Too Much Iron Can Be Just as Dangerous as Too Little

Today we are chatting about iron overload, hemochromatosis, something that is part of my own personal journey and was certainly part of my late brother Saul's journey as well. And we are talking with the author of The Iron Curse, Dr. Kristi Locke, who is a chiropractor and a functional medicine clinician, and she goes deep. On iron disorders. Her work was shaped by her husband's diagnosis with hereditary hemochromatosis and subsequent health complications that so commonly result from the silent condition. This led her to uncover a wider, often missed pattern of iron overload in patients. We talk about the frequency, the incidence of this in society, which kind of blew my mind. We talk about symptoms, solutions, why this matters in terms of our long-term health outcomes. We even go over my labs in real time, my genes, which was off the cuff and unexpected, but it was a really cool uncover of what's going on. And I think you guys will find it fascinating too. So let's dig in.

So Christy, I am really, really excited to have this conversation today. You don't know this, but I am a carrier myself of hemochromatosis and have been having issues of late in the last couple years because of it. And so I'm excited to kind of unpack all of the conversation around iron and how sometimes So many of us think about low iron, but a lot of us too experience higher levels of iron, and that too can be problematic. So welcome to the show.

Thanks for having me. Yeah, so I, I'm not really that surprised to hear that cuz that's a pretty common story that you are a quote unquote carrier of the hemochromatosis gene and you're having problems and also you're My name is McCall McPherson, and the Mc is like a very Irish type name. And the United Kingdom, Ireland has the highest rate in the world. So that's pretty common.

I love it. Well, I want to unpack all of that as we do that. And kind of leading up to it, will you tell us a little bit about what hemochromatosis is? Probably a lot of listeners have never even heard of this.

Yeah. So hemochromatosis is where you have too much iron. It can also be called iron overload. And so about most of the people that have hemochromatosis have a hemochromatosis gene. There is a non-hereditary hemochromatosis that you can get when you don't have a hemochromatosis gene, but about 30% of the population has one of these HFE hemochromatosis genes, and there's 3 different hemochromatosis genes. And you said you have one of them and I'm not sure which one it is, but do you know which one it is? No, that's okay. Yeah, that's okay. So, cuz there's 3 of them and about 30% of the population, probably more, has a hemochromatosis gene. And they're more common in the European, Northern European ancestry areas. So. What happens is when you have these genes, or even if you don't have these genes, you end up becoming high in iron. And then the iron, it— well, we need it and it's important. If you have too much of it, then it can really be a problem because your body doesn't have a lot of ways to get rid of iron other than through like blood loss is the main way. So this is why women tend, especially premenopausal women, tend to have a lower risk for hemochromatosis. But it can still happen, especially if you have the right combination of genetics and epigenetics. So the, this basically you get too much iron and the iron starts depositing in your tissues and it be— creates a lot of oxidative stress, which just means like it's creating a lot of damage in those tissues. And iron likes to deposit in certain parts of the body. Like it really likes to deposit in the liver and it also likes to deposit in the pancreas. So in the liver, it can cause liver cancer, fatty liver, liver damage. A lot of times people will have like high liver enzymes. Enzymes. It'll deposit in the pancreas causing like type 1 diabetes, type 2 diabetes, inflammation in the pancreas. It'll deposit in the heart causing cardiovascular disease, plaque and congestive heart disease, increasing your risk for a heart attack. It'll deposit in your brain causing Alzheimer's, dementia, Parkinson's, bipolar, you know, you name it. Depression, severe depression. It'll deposit in your skin causing skin cancer, pituitary gland, causing your thyroid, causing thyroid disease, Hashimoto's, non-Hashimoto's thyroid, hypothyroidism and stuff. So yeah, it's, it's a serious issue and it's really a root cause issue that is easy to diagnose and screen for and treat. Yet most people go undiagnosed and untreated with the primary problem of the having too much iron. And then they get these secondary diagnoses of hypothyroidism or liver disease or liver cancer or diabetes or heart disease. And the really, the underlying problem is like they were not properly treated for the hemochromatosis.

Wow. That's fascinating. So it can even drive cardiovascular disease in the form of plaque?

