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High Iron
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High Iron

Female, age 59.  Have taken Celebrex & Lipitor last 2-1/2 years, also medications for high blood pressure (moderately high) and low thyroid.  Recent readings:
11-23-03:  AST 38, ALT 43, 3-30-04:  AST 40, ALT 46, 5-20-04:  AST 37, ALT 52, with ALP of 117.  Testing on 5-25 showed negative for Hepatitis, but iron tested 277 (normal 150).  NO alcolol since Dec. 89  Prior 15-20 years, consumed 5-6 oz. bourbon mixed with coke each evening.  I would sip it over a period of 3 hours and eat afterward before bedtime.  This was my way of unwinding from the stresses in my life.  I was not feeling ill at all and went to work every day.  My doctor in 1989 called and told me (after routine blood test) that drinking was involved, high cholesterol (around 300), that I could have a stroke.  He wanted me to stop drinking for 3 weeks and have liver tests.  I had noticed about that same time that my viens in my abdominal area were almost showing thru my skin and my palms were red.  I know red hands are one of the signs of cirrhosis and the veins a sign of portal hypertension (from recent reading).  (These symptoms disapeared after I quit drinking.)  I quit drinking but did not have more tests because I was afraid.  Told him I was afraid it would show cirrhosis, and he assured me I did not have cirrhosis of the liver and should have the tests to ease my mind.  As said, I did quit drinking immediately in Dec. '89.  When I started seeing an internist at age 53, I began having liver function tests as a routine part of annual physical.  All have been normal until this past year (November 2003). Did aerobics 10 years (1989-1999)and now have osteoarthritis of knees (only).  As of this month, I am now taking ibupropen (instead of Celebrex)...usually only 2 tablets in morning and Cholest-Off, by NatureMade (instead of Lipitor) which they claim does not affect liver (advised me by email).  Plan to retest iron about 3 months.  Should I be worried?  Other than arthritis, I feel very well  all the time.  Have very healthy diet and get plenty of rest.  No other health complaints except arthritis pain.  Don't have any of the listed symptoms for cirrhosis or cancer. Questions: Is iron level 277 incredibly high as compared to the norm?  Do some people have iron levels much higher than this?  Is it OK to take the ibupropen and Cholest-off?  Would B-12 or Folic Acid help lower the iron? Can someone have cirrhosis even if they have not been drinking in past 15 years and have had normal liver function tests past 6 years?  Can the high iron be rectified thru diet?   Can this be improved by "milk thistle" or silybin as I have seen advertised?  Could there be any harm by taking this type supplement?  I am just terrified at the thought of liver ultrasound and/or biopsy.  From what I have read, these tests are to detect cancer or cirrhosis.  If I have either one, I would not want to know as long as I am feeling good and not having any symptoms.  Why scare myself to death.
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To answer your questions:
1) That iron level is moderately high.  I would suggest a Ferritin test to get a better idea of iron stores.

2) Cholest-off is made of plant sterols and I cannot comment on it's effect on the liver.  It is not FDA-approved.  Ibuprofen in moderation shouldn't affect the liver, but periodic monitoring of liver enzymes should be considered if this is suspected.

3) By itself, B-12 or folic acid should not have appreciable effects on the iron.

4) It is unlikely that someone can have cirrhosis after 15 years of abstinence and normal liver enzymes.

5) Taking any type of non-FDA approved supplement can harm the body.

6) A liver ultrasound is a simple, painless test that would be a reasonable first step to evaluate the liver.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
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5 Comments
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Thank you for the prompt response and answering my questions.  I wish that I had included the question as to whether Celebrex or Lipitor might have had an effect on my iron level?  Does anyone know the answer to this?  I know from reading (and from others) that Celebrex can cause liver damage.  In what respect does Celebrex damage the liver and it is reversible or permanent damage?
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To evaluate your iron have your doctor do serum iron, TIBC, and ferritin tests.  If these levels are high don't ignore them. High levels of iron can be a sign of hereditary hemochromatosis.  An iron overloading disease.

