- MONDAY, Aug. 25 (HealthDay News) — Bloodletting is often
dismissed as a primitive form of medicine, in which early doctors
attempted to rid the body of bad humors by draining the life-sustaining
fluid.
But there's at least one disease left where bloodletting is still the
preferred means of treatment.
Hemochromatosis is an inherited disease in which the body becomes
overloaded with iron. When that occurs, the iron builds up in organs and
tissues, causing slow damage from within that prompts a multitude of
symptoms and illnesses.
“Until people get sick, they don't usually know it's there,” said
Gerald Koenig, director of the Iron Disorders Institute. “We think it's
the most underdiagnosed disease in the country.”
There are about one million people in the United States with a genetic
predisposition for contracting hemochromatosis, Koenig said. “About
150,000 can expect to get sick, some very much so,” he said.
Hereditary hemochromatosis is one of the most common genetic disorders
in the United States, most often affecting Caucasians of northern European
descent, although other ethnic groups are also at risk, according to the
U.S. National Institutes of Health.
Iron is an important micronutrient for the human body and is found in
many foods, mainly in red meat and iron-fortified breads and cereals. In
the body, iron becomes part of hemoglobin, a molecule in the blood that
transports oxygen from the lungs to all body tissues.
“Most people maintain just the right amount of iron in their bodies,”
Koenig said. “It varies by a gram or two between people.”
But hemochromatosis causes the body to absorb too much iron from food,
with the metal collecting over a period of years in such organs as the
heart, liver and pancreas. Depending on how each person's body deals with
the excess iron, the symptoms of hemochromatosis can vary widely.
And this makes it very hard to diagnose the true disorder accurately,
said Eugene Weinberg, professor emeritus of biology and microbiology and
immunology at the Indiana University School of Medicine, in
Indianapolis.
“It takes a while for even an astute physician to detect,” Weinberg
said. “It's interesting how different the presentation is from patient to
patient. It's such a jumble, and that's what puts a burden on the general
practitioner.”
Blood tests, combined with a thorough family medical history, usually
are used to narrow the diagnosis down to hemochromatosis.
But, iron levels aren't usually tested during normal blood screening,
Weinberg said. Patients must request the testing, although some experts
are working to make it part of medical checkup screenings.
“We're tying to get an iron test put in there, so we can get at iron
loading,” he said.
Cirrhosis of the liver is one of the most common diseases resulting
from hemochromatosis, Koenig said. “Ninety percent of the iron absorbed
will go to the liver,” he said, adding that the disorder can also cause
enlarged liver, cancer of the liver or liver failure.
Joint pain and severe arthritis in the fingers are other very common
symptoms, Weinberg said. “If a person comes in and can't open their fist,
that's referred to as 'iron fist,' ” he said.
Undiagnosed and untreated, hemochromatosis increases the risk for
diseases and conditions such as diabetes, irregular heart beat or heart
attack, arthritis, cirrhosis of the liver or liver cancer, depression,
impotence, infertility, hypothyroidism, and some cancers, according to the
NIH.
The NIH lists other common symptoms and diseases related to
hemochromatosis, including:
Some people might not suffer any problems at all. Weinberg said there's
a 100-year-old retired faculty member he knows who has a very high iron
load but no ill effects from it.
“Here's a person who was able to tuck away the iron without it causing
destruction of the organs,” Weinberg said. “And yet there are other people
who can't handle it.”
The best means of treating hemochromatosis is phlebotomy, Koenig
said — bloodletting, one of the most ancient, and mostly discredited,
forms of medical treatment. But, in this case, the draining of blood
forces the body to process its excess iron.
“When you take blood out of the body, iron stored in body tissue is
used to make new blood,” Koenig said.
Some hemochromatosis sufferers can give blood as frequently as twice a
week to stay healthy, very often to blood banks. “Most people only are
allowed to give blood once every seven weeks,” Koenig said.
Oral medications that would help the body better rid itself of iron are
being tested, but, for the time being, bloodletting is the most simple and
pain-free way to help sufferers lead normal lives, he said.
More information
To learn more about hemochromatosis, visit the Iron Disorders Institute.
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