Yeah. The iron is, creates a lot of oxidative stress and inflammation, and then your, you know, your body's like, okay, we gotta lay down all this cholesterol. To try to heal up all this damage in the arteries and the capillaries. And then you start getting that plaquing and over time it calcifies and you get calcification.

Wow. Okay. I looked at my variant. Well, no, it's on 23andMe, so that's okay. Doesn't, yeah, it says the HFE gene, but there's two components. Is there a way I can look at what?

Yeah, there's a way you can look if you kind of scroll down. Oh.

C282Y.

Why? And you just have one? Yeah. Cuz you said you're a carrier. Yeah, I'm a carrier. Okay. And that's the, we gotta talk about the carrier mess too, but that's what I would've guessed you had because the C282Y is the gene that is the most powerful at causing hemochromatosis because it's the gene that is the strongest at causing an increase in iron absorption. And so being a, you know, a menstruating female having a problem with hemochromatosis, like you said, then, or at least having a problem with issues are showing up, then I would guess you had one C282Y gene, cuz that's the most powerful. But there's two other hemochromatosis genes that can also cause hemochromatosis. They're just less likely. So I think of it as like the heavyweight, heavyweight champion is the C282Y. And if you have two of those, like you're really likely to have a problem with too much iron at some point in time in your life. And it can vary, you know, it can come and go. But most people with two C282Y high-risk heavyweight champion hemochromatosis genes are gonna have iron overload at some point in time in their life. I mean, there's exceptions to the rule. There always are. Like I have a patient that has two and she had a gastric bypass and she doesn't have iron overload because she's not absorbing any of her minerals, including iron. But for the most part, two of those is gonna cause a problem. One of those is gonna cause the problem too, in most people at some point in time in their life. And the— but there's this myth that one makes you safe, like you get a pass because you just have one, and that's dangerous. That's a carrier myth. But then there's the two other genes, which there's one called H63D. Which is the most common. It's the mo— the highest frequency in the population. And you can have, you know, one of those or two of those. You can have a combination of like one of the middleweights, H63D, and one of the heavyweights, C282Y. So H63D is like the middleweight champion. I see a lot of people that get one of those and have hemochromatosis. So you can still get it. And then there's the much less common one called the S65 3, and that's very rare, but it's out there and it is less likely to cause hemochromatosis as the other two, but it still is a risk and everybody needs to know if they have it. Interestingly enough, 23andMe, which I am a big fan of because I think it's a really valuable data source for like health reasons such as this, they sequence the S65C, but they don't report on it. So I have a genetic report called Genetic Detoxification, where if you download your 23andMe and upload it to that Genetic Detoxification, it'll tell you if you have the S65C and the other ones, and then a bunch of other important health stuff like MTHFR and all the things. And then I really wanna spend a minute to talk about the carrier math because you might have been familiar with this maybe at some point in time in your life or career or education. You know, you were told one hemochromatosis gene, you're fine. And And even if you look at 23andMe, it says one risk not likely to increase, you know, one gene carrier, whatever it says, not likely to increase risk. Right. That's what it says. That's misleading because here you are having problems. Right. So what are the problems that you're having? Like, what is this looking like in you?

So for me, here's the thing. I'm a little, it's hard. Like the water is muddy for me. So I rely pretty heavily on objective data. And so my story is probably like a lot of other women who don't know that this is a thing. I was fine. I had very heavy periods my whole life. I'm 43, I think. Maybe I'm 44. No, I'm 43, somewhere around there. And so I'm not yet in menopause, but I had an ablation, a uterine ablation that took away my periods. My hormones still cycle, everything's still normal. And now my iron is increasing. I would say maybe I have a little uptick in joint pain, but I think potentially my experience is more having to do more to regulate my inflammation, which is already chronically an issue, but now I feel like it's more of an issue. And then I have some labs here too. I'm happy to share them with you if you want to.

Yeah, let's do that.

Isn't that fun?

Okay, very fun. There's so much to unpack with what you just said, right?

No, I bet this is— I've never done this on the podcast where we do like an in-person, real live. Yeah, this is great.

Okay. So technically you don't have hemochromatosis, but I'm gonna explain why that is and then why we don't care. So technically you're— to have hemochromatosis, you have to have two things, an iron saturation over 45%, which you have. Your, your transferrin saturation is 61.9.

