-50%
    TSH 1.08 range .35-4.00

    I was taking vitamin c 500mg and vitamin d 2000iu. and sometime multivitamins

    I got another blood test in the first week of August
    Ferritin 478 range 20-345
    HS-CRP 1.5 range <3.0
    Sed rate by westergren 6 range <15

    Funtional adrenal stree test
    cortisol 6-8am 37.4 range 13.0-24.0
    cortisol 12-1pm 3.0 range 5.0-8.0
    cortisol 4-5pm 4.3 range 4.0-7.0
    cortisol 10-12pm 1.6 range 1.0-3.0
    cortisol sum 46.3 range 23.0-42.0
    DHEA-S Average 5.31 range 2.0-10.0
    cortisol DHEA-S ration 8.72 range 5.0-6.0

    I did a blood donation
    then after a week retest ferritin which came back 369.

    I'm just wondering if maybe this is the core problems of my problems.

    Thank you

    • Gabriela Segura, MD  August 30, 2015

      It could be Jansen. Ferritin was too high and it doesn’t seem to be as a marker of inflammation. Saturation was at 35% which is high. Ideally ferritin should be closer to 100. You can experiment with blood donations and/or EDTA supplements to help you chelate iron and heavy metals. It might help you restore your adrenals and eventually, decanting iron overload might help you address other core issues more effectively.

      Hope you’ll feel better!

      • Jansen  August 31, 2015

        Thank you for your reply Dr Segura. I will do the next blood donation next week. Does turmeric also help in reducing iron? Thanks


      • Gabriela Segura, MD  August 31, 2015

        Turmeric turns down the fires of inflammation. Excess iron oxidizes and inflames the body, so in that sense, turmeric is great. It is really a great addition to anyone’s diet or supplement regime. Great stuff! All the best!

  7. John  December 1, 2015

    Hello doctor Segura. I was hoping you could advise me on what to do. I have a ferritin level of 188 & I am on the keto diet for almost 2 years. I have had no luck with doctors & have been refused blood donation due to their ignorance (both M.D.’s & G.P’s) since the blood bank are guided by doctors & continued fatigue & fibromyalgia is a big no no, so no hope there. Anyway I am using EDTA & have IP6/inositol (unused) & am planning to use iodine for hyperthyroidism (I actually fluctuate between hypo/hyper but mainly hyper when I’m active) & have all the reading material on the protocol. I have Lugol’s 15% & plan to start with 2 drops. I have the co-factors (selenium NAC B -complex B2 B3 trace minerals magnesium etc) but I can’t find anything on the safety for those with Both hypo & hyperthyroidism with the inability to donate blood. All I can do is read between the lines on iron overload, iodine protocols & go slowly. Could you please provide any views as I feel there’s gaps in my knowledge here. Oh by the way, I also have bentonite clay but I barely use it as its easy to get constipated with it! Thanks in advance.

    • Gabriela Segura, MD  December 1, 2015

      Do you know your transferin saturation? Donating blood shouldn’t be a problem with your thyroid problems. I wouldn’t worry if you can’t donate and nobody wants to give you a prescription to decant blood though.

      Your ferritin levels should go down with the lugol. And they are not terribly high either. I would start with one drop of lugol + cofactors and liver support, and see how it goes. If you can manage detox symptoms with salted water and the cofactors, you could take two drops. Wait some 6 months or so before checking your iron markers again: TIBC, iron, transferrin, ferritin. You are on the right track.

      If detox symptoms get out of hand on lugol, you can take it on alternative days or do pulse therapy (skipping 48 hours at a time until detox symptoms disappear with the cofactors).

      Hope this helps!

  8. Malik  December 1, 2015

    Hello doctor Segura. I was hoping you could advise me on what to do. I have a ferritin level of 188 & I am on the keto diet for almost 2 years. I have had no luck with doctors & have been refused blood donation due to their ignorance (both M.D.’s & G.P’s) since the blood bank are guided by doctors & continued fatigue & fibromyalgia is a big no no, so no hope there. Anyway I am using EDTA & have IP6/inositol (unused) & am planning to use iodine for hyperthyroidism (I actually fluctuate between hypo/hyper but mainly hyper when I’m active) & have all the reading material on the protocol. I have Lugol’s 15% & plan to start with 2 drops. I have the co-factors (selenium NAC B -complex B2 B3 trace minerals magnesium etc) but I can’t find anything on the safety for those with Both hypo & hyperthyroidism with the inability to donate blood. All I can do is read between the lines on iron overload, iodine protocols & go slowly. Could you please provide any views as I feel there’s gaps in my knowledge here. Oh by the way, I also have bentonite clay but I barely use it as its easy to get constipated with it! Thanks in advance. P.s. I noticed there was another John in the replies so I’m differentiating, apologies for the double post.

