High Iron

[Jean F.]

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.

[Kevin Pho, MD]

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:
kevinmd_b