Iron Deficiency to be Studied in People of Scottish & Irish Descent - hemochromatosis - Brief Article

Nutrition Health Review, Wntr, 2001

CHAPEL HILL, N.C.--Low-income people in western North Carolina will be tested over the next two years for hemochromatosis, the most common genetic illness in North America, through a new University of North Carolina at Chapel Hill (UNC-CH) public service and research effort.

Although the condition--a deficiency in the way the body processes iron--appears in all ethnic groups, it is most common in people of Celtic descent--those with Scottish and Irish ancestors, said Dr. Rebecca J. Laudicina, Associate Professor of Allied Health Sciences at the UNC-CH School of Medicine. About one in eight people carries the trait, and it affects about one in every 200.

"The Scottish and Irish settled the mountains of North Carolina, and so we're expecting to find a fairly high incidence of the disorder there," Dr. Laudicina said. "We'll screen people and then do follow-up laboratory and genetic testing when we find people with elevated iron levels."

"Physicians and other health care providers learn about this disease, but they don't learn how common it is," the researcher said. "Unlike conditions such as cystic fibrosis, which are apparent almost from birth, hemochromatosis develops primarily in adults." The gene was identified in 1996.

People with the illness absorb iron too readily, and eventually the element poisons them, Dr. Laudicina said. It can damage the liver, pancreas, joints, and heart muscle. It also can lead to arthritis, diabetes, and liver cancer and often is missed by health professionals.

"This is an ideal disease to screen for because we may be able to pick it up before chronic health conditions develop," she said. "There's a very safe, low-cost and effective treatment for hemochromatosis."

Treatment consists of going to a physician's office and donating a pint of blood every week or two at first and then less often once excess iron has been removed, Dr. Laudicina said. Eventually, patients may need to have blood removed only every month or so.

"People don't need to take a dangerous drug with a lot of side effects," she said. "They just get rid of excess red blood cells and therefore excess iron."

In the past, physicians have tended to think of hemochromatosis as a disease of men, but that's not true, Dr. Laudicina said. It occurs equally in men and women but usually appears later in women because they lose blood naturally through menstruation during their childbearing years.

"Younger women who eventually will develop this disorder have the protective effect of regularly losing red blood cells."

Otherwise healthful Western diets may make hemochromatosis worse, she said. Such diets are heavy in iron, and most cereals are fortified with the mineral even though that's unnecessary.

"One of the reasons we're doing this work is because Medicare and Medicaid do not pay for many laboratory screening tests, including this one," Dr. Laudicina said. "We want to change the perception that hemochromatosis is a rare disease and one that affects chiefly men."