Okay.

So you've checked that box. You technically have to have a high ferritin too, and you technically don't have a high ferritin. But it's come back in a month and it'll probably be high, you know? Right. It's gonna get there. It's only a matter of time. And do we wanna like wait for you to have a diagnosed another disease? No. I don't ever like ferritin to be over 100. In my opinion, if your ferritin's over 100, you better have a good reason for it and you likely have inflammation or too much iron or both. I like ferritin to be realistically in like a 50 to 100 range, and I'd like to look at people's genes to kind of give 'em a realistic expectation for what what their range should be. For you, if you have one C282Y gene and a ferritin of 142 and a transferrin saturation of 62, if you walked in my office or, you know, whatever, I'd say, hey, you don't technically have hereditary hemochromatosis, but you're on your way there. It's only a technicality. You're in your forties. If you don't deal with this now, which you're so smart, you're like catching this very early, then It's only a matter of time before this becomes a serious issue. And then, you know, it can cause cancer, it can cause all these issues, and we just don't wanna deal with that. So I would say, okay, let's look at your CBC.

And I don't think we have one on here. This is like Vibrant Labs. We're doing a full Vibrant Labs exploration right now.

Okay. Yeah. So we got your CBC and Your red blood cells. Where are your red blood cells and hemoglobin? I mean, that's on a different page. Let's keep looking.

Yeah. They, it's not in regular order on here.

I can't stand that, but that's okay.

I know, right? Let's at least the CBC and the CMP together. Yeah. Okay. This is part of a CMP scrolling down.

Here we go.

Oh, so look, look, your liver enzymes high. Yeah. LDH is high. That is likely from the iron being too high. The liver enzymes will come down. The LDH will come down. That ApoB will come down. The LDL cholesterol will come down. The homocysteine will come down. You'll probably need to add some extra inflam— you know, methylated stuff in there. But look, your CRP's good. So your ferritin's not from inflammation. That's a really good CRP. So I still haven't seen—

if your CRP is normal and your ferritin is elevated, it's likely not just Because people don't understand ferritin's a marker for inflammation and it can elevate just in, in states of inflammation. So if my CRP was high and my ferritin was high, it'd be more likely due to inflammation.

Is that right? Yes. Yeah, exactly. And then you have to figure out how to get the CRP down to see what is the ferritin like for iron reasons. Cuz it can, you can have both, you can have too much iron and inflammation and people with hemochromatosis do have both. So, um, yeah. Search the RBCs to see if we can find that RBC.

Let me keep looking. There's my hematocrit.

Oh, wait, hematocrit, RBC. There we go. Okay. Yep. So look, your red blood cells are high. This is so much fun. I wish more people would have me do this. So your red blood cells are high, your hematocrit's high, your hemoglobin's almost high, and all of these are caused by having too much iron. And this is actually really good news because you're the perfect candidate to have blood removed to lower your iron. What, what's harder is when a person comes in and they have low red blood cells, low hemoglobin, and they have too much iron, and that does happen sometimes, and you can't remove blood in those people. You have to figure out other ways to work on getting them better until they can have blood removed, if they can. But you are like the perfect candidate for this. Just, you know, have that blood removed and then, and maybe, you know, your testosterone will come up. Testosterone does increase iron absorption. So a lot of women and men are taking testosterone and that's causing them to absorb more iron. And then if they have an hemochromatosis gene, then it's like, can really create another layer to that problem and it, it, it gets missed all the time. So yeah, that was, I think, really helpful.

That was fun. And so I do wanna dig into, to the treatment kind of components. I wanna back up for a moment and just derail our conversation a little bit. Number one. This is really fascinating for me, not only because I'm having this experience, but 6 months ago, my brother, who's just a few years older than me, who's 48, perfectly healthy, no cholesterol issues, had a perfect calcium score, died of a heart attack. Was thin. You never in a million years would have guessed, but he did have hemochromatosis. He was a carrier, but had a lot more iron than I did.

A lot more.

Well, he didn't have heavy periods his whole life.

Exactly.