    • Gabriela Segura, MD  December 1, 2015

      Do you know your transferin saturation? Donating blood shouldn’t be a problem with your thyroid problems. I wouldn’t worry if you can’t donate and nobody wants to give you a prescription to decant blood though.

      Your ferritin levels should go down with the lugol. And they are not terribly high either. I would start with one drop of lugol + cofactors and liver support, and see how it goes. If you can manage detox symptoms with salted water and the cofactors, you could take two drops. Wait some 6 months or so before checking your iron markers again: TIBC, iron, transferrin, ferritin. You are on the right track.

      If detox symptoms get out of hand on lugol, you can take it on alternative days or do pulse therapy (skipping 48 hours at a time until detox symptoms disappear with the cofactors).

      Hope this helps!

      • Malik  December 2, 2015

        Thanks for the reply. Here is my blood work results from 2 months ago: haemoglobin 138g/L, white cell count 5.4 x 10*9/L, neutrophils, 3.7x 10*9/L, lymphocytes, 1.3 x 10*9/L, monocytes, 0.3 x 10*9/L, & platelets, 293 x 10*9/L. ESR – 1, reticulocyte count 0.5%. Renal function normal with a urea of 2.5mmol/L & creatine of 86 pmol/L. Liver function normal. Glucose normal at 5.7 mmol/L. CRP normal at 2 mm/h. Thyroid normal – T4 14.1 pmol/L & TSH 2.62 mlUL. Vitamin D normal at 170 nmol/L. Ferritin normal – 188 ng/mm, iron normal at 16.2 pmol/L, & transferrin saturation normal at 29%. Red cell folate normal at 287 nmol/L & active vitamin B 12 normal at 84 pmol/L. Celiac screen – negative.

        It ends by saying that there’s no evidence of haemochromatosis. I just want to thank you again for your advice as the last 7 months has been as bad, if not worse than before I gave up the SAD & was ignorant about diet/nutrition & it’s effects on cognition. Less pain, (fibromyalgia) but serious chronic fatigue & my will to research has never been so low. If this protocol works I may be able to get my MTHF (methylation) mutation problems under control.

      • Gabriela Segura, MD  December 2, 2015

        Iron saturation is normal. So you should get a hold of the ferritin with lugol. I’m sure it will be enormously helpful for your chronic conditions as well. Don’t worry too much about methylation issues, if you can detox and recover health with lugol, your body will be more able to deal with the environment as well. All the best!

  9. Remco  December 8, 2015

    Hello dokter Segura,
    My transferrin saturation level was 5 years ago 71%. Dokter didnt do anything with it then and now i am aware of possible iron overload i got a test and now its 47% (transferrin saturation) and ferritine 243.
    I didnt had a blood donation in the mean time so how did the TS go down on its own like that?
    I did take huge amounts of melatonin (not anymore) and i read somewhere that melatonin can chelate iron also?
    I am seeing a dokter about this end off the mnth.
    Do you think I stil could have hemochromatosis? Even when the TS went down on its own so to speak?

    • Gabriela Segura, MD  December 8, 2015

      Hello Remco,

      It was either a chelator that you took accidentally (i.e. melatonin) or a blood loss. Other physiological factors can also decrease the iron load, i.e. doing exercise.

      I think there is a fair chance that you could have a gene that predisposes you to absorb iron better, whether a carrier gene for Hemochromatosis or other. With those levels, a mainstream doctor who is not aware of this research might declare your levels normal even when the saturation IS high. If you don’t have contraindications, I would become a regular blood donator. Iodine therapy also decreases ferritin levels. Best!

      • Remco  December 8, 2015

        Thank you so much for your very quick reply!
        Thankfully i have blood type O negatif so they should be interested in my blood at the bloodbank :)
        Here in Holland one can donate max 5 times a year if you have a blood type that is in demand.

