What are the thoughts on the following article regarding out of balance iron levels?
I'd hazard a guess that a large number of the Paleo community may be getting too much iron - particularly if 13% of Americans fall into that category. Specifically interesting is the following reocmmendation: "for others with high stores the recommended treatments include phlebotomy and frequent blood donation."
Anything to this as viewed from an evolutionary perspective? Would paleo man have frequently bled more often, thus balancing a higher iron intake from more meat?
At last week's Ancestral Health Symposium, Chris Kresser presented a talk on this very issue. Iron overload can be a problem for some and can be dangerous if not addressed.
We have mechanisms where the stomach can tell how much iron we have in our body stores, and when the body is low in iron, we absorb more from the gut. When we have enough iron, we don't absorb much or any iron. When everything is working correctly, a large iron intake should not be a problem.
However, there are mutations, such as Hereditary Hemochromatosis (mentioned in the article) that cause a problem with this regulatory mechanism and can result in iron overload. If that is the case, frequent blood donation is probably the best treatment. Chelators and chelating drugs that affect both iron absorption and excretion can also be taken. But I don't know what if any side effects there are from chelators, plus donating blood has the added benefit of helping others.
Chris recommends having your doctor perform an iron blood work to check your levels. Also, if you have any genetic testing, such as at 23andme.com they will tell you whether you have Hereditary Hemochromatosis.
Here is is list of references and some selected slides from Chris's talk: http://chriskresser.com/ahs12
Some interesting asides. Hereditary Hemochromatosis is thought by some to have originated in a single ancestor in what is now Ireland. According to the CDC, it is the most common inherited single gene disorder in people of Northern and Western European descent. Hereditary Hemochromatosis actually provides some protection against certain pathogens early in life before iron overload occurs and may have provided an evolutionary advantage in Europe during times of widespread plague (hence its success in becoming more widespread in the European population).
I give blood three days out of every month.
On a more serious note, I don't think Paleo man ate meat as frequently as modern man can. We can theorize all we'd like, but it comes down to having to hunt down or catch your own food as opposed to bulk-ordering a half steer online from a rancher, you're probably going to come away empty-handed more often than not. If you do get lucky, small animals such as birds and ground critters like rabbits were probably a staple protein source along with eggs and molluscs for the coastline dwellers. It's pretty hard to OD on gopher meat. The big game would be reserved for group hunts or when a hunter would get lucky.
That article includes enough misinformation that I wouldn't draw too many conclusions from it. For example, Brody repeats the unsubstantiated belief that saturated fat causes heart disease. She discusses (apparently epidemiological) studies suggesting people who ate red meat a certain number of times a week had too-high iron, but like all such reporting of studies, she doesn't tell us what the people actually ate. I'd like to know what else was on the plate, so to speak.
She suggests that the use of fortified products has made iron deficiency more rare, then attributes iron overload to non-fortified foods like red meat. I'm curious why she doesn't discuss how the increasing reliance on processed foods (nearly all of which contain fortified ingredients--if only in the form of enriched flours) might contribute. A bowl of Cheerios has twice the iron of 8oz of 85% lean ground beef. It seems likely to me that a vegetarian eating a lot of fortified cereals could be at greater risk for iron overload than a person eating meat and eschewing cereals. Yes, the iron in meat is better absorbed, but it's also present in a smaller concentration than a typical American eating processed, enriched foods might consume.
I think she raises an interesting topic, and it could well be that eating huge amounts of red meat could contributes to iron overload, but she doesn't make the case persuasively here.
I always wondered about "blood letting" or the use of leeches as an ancient medical practice. Although it seems so barbaric, there had to be some appreciable benefit at least some of the time or they wouldn't have continued. I wonder if an excess of iron was common?
I got back lab results yesterday showing a Ferritin (stored iron in the blood) level of 1522 ng/mL (normal range is 22-322). I gave blood today, but everything I've read so far indicates that with levels this high I should be bled of a liter twice a week! But at least now I have some idea of where the fatigue and excessive post-workout soreness (among other issues) has been coming from. It certainly makes medieval physicians' practice of bleeding their patients seem a lot less ignorant.
Hemochromatosis doesn't seem to be caused by Paleo, though Paleo probably slightly speeds up iron accumulation by providing more iron than SAD. I'm going to leave my beautifully seasoned cast iron skillet and dutch oven in the cupboard, but I don't think I'll cut back much, if any, on good red meat.