And he had the C282Y gene, I guarantee you. Yep. And maybe he had another one. Maybe he had that third one that doesn't really get sequenced often, the F65C. But so that tells me one of your parents probably had two. I don't know which one, because maybe, maybe not. But my guess is one of them had two. And then what saved you from a heart attack is your heavy periods. But your heavy periods are done. So now you're quickly going up, right?

Yeah, exactly. And so tell women who are listening, obviously, we want to be highly attuned to this postmenopausally as periods get less frequent, but it can also manifest earlier, especially if you have two genes or more, right? Tell women what symptoms they might want to tune into that kind of manifest in cases of iron overload. And that being said, I always think too, data is so powerful, right?

It really, truly is.

Yeah.

Yeah. I mean, I always feel like I'm selling people short when I say like, look at symptoms for this because it's so easy to diagnose. Look at your iron saturation, look at your ferritin. If those are in a questionable range or high, then get the genes. Personally, I think you should get the genes anyways. 30% of the population has these genes. If you've got an Irish or UK last name, you're like in the 50s to 60s percentage. So get the genes, get your labs done. Now, symptoms, symptoms-wise, everybody wants to know symptoms. Literally anything. You name a symptom, I'll tell you how it's connected to hemochromatosis. It could be fatigue. You know, not enough iron causes fatigue. Too much iron causes fatigue. It could be that you're having a hard time with— if you drink alcohol, you have more of a hangover. You're not detoxing it as well because your liver is getting damaged from all the iron. And now you're not detoxing alcohol. You're not detoxing everything as well as you should. It could be that you're, like I said, your blood sugar. You could have a high hemoglobin A1C. You could be diagnosed with blood sugar issues. It could cause you to have— I mean, I talked about a lot of the labs and stuff with the cardiovascular disease, depression, Schizophrenia, bipolar, Parkinson's, Alzheimer's. I mean, these are things that are caused by undiagnosed hemochromatosis in some cases, not all cases, but some cases. Joint pain is very common. Joint pain is also one of those things that, um, it often takes a while to really get the hemochromatosis like under control. And I find that curcumin helps a lot also for multiple reasons, not just with the inflammation, but it's really good for joint pain, but also it'll bind to that iron and help pull the iron outta the tissues. Because here's the deal, the iron actually likes to deposit into the tissues. And if you remove blood and get your iron in a better range, that's great. That's wonderful. Having said that, if you're a somebody with this gene and you've been having high iron for a while, you've been hoarding iron. Like the body likes to hoard it away for a rainy day and the rainy day never comes. And then, you know, you end up dying from too much iron. So, but the body likes to deposit it into tissues and there's some supplements that can chelate that iron, like curcumin's one of them, um, green tea extract, alpha lipoic acid. These are just a couple of the things I talk about, all the supplements in my book, The Iron Curse too. And that's a good reference for this type of topic. But these supplements, you can take them and they can actually pull the iron outta the tissues, which is really valuable. And that takes a while. So That's where, like, let's say you have, you know, iron deposits on your liver, potentially that could go away with the right tools. You just have to keep checking and see if it goes away.

And so, yeah, I love that there's kind of two phases— not phases, but two aspects of treatment. One is pulling the deposited iron out of deposition to be circulated to get rid of. And the other that people are probably completely also unfamiliar with is when you have too much iron, when it's too concentrated, you go and you donate blood, you get rid of blood so that it depletes the concentration of iron circulating in your blood so that it doesn't go deposit in vital organs, etc. Correct? Is— do you want to expand on any of that just so people can understand?