I do not feel that the medications you listed have any affect on iron values.
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Jean,
You said you have low thyroid function. Are you taking meds for it????? Hun, if not, you NEED to be on thyroid hormone replacement therapy ASAP!! If you are, you are not on a high enough dose or you are not converting T4 to the active T3 properly (most doctors will stick you on Levoxyl or synthroid). I am not saying they are 100% bad, but Armour is superior in my opinion, or Armour with a tad of T4 in the mix. All your aches are from the low thyroid and the high cholesterol is from LOW THYROID function. Please trust what i am saying to you. My Grandmother (74) was finally diagnosed with low thyroid when she was 62 (probably had it for years since she had symptoms for years). At the same time that it was diagnosed, she had a brain clot. What do you think it was from? She had high cholesterol levels for years. I have Hashimoto's (autoimmune thyroid disease) and my mother is currently being tested (I guarantee she has it too). Guess what? We all have high cholesterol. Her sister just informed her today that she has gained a lot of weight and has high cholesterol - HUM! Now, not to scare you (but to inform you), my grandmother was put on Zocor (same as lipitor) and prednisone for the brain clot (she had surgery). She was just diagnosed with cancer of the liver and bowels after 12 years of taking these HORRIBLE drugs!!!. Listen to me, doctors will throw pills at you to mask the symtpoms and not cure you at the site. For you it sounds like you have some issues that need to be cleared up with the thyroid, and therefore your other symptoms will go away - TRULY! For some reason doctors are clueless about how thryoid disease can wreak havoc on every organ in your body. Liver is one of them. I think you will be fine, enjoy a long life, once you get seriously informed about your thyroid and get on an optimal does of thyroid meds. All symptoms should be erradicated once you are on an optimal dose. This means, for many, going against the medical grain and discarding thyroid labs altogether. A good doctor will go by symptoms and not labs to get you to feel better. Here's a very basic test. Get a mercury thermometer (shake it down), and take your temperature under the armpit for 10 minutes, 5 days in a row. Record the time and temp (do not do this orally). If the average of your temps are below 97.8, then you are not on an optimal dose of thyroid meds (or you are not on any at all). The range you should be in for the 5 days is between 97.8 - 98.4. The higher the range, the better functioning is your thyroid. TRUST ME! If you put all your trust into doctors (sorry to say), you will take years off your life. I am 32 and learned this really quickly after being bombarded with heart pills, paxil (anxiety pills, stomach pills etc... until I FINALLY got tested for thyroid antibodies, which were sky high. My other thyroid labs were normal with a slightly elevated TSH after my 2nd baby (which is usually when thyroid disease will go crazy). I was falling apart and a complete wreck of a human being. This is how I know thyroid labs are BUNK! Good Luck!!!!!!!!

Denise
d_timmsjosey***@****
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Does anyone know if osteoarthritis can cause iron levels to elevate, particularly when you are having a bad flare up and the muscles are inflamed around the knee joint area?
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Per suggestion, I had my ferritin tested by my doctor when I was in for my first synvisc injections in my knees (arthritis specialist).  It was VERY high (1580), seven times normal 220.  At same test, all my liver functions were not only normal but in the low to medium "beautiful" normal range.  

Since I had been taking both lipitor and celebrex and had inflammation in knee joints, assumed the liver enzyme slight elevation level (period of 3 months)was because of one or more of those reasons.  Had they not checked my ferritin, and since my liver enzyme level went back to normal after I quit the celebrex and lipitor. I don't feel that the HH (hereditary hemochromatosis) would have been detected.  

I am what is called homozygote for the C282Y mutation, which means I got the gene from both parents sides.  It is common when you have ancestors of Dutch, Irish, French decent (among others).  When I say common, it is extremely UNcommon for the general public.  About 1 in 250 people develop hemochromatosis, that is less than 1/2 percent.

Yesterday, 6-18-2004, had my first phlebotomy treatment.  Since I had never been a blood donor, I was afraid.  It was totally painless.  Had six cans of juice during the process.  Of course, I never looked at the needle nor the container for the blood.  I am scheduled for once/week for a month.  They will take labs each week and determine, based on the readings, the frequency of future treatments.  

Can't imagine how many people out there with high ferritin levels that are never detected.  

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