How to chelate iron from the body?

Hereditary hemochromatosis, a genetic disorder affecting how the body absorbs iron, is surprisingly common among people of Northern European descent, with some studies estimating 1 in 400 carry two copies of the faulty gene. Learning how to chelate iron from the body is essential for managing conditions of iron overload and preventing potential organ damage, including the heart, liver, and pancreas.

Quick Summary

This article outlines the medical and dietary approaches for managing iron overload and preventing organ damage. It covers therapeutic phlebotomy, prescription chelating agents, and natural iron-reducing compounds found in foods and supplements, all under medical supervision.

Key Points

• Therapeutic Phlebotomy: The primary treatment for most iron overload patients involves regular blood removal, similar to blood donation, under medical supervision.

• Prescription Chelation Drugs: Oral (e.g., Deferasirox) or infused (e.g., Deferoxamine) medications are prescribed for those who cannot undergo phlebotomy or require more targeted iron removal.

• Tannin-Rich Foods and Drinks: Consuming beverages like black tea or coffee with meals can inhibit dietary iron absorption due to their tannin content.

• Foods High in Phytates and Oxalates: Whole grains, legumes, nuts, and leafy greens contain compounds like phytates and oxalates that can reduce the absorption of non-heme iron.

• Calcium-Rich Foods: Dairy products and other calcium sources can inhibit both heme and non-heme iron absorption, especially when consumed in higher doses with meals.

• Curcumin and Other Natural Chelators: Supplements and foods containing natural compounds like curcumin, silybin, and green tea catechins offer mild iron-chelating effects and antioxidant support, but should complement, not replace, medical treatment.

• Avoid Iron and Vitamin C Supplements: Unless advised by a doctor, individuals with iron overload should avoid iron supplements and excessive vitamin C, as they increase iron absorption.

• Avoid Alcohol and Raw Shellfish: Both alcohol and raw shellfish pose specific risks for individuals with iron overload and related liver complications.

• Medical Guidance is Essential: All treatment plans, including dietary modifications, for managing iron overload must be supervised by a healthcare provider to ensure safety and effectiveness.

Understanding Iron Overload and Chelation

Iron overload, or hemochromatosis, occurs when the body absorbs and stores too much iron. Unlike with other minerals, the body has no natural way to excrete this excess iron, leading to its deposition in tissues and organs over time. This can result in serious complications, including liver disease, heart problems, and diabetes. Chelation is the process of using chelating agents—substances that bind with metal ions—to remove this excess iron from the body. For severe iron overload, especially for those receiving frequent blood transfusions, medical intervention is necessary. However, dietary and lifestyle changes can also play a supportive role in managing iron levels.

Medical Treatments for Iron Chelation

For hereditary hemochromatosis and other conditions causing severe iron overload, the primary treatment involves medical procedures and prescribed medications supervised by a healthcare provider.

Therapeutic Phlebotomy This is the standard and most effective treatment for most patients with hereditary hemochromatosis. The process is similar to donating blood:

• A medical professional removes about a pint (470 mL) of blood from the body on a regular schedule.
• The frequency of this procedure depends on the severity of the iron overload and is determined by monitoring iron levels (e.g., serum ferritin).
• Initially, phlebotomies may occur once or twice a week until iron levels return to a normal range. The process then transitions to a maintenance phase, requiring sessions every few months.

Prescription Chelating Agents For individuals who cannot undergo phlebotomy due to conditions like anemia, or for those with specific heart problems, medication is used to remove excess iron.

• Deferoxamine (Desferal®): Traditionally administered via subcutaneous or intravenous infusion using a portable pump, often worn overnight.
• Deferasirox (Exjade®, Jadenu®): An oral, once-daily medication available as a dispersible or film-coated tablet.
• Deferiprone (Ferriprox™): An oral medication taken multiple times a day, though it requires frequent monitoring of blood counts due to potential side effects.

Natural and Dietary Methods to Manage Iron

While not a replacement for medical treatment, certain foods and natural compounds can help manage iron levels by reducing absorption or offering mild chelating effects. It is crucial to discuss any dietary changes or supplements with a doctor, as self-treating can be dangerous.

Foods that Inhibit Iron Absorption

• Tannins: Found in black tea, coffee, cocoa, and red wine, tannins bind to iron and reduce its absorption during meals.
• Phytates: Present in whole grains, legumes (like lentils and dried beans), and seeds (including walnuts and almonds), phytates can significantly inhibit non-heme iron absorption.
• Oxalates: This compound, found in spinach, kale, rhubarb, and chocolate, also reduces the absorption of non-heme iron.
• Calcium: A potent inhibitor of both heme and non-heme iron absorption, calcium-rich foods like dairy products, tofu, and broccoli can help manage iron levels when consumed with meals.
• Soy Protein: The phytate in soy can strongly inhibit non-heme iron absorption.