        Anyway your comment about lugols got me thinking.
        For years i have used lots of lugols with co-facters and it worked wonders for my fatique and brain fog until it didnt work anymore?! I am still puzzled about that.

        I have severe fatique, sleep problems, pain in the knies, body hair loss on the legs (not only calves but everywhere) armpits and chesthair. Its not alopecia areata or any other known cause. Its diffuse hairloss and gets gradually worse like normal male pattern hair loss only this is with my body hair. Dokters diagnoses: “Thats just something you have” Pffff :(
        Also i have hyperpigmentation on my forehead. Looks exactly like melasma.
        Dokter says its sun damage after looking at it for one second.
        But thyroid test are oke. TSH is about 1 and freeT4 is mid range.
        Any thoughts?
        Thank you for your time!

      • Gabriela Segura, MD  December 8, 2015

        Perhaps a stealth infection. Lugol can balance your hormones, but anti-microbial doses are typically much higher than regular supplementing doses. I would look into “Why Can’t I Get Better” by Horowitz, see if it rings a bell. Stealth infections, toxicity, inflammatory diet (gluten, dairy, GMOs, a “normal” high carb diet) are often at the root of health problems. Lugol can deal with the toxicity, but higher doses are needed for anti-microbial purposes. Some thoughts. Best!

  10. Doug Arden  December 29, 2015

    Hello Dr. Segura:
    I have just been diagnosed with Hemachromatosis. My blood tests revealed the following:
    Iron – 38.6%
    TIBC – 59.5
    Iron Saturation – 65%
    Ferritin Level – 387
    I have been on the Paleo diet for the last 4 years. Is this perhaps the cause of my condition and if so, do I need to drastically change the way I eat?
    I am currently waiting for an appointment to see a Hematologist.
    Thank you.

    • Gabriela Segura, MD  December 30, 2015

      Hello Doug,

      Yes, that would be iron overload for sure. I would take the opportunity and request firmly for blood-letting prescription. That will unload the excess iron. Other protocols such as EDTA and iodine therapy are also effective in lowering ferritin levels and iron saturation.

      I suspect that the paleo diet uncovers these issues because the gut is restored and your body starts absorbing nutrients much better. You should have a predisposition to absorb iron better. Changing your diet is not the solution. Iron is EVERYWHERE. I would not blame the paleo diet, on the contrary. However, I would make it a priority to donate blood some 3 times per year and monitor iron saturation levels in the body. If you can get a prescription to decant blood, much better.

      As far dietary changes goes, just avoid orange juice which is a ton of useless sugar anyway.

      It is good that you got a hold of this problem in time. Best!

      • Doug Arden  December 30, 2015

        Thank you!

  11. Anthony Jauw  January 6, 2016

    Hi Dr. Segura,

    My name is Anthony. I recently lost quite a bit of weight, about 7kg within 2months time, without changing my diet nor doing any exercise. My fiance worried and convinced me to do a blood test.
    Hemoglobin : 42.6 (range 40-52)
    Ferritin : 1,010 (range 28-365)
    Creatinin : 0.57 (range 0.7-1.20)
    FT4: 4.87 (range 0.89-1.76)
    TSH: <0.008 (range 0.55-4.78)
    GOT: 25 (range <33)
    GPT: 28 (range <50).
    Went to see an endocrinologist yesterday and was told that I suffer from hyperthyroidism. Prescribed with 10mg Thiamazole.
    How severe is my condition? Do I have to take any medication to lower my blood iron level? Will it go down automatically if the TMZ medication begin to work?
    I am only 27 years old and really worried how this condition will affect my life.
    Thank you in advance.

    • Gabriela Segura, MD  January 6, 2016

      Hello Anthony,

      Besides the hyperthyroidism, there is definitely indications of hemochromatosis. Ferritin should be around 100 and yours is 10 times the normal value. I would consult an internal medicine doctor, hematologist and/or a gastroenterologist for the relevant tests on iron overload. Those levels can only normalize effectively with blood decanting and thyroid medication will probably not modify the iron levels. Don’t despair, but don’t let this issue go by. Make it your priority to address this. It is not good for you to have such an iron overload as it damages tissues.

