Hi Paul and Kitty,

I finally went to the blood bank recently, I delayed going to it among
others because I caught a flu.

[The fact that you caught the flu at all suggests that your immunity is not as
high as it could be. Although I know from private emails that you live with
several other people in the same household, if your immunity was sufficiently
strong then communicable viruses and bacteria should mostly be destroyed before
they replicate sufficiently to give major symptoms. Neither I nor Kitty have had
flu for many years (I not since 1990) even though we frequent dance clubs
closely packed with many other people.

After reading of the differences in test values between you and Egill, I would
like to know if he got the flu also. If he did not that might be another sign
that your iron is too low for optimal immunity. --Paul]


I wanted to be sure the my ferritin
level wasn't raised because of its role as an acute phase reactant.

--- In morelife@yahoogroups.com, Ólafur Páll Ólafsson
<olafurpall@y...> wrote:
> >
> > The reason I want to donate blood is because I want to know my
> > iron stores and possibly lower them by donating blood. As a male
> > that has never donated blood in my life I probably have higher
> > than optimal iron stores. I also want to know my ferritin level
> > which is one of the markers for iron stores.
> >
> > [Do they do these tests for everyone who donates blood? In the US,
> > all they test is the total cholesterol, more as a "freebie"
> > incentive to get some people to donate. --Paul]
>
> Hemoglobin is measured every time people donate but the ferritin
> level is only measured in new blood donors and is not measured again
> unless the blood banks nurses see a reason to do so. I would guess
> the ferritin level is only measured again if the hemoglobin is very
> low.

I found out that ferritin is only measured again if the patient
reports having symptoms of anemia. Which means you can fake the
symptoms of anemia if you want to know your ferritin level:-)

[Tut, tut! How could you even *think* of such an action? :) Seriously, this is
the whole problem with state planned and organized semi-charitable arrangements.
If instead of paying taxes you had complete control of what your money was to be
spent on, you would simply make such a decision according to your own
evaluations and would pay for it accordingly. As it is, the system clearly
promotes such faking in order to get something extra. --Paul]


> > By the way I just noticed by looking at your blood test record
> > that you and Kitty both have a very low ferritin level.
> >
> > [This is probably because we avoid all iron enriched foods,
> > particularly breads. However, we do eat sufficient iron rich foods
> > to give us adequate iron for our hemoglobin needs. Our serum iron
> > is also within range, although low, but that's exactly where I
> > want it to be. --Paul]
>
> I too don't eat anything iron enriched and haven't done so for a few
> years. But I used to eat lots of iron enriched cereals when I was a
> teenager, I probably got more than the RDA of iron just from eating
> the cereals. This is one of the reasons I would guess that my iron
> stores are a bit higher than I would like them to be.
>
> > Paul was
> > measured with a level of 23ng/ml in 1999 an 17ng/ml in 2002 while
> > Kitty was measured with a level of 9ng/ml in 2002. Serum ferritin
> > level of less than 15mcg/l is defined as iron deficiency (PMID:
> > 1878420). According to this Kitty should have iron deficiency and
> > Paul should be on the edge of deficiency but neither of you has
> > iron
> > deficiency. This might be explained by the fact that while serum
> > ferritin level generally directly relates to the bodies iron
> > stores
> > ferritin is more than just a marker of iron stores. Ferritin is
> > regulated by many other factors than iron. Oxidative stress and
> > cytokines such as TNF-alpha and IL-1 seem to increase ferritin
> > levels in the body (PMID: 11986201). Both of you take many
> > supplements that have been shown to reduce these cytokines as well
> > as reducing oxidative stress. According to Kittys blood test
> > records she has a very low level of both of these cytokines. They
> > are not found on Pauls blood test records but I would suspect him
> > to also have a low level of these cytokines.
> >
> > [I did not take the detailed tests (which are expensive) because
> > if C-reactive protein is low, then the others are generally also
> > low. We only got the details for Kitty because she had one very
> > high reading for C-reactive protein, which we now think was a
> > mistake and caused us unnecessary concern (not to mention extra
> > money) for detailed tests of inflammatory cytokines. --Paul]
> >
> >
> > This might cause the
> > serum ferritin level test to underestimate your iron stores. The
> > opposite can occur in the case of illness. As an acute phase
> > reactant ferritin is produced by the liver in response to
> > inflammation and is therefore often elevated in the case of
> > illness. IL-1 and TNF-alpha are also secreted in states of
> > illness and might contribute to the rise in ferritin that occurs.
> > Because of this measuring the ferritin level shortly after
> > recovering from a flu or a cold is probably not a good idea.
> >
> > [Thanks for the analysis, Olafur. I had wondered why we were so
> > healthy in terms of hemoglobin and energy with a low ferritin,
> > but had not bothered to look into it, merely thinking that
> > our "strange" diet and supplement lifestyle was responsible for us
> > not being "normal". You have now verified that and provided a
> > possible explanation for it. Thanks again. --Paul]
>
> You're welcome. I suspect that this is also the case with me. I
> don't know my cytokine levels but there are several reasons to
> suspect they would be pretty low. On top of my diet and supplements
> my low visceral body fat also suggests that I have low level of
> these cytokines. I'm going to the blood bank soon and will let you
> know when I get the results from the measurements. I'm hoping my
> ferritin level is low compared to my hemoglobin level, that would
> indicate that I too have low level of these cytokines.

Here are my results from the blood drawing at the blood bank. I
converted the values to US numbers:

Hemoglobin: 13,4g/dL
S-ferritin: 6,54ng/mL

I am very glad to see that my ferritin level is so low. It suggests
that I have very low iron stores while my normal hemoglobin level
indicates that my iron stores are sufficient to prevent anemia which
is in accordance with my lack of symptoms of anemia. This is in line
with my hypothesis that my ferritin level is low because I