Natural Supplements and Herbs Research has explored several natural compounds for their iron-chelating and antioxidant properties, but they should only be used as a complement to, not a replacement for, conventional therapy under a doctor's guidance.

• Turmeric (Curcumin): The active ingredient, curcumin, has shown strong iron-chelating and antioxidant properties in laboratory settings, helping to reduce iron stores and protect against oxidative stress.
• Milk Thistle (Silybin): The flavonoid extract silymarin and its main component, silybin, have been shown to chelate iron and reduce absorption.
• Green Tea Catechins (EGCG): The polyphenols in green tea, particularly EGCG, are potent antioxidants and have demonstrated iron-chelating activity.
• Quercetin: Found in many fruits and vegetables, quercetin is a flavonoid with iron-chelating properties and strong antioxidant effects.

Comparison of Iron Chelation Approaches

Feature	Therapeutic Phlebotomy	Prescription Chelation Drugs	Dietary & Natural Methods
Mechanism	Removes iron directly by draining blood, forcing the body to use stored iron to replenish red blood cells.	Binds to excess iron in the bloodstream and organs, which is then expelled via urine or stool.	Inhibit the absorption of new dietary iron and offer mild chelating effects from certain plant compounds.
Efficacy	Highly effective and the gold standard for most hereditary hemochromatosis cases.	Very effective for patients who cannot tolerate phlebotomy or have specific conditions like heart disease or anemia.	Supportive and complementary only; not a primary treatment for significant iron overload.
Administration	Requires in-person medical procedure, similar to blood donation, at a clinic or hospital.	Oral pills (Deferasirox, Deferiprone) or infused medication (Deferoxamine) administered under medical supervision.	Involves intentional food choices and, potentially, carefully selected supplements.
Considerations	Well-tolerated, low-cost. Requires consistent attendance at medical appointments. Not suitable for all patients.	Effective for systemic iron overload, but can have significant side effects and requires careful monitoring of organ function.	Best used in conjunction with medical treatment. Potential for supplements to interact with prescribed medications.

Conclusion

Managing iron overload requires a comprehensive strategy tailored to the individual's specific needs and the underlying cause. For conditions like hereditary hemochromatosis and transfusional iron overload, medical treatments like therapeutic phlebotomy and prescription chelating drugs are the most effective and safest options. Natural and dietary strategies, including the use of certain supplements and foods that inhibit iron absorption, can provide valuable support and should be discussed with a healthcare provider. Never attempt to self-treat iron overload with unapproved products, as they can be ineffective and dangerous. Early and consistent management is key to preventing long-term organ damage and maintaining a high quality of life.

Frequently Asked Questions

What is the most effective treatment for iron overload?

For most individuals with hereditary hemochromatosis, therapeutic phlebotomy (regular blood removal) is the safest and most effective treatment. It directly reduces the body's iron stores and is typically managed by a healthcare provider.

Can I use natural supplements to chelate iron from my body?

Natural supplements and herbs like curcumin (from turmeric), milk thistle, and green tea extract have shown mild iron-chelating properties. However, they should only be used as a supportive measure in addition to prescribed medical treatment and under a doctor's supervision.

What dietary changes can help manage iron levels?

To help manage iron levels, you can reduce consumption of red meat (high in heme iron), avoid iron-fortified foods and supplements, and incorporate foods that inhibit iron absorption, such as coffee, tea, whole grains, and dairy products, especially with meals.

Should I avoid all iron in my diet if I have iron overload?

No, you should still maintain a healthy, balanced diet. The goal is to reduce dietary iron absorption and avoid high-iron foods and supplements, but not to eliminate all iron. Your body still requires a small amount of iron for normal function.

How does vitamin C affect iron levels?

Vitamin C significantly enhances the absorption of non-heme (plant-based) iron. People with iron overload should avoid vitamin C supplements and be mindful of consuming vitamin C-rich foods and beverages at the same time as high-iron meals.

Are there any risks with using chelation therapy?

Yes, prescription chelation therapy can have significant side effects and must be administered under close medical supervision. It is not approved by the FDA for all conditions and can be dangerous if used improperly, particularly with over-the-counter products.

What are the common causes of iron overload?

Iron overload can result from a genetic disorder like hemochromatosis, repeated blood transfusions, or certain chronic liver diseases. Excessive intake of iron from diet or supplements can also be a factor.