      Find a specialist who will study you for hemochromatosis. Make that your priority. If you are genetically positive for hemochromatosis, then your parents and other family members could be screened as well.

      Best regards.

      • Anthony Jauw  January 6, 2016

        Thank you doctor. Is it true that donating blood helps? But can my condition and medication prevent me from donating blood?

      • Gabriela Segura, MD  January 7, 2016

        It could, you’ll need a prescription for a blood decant.

  12. Ashley  February 5, 2016

    I have diagnosed Hemochromatosis – my levels went down after a year of phlebotomies but this last test (3 months in between) my levels went up. Iron sat went up to 100% and ferritin went up from 318 to 350. The only thing I did different was one less phlebotomy and green smoothie with hemo seeds daily for a month. I drink coffee with the smoothies to help decrease absorption. I drink wine prob 4 nights a week but dr says that’s fine. I’ve cut out gluten and dairy the last month and sugar. That doesn’t account for the 2 previous months that I had to build up iron but basically I had 2 phlebotomies I before my test. So frustrating! I am trying so hard but don’t know what to do? No red meat and only chicken. Any thoughts? Oh and now I have hyperthyroid :-)

    • Gabriela Segura, MD  February 6, 2016

      I would not concentrate on the diet because it is so hard to avoid iron. Besides, eating anti-inflammatory foods has added benefit in your health. I would rather insist on the phlebotomies and start doing regular cycles of EDTA in order to chelate iron. You have to re-mineralize later as EDTA chelates minerals too, but overall it can make the whole difference for you. I’m glad you learned about HC and are doing something about it. Best!

      • Ashley  February 6, 2016

        Where do I get EDTA Chelates?

      • Gabriela Segura, MD  February 6, 2016

        EDTA is available over the counter. You can find it in supplement websites such as Super Smart and others.

  13. Kim  March 20, 2016

    Dr Segura in December 2015 my ferritin was 650ng/dL and transferrin was 263 and saturation was 38%. I had been taking iron supplements because I thought I was still anemic. I’ve been anemic most of my adult life. I stopped the supplements. Now my ferritin is at 450 I’ve done no intervention other than stopping the iron supplements. Should I give up alcohol and red meats etc. to continue to lower it or do you think I need to do blood donations?

    • Gabriela Segura, MD  March 21, 2016

      I would give up on alcohol and any fruit juices, specially orange juice. Other than that, it is really not worth to remove organs and meats. You can wait to see if your ferritin goes further down. On the other hand you could try iodine and/or EDTA supplements which both lower ferritin and iron saturation levels.

      Here is a summary of the iodine research:

      If you are not anemic, you could try donating blood once as well.

      • Kim  March 21, 2016

        Wow I appreciate your fast follow up! Thanks a lot! I will read the article.

  14. Anton ringer  March 26, 2016

    Hi there! I found out I have hemochromatosis in 2011 and luckily I haven’t had to have any phlebotomies since my iron has been pretty low. I’m a 33 year old female. I was wondering if it is safe to take a B complex vitamin. My hematologist said yes but I’ve read some things only line that say you shouldn’t. I have a lot of anxiety and hoping the vitamin could help.

    • Gabriela Segura, MD  March 28, 2016

      If you don’t have iron overload, there shouldn’t be any problems. Just keep monitoring your levels. You can also take methylated B vitamins which are metabolized better. No need to worry if you feel in the need of experimenting with B vitamins.

  15. NickC  April 14, 2016

    Dr Segura,

    I have suffered with gout for around twenty years and have recently found that lowering my iron level appears to be a miracle cure for gout.

    After avoiding foods with iron and trying some iron chelation for a couple of weeks my iron levels were:
    Ferritin: 257
    Serum iron: 14umol/L
    Saturation iron binding capacity: 58umol/L
    Iron saturation: 24%

  16. katerina  May 18, 2016

    My ferritin level is 800 and due to low hematocrit i am not able to blood let, i am iron overloaded due to supplement consumption for many years! The doctor recommends exjade but i read so many bad things about it! What should i do?

    • Gabriela Segura, MD  May 19, 2016

      I would take EDTA supplementation and if necessary, do the iodine protocol which lowers ferritin as well.

      • Katerina  May 19, 2016

        Thank you so much for your answer! So am I right not to take exjade?

