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Detecting excess iron symptoms
The symptoms of iron overload are often not apparent until substantial tissue damage in vital organs has occurred. In fact, this is one of the primary risks of iron overload. Common, non specific complaints include abdominal discomfort, lethargy, and fatigue. The lack of specific excess iron symptoms, coupled with its potential to cause severe damage to key organs, means that screening for iron overload in high-risk patients is recommended.
Iron overload affects body tissues differently. In major organs such as the heart or liver, hemosiderotic injury can be fatal. In the skin, advanced hemosiderosis can cause a characteristic but benign bronze pigmentation.
CELLULAR DAMAGE CAUSED BY IRON OVERLOAD
Under normal conditions, most iron in the body is tightly bound either to functional molecules such as hemoglobin, to transport proteins such as transferrin, or to intracellular storage proteins such as ferritin. In this tightly bound state, iron can not cause cellular damage because it cannot participate in oxidative reactions [1]. The cellular uptake of transferrin-bound iron is well controlled.
When heavy iron overloading occurs, the body's iron transport and storage proteins become saturated, and excess iron binds weakly to various other low-molecular weight proteins in the plasma, such as non-transferrin bound iron (NTBI); NTBI is therefore detectable in the plasma of patients with heavy iron loading [2]. When excess iron is present the cellular iron uptake is not regulated, normal iron transport and storage proteins become saturated, and the intracellular labile iron pool of weakly bound iron increases. When this labile iron reaches critical levels and exceeds the cell antioxidant capacity, it evokes the formation of reactive oxygen species that lead to cellular dysfunction and death by affecting lipids, proteins, and nucleic acids [3].
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