Yeah, yeah. I mean, donating blood is to me a medical procedure. That's why they always have to check your hemoglobin before. Personally, I think Everybody that's donating blood as an altruistic thing, they should get an iron panel and a CBC before they go do that. Me personally, I don't have a hemochromatosis gene. I tend to be on the lower side of iron. I have to kind of fight to be higher, normal. And if I donated blood, it would be like a death sentence to me. Now you donating blood, that's wonderful. And I don't want people to go donate blood to lower their iron if they have like a history of Lyme disease or— a bloodborne infection, you can still have blood removed without— if you need to have blood removed, there— just ask your doctor to give you a therapeutic blood removal form and they will just take that blood out and throw it away. And then you're not causing harm to other people. And there's some people that are on blood thinners and they, or they've been to countries with malaria and they can't. So there's ways to have blood removed. It is a medical procedure and I think people need to kind of take it more seriously in that regard. So. But it is, there are a lot of people that just donate blood, you know, regularly because they have the right type of blood and they're real altruistic and they're just fine. And, and I'm always like, you must have a hemochromatosis gene because there's no way you could donate blood every 8 weeks and not, and be alive. So the blood removal's key. That is the primary treatment that hematologists and the medical profession uses. I think that's selling people short. And so the, there's a couple reasons for that. The supplements and the diet are key too. Also diet-wise, if you're trying to lower your iron, don't eat a lot of red meat. You wanna get more like fish, chicken, those type of things that have lower iron intake, uh, lower iron content. And then although a lot of people can still lower their iron while eating red meat, it's just if you're really high, it's probably best to kind of change your diet a little bit. You can also drink coffee or tea with something that has iron in it, like red meat. Decrease the iron absorption. So some people are just avid coffee drinkers and avid tea drinkers, and they actually become low in iron just because they're consuming so many of these beverages that decrease iron absorption. So diet's important. Don't supplement with a lot of vitamin C, cuz vitamins can change your iron. Vitamin C can increase iron absorption. And then there's other supplements that can lower iron absorption. Like I talked about some, some of them, but then there's more like quercetin decreases iron absorption. And I wish that more doctors were using the supplements with the hemochromatosis patients. Well, I guess first I wish that patients were getting diagnosed properly. Yeah. And then secondly, I wish they were being treated not just with blood removal, but supplements because people get better so much faster and they get more resolution and you really start healing up on a more cellular level rather than just kind of like taking away the top layer. We're kind of taking away the other layers of damage, the deeper layers of damage.

This is such a fascinating conversation for me. I'd love for you to tell listeners, too, what made you so interested in this topic. Like, how did you become the Iron Lady?

Oh yeah, I will. Can I ask you a question first?

Of course.

Do you have a celiac gene too?

I do. Oh my gosh. I wanted to talk about that. I do have a celiac gene.

I thought you did for two reasons. Because you said you have this kind of lingering inflammation and you have a hemochromatosis gene and your name is McCall McPherson. So you're like Irish. The Irish population has the highest rate of celiac gene too. So the, the hemochromatosis and the celiac gene are often in the same people. Like I have a celiac gene. My husband has a hemochromatosis gene. My daughter has both cuz it's their Irish heritage coming down. But the reason that I wrote this book is because my husband had undiagnosed hemochromatosis. And because of that, he developed a lot of health problems. It was causing him to have liver issues. It was causing him to have really thick blood. High red blood cells, hemoglobin. It was causing him to have low testosterone. The testosterone came higher because I forgot to say this, but iron damages your gonads, causing infertility in men and women. So it's a big— it damages your pituitary gland. It likes to deposit into the anterior pituitary gland. This is one reason it can cause so many hormonal problems like thyroid issues and growth issues and hormone issues, all these things. So my husband had an undiagnosed pituitary tumor that was causing him to secrete too much cortisol. So he had Cushing's disease from the pituitary tumor, which I believe was a result of him having undiagnosed hemochromatosis because the iron really likes to get into the pituitary gland and just kind of hang out there and cause damage. So the pituitary tumor seems to be resolved now. That was a whole nother kind of medical experience that you've learned something from, but you'd rather have lived without. But it, what happened was once I figured out he had undiagnosed hemochromatosis, I was at the same time, this was probably around 2016 or so. I was really getting interested in 23andMe and genetic testing in people. And I started really looking at my patients closely who had these genetic tests. And I'm like, there's a lot of people with undiagnosed hemochromatosis.. And I keep telling 'em they have this problem and they keep going and getting a second opinion and they come back to me and they say they're fine and they're not fine. And it just started to really wear on me. So I decided to write the book and teach the workshop and it's just kind of, that's, it was the origin.