      • Gabriela Segura, MD  May 22, 2016


        If you have significant iron overload, exjade can be a solution. If you can control your levels with blood donations and/or EDTA, then that should be enough.

  17. Katerina  May 19, 2016

    Please will you give me the exact amount of the two supplements, iodine and Edta that I should receive and how many times each day? In other words the exact prescription? I am 42 years old and weight 54 kilos, if that matters. Thank you for your precious advice!

  18. paul  July 9, 2016

    3 months,no beer,ferritin decreased 140.alt decreasd to normal range as well.

  19. Robert  February 14, 2017

    I went from a shockingly high Ferritin level of 1160 ng/ml at the end of August last year to a current level of 141 ng/ml(last Friday).
    A single blood donation is good for about a 23.5% quick drop and I have made 2 blood donations in this period.
    Most of the overall decrease however is the result of taking 2 level teaspoons of IP6(Inositol Hexaphosphate) first thing in the morning with water. (You have to understand “Water” and “Empty Stomach” or it will combine with other minerals and not work as an iron chelator.)
    IP6 is on the FDA’s list of Iron Chelators, it is natural and safe unlike the pharmaceutical chelators which seem more dangerous than high plasma iron levels.
    The iron Disorders institute recomends a ferritin level between 20 and 80, but my research indicates that indications of thyroid dysfunction begin to occur at levels below 50. Also it seems optimum thyroid function is maintained by a ferritin level between 90 and 105. So my conclusion is to strive for a long term ferritin level between 90 and 105.
    The plan now is to continue with the IP6(currently dropping 5 points/day) and to do one last donation this coming Friday.
    In about 1.5 weeks I will be at about 60 for ferritin, and the final donation will help lower my hemoglobin level which is quite high (the Iron Disorders Institute indicates this as a problem also).
    After that I will allow the ferritin to climb back up to about 100 ng/ml(start eating oysters and red meat again…”Deliscious!”) and monitor and maintain that level for the long term.
    It’s been a long haul dealing with Ferro-toxicity and I will be glad to have regained my health and lowered the oxidative stress and predictor of many inflammatory diseases!
    I hope this info helps someone! :)

  20. Dan  April 11, 2017

    Does liposomal C cause increased iron absorption the same as standard Ascorbic acid?

    Or does the liposome form keep the vitamin C from contacting/reacting with the iron?

  21. Tiffany  January 4, 2018


    I’m curious as to which chelator is best? IP6, EDTA, Lugol or Activated Charcoal? Also specific brands and instructions on use? 33 year old female diagnosed with HH this year as well as Auto-Immune Thyroid/Hashimotos(?) (Thyroid Peroxidase Ab: 194) with all other thyroid markers falling within normal range. Have seen TWO different Hematologists and both basically scoffed at my numbers, and told me to “live my life” aka eat red meat, drink alcohol and not worry. They also both denied my request to be given an Rx for therapeutic phlebotomy making me feel as if I was being a hypochondriac! Since then I have taken matters into my own hands and donated blood twice (while avoiding red meat, Vit C and limiting alcohol consumption). Ive always followed a mostly low carb diet due to bloating and digestive issues.

    After two blood donations my Ferritin levels have dropped from 231 to 94!

    Other current values:
    TIBC: 230 30-160
    Iron: 187 228-428
    % Transferrin Sat: 81 20-50

    My concern is that there aren’t always blood drives available for me to donate at, and I would like to stay on top of keeping my iron levels as “controlled” as my body will allow. My other concern is it there is any reason I should not incorporate a chelator due to the Auto-immune thyroid issue? Currently taking daily selenium, zinc to support my thyroid. Also does anyone else out there have hemochromatosis AND a thyroid issue? These two seem to be interconnected.

    Any and all advice is much appreciated!!

    • Gabriela Segura, MD  January 7, 2018

      A drop of lugol every two days should keep the iron stores low. Also doing some EDTA once every two months will help as well. Hope you get the chance to donate regularly.

  22. Derya  January 24, 2018

    I would like know with iron overload how can we get vitamin C which is so crucial for general health and lowers inflammation of the body?

    • Gabriela Segura, MD  January 24, 2018

      You can still take vitamin C, just don’t megadose without periodically donating blood and/or or doing some chelation.


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