Wow. So fascinating. And that is the origin story for so many people, you know, that make an impact in these micro topics that are largely unaddressed or underaddressed. So gosh, I commend you. What sweet love you also have for your husband to dedicate all of this work to, you know, solving a problem that he first exposed you to. Interesting, kind of to go back to the celiac conversation. So one way in medicine that celiac is often kind of potentially flagged for a workup is chronic iron deficiency. So why? Because they're not able to absorb iron because the little hairs on our intestine get eroded away that are responsible for largely our nutrient absorption. So it decreases that surface area, minimizing and reducing our access to absorbing nutrients that we need to function every day. But I almost wonder if in the evolution of us and our genes, if that was a compensatory mechanism. So celiac people have low iron genetically. Now let's layer into high iron because they're— they center and origin from the same population. So celiacs originated in Ireland. It sounds the same for hemochromatosis, which is wild.

Yeah, that's really interesting. I've thought about that. I think there's something to that, and I don't know that they both originated in Ireland, but they both became very common in Ireland because they came there early. Those genes came there early and then it's an island and so it gets very inbred. And then the Great Famine in Ireland caused a large number of people to die. Like 8 million people lived in Ireland before the Great Famine, and then also known as the Potato Famine. And then a million people died from the famine. And then 1.5 million people left and most of them came to America. But after the Great Famine, there was this explosion of hemochromatosis because the people who survived were the people who could absorb iron better, because when you're going through a famine, you don't have food, period. So interestingly enough, it was also a famine that led to the diagnosis of the celiac disease, but we'll save that for another day. But yes, so I think you're right about them living in the same population and like the celiac gene. So celiac is also a genetic disease. 99% of people with celiac have a celiac gene. And the celiac gene, it causes you to have an overactive immune system and to go after gluten, but it also prevents you from dying of infections. So yes, like there's this balance. Okay. I may not die of an infection, but if I live in a world with too much gluten, then I could die of celiac disease or develop celiac disease. But it's not that big of a deal because now I have the hemochromatosis gene to help me absorb more iron. So I'm less likely to die of iron deficient anemia. And, you know, this is kind of the evolutionary questions that definitely this happened in some people at some point in time.

So interesting. It really is. I would love for you to tell us a little bit about your book, The Iron Curse. And also, because this is such an incredibly underserved topic, diagnosis issue, I would also love if you could share a little bit about your workshops educating and empowering people in both aspects is just a powerful, powerful way to make an impact.

Yeah, I'd love to. So written a couple books. The most recent one is The Iron Curse, and I go into a deep dive about hemochromatosis, iron overload. I also talk about low iron and anemias. And then when I was writing that book, I had a lot of people that wanted me to teach a workshop. And so I decided to teach a workshop that's about 5 to 6 hours and that workshop can be found at ironcurse.com and you can watch the first video for free. And then I have a number of other videos, workshops that I've taught, and one of them is on autoimmune diseases and celiac. And I, what I do is I try to really find these important but common and really undervalued and underutilized genetic disorders and look at the genes and plus the environmental factors and what you can do to protect yourself. So I have the Iron Curse one about iron, and then I have the autoimmune one that I talk a lot about celiac, and I take a deep dive into gut issues. And then I have one on heart disease and one on brain health and one on methylation and one on age-related macular degeneration. Wow.

How interesting. Well, I will put all of that in the show notes. Tell listeners to where they can find you online, keep up with you, keep up with your work.

Yeah. So, um, drchristiesutton.com is a website, and then I have Instagram @drchristiesutton and Facebook, Dr. Christy Sutton.

We have to get you on TikTok. It's the most—

Oh, I am on TikTok. Yeah. Dr. Christy Sutton. Yeah, I am. Thank you.

I'm partial to TikTok, so I'm like, everyone needs to be on this.

It's a great— No, it's, it's, it is a great place to educate. Yeah. I forget about it sometimes.

I know, yeah, I kind of forget about Facebook sometimes. Thank you so much for this. Thank you, and it was so fun and enlightening. Is there anything else at all that maybe I didn't ask that you want listeners to know, or you think that they should know?

I think this was a really good— I think you did a great job covering this in a short amount of time. So I'm sure there's something else that I'd like people to know, but I think this was a really valuable talk I would love some time to have another talk about celiac disease.

Oh, I'd love that.

And go into those genes. That would be really fun.

I would love that. That would be so fun. We'll bring you back for that.

Okay.

All right. Until next time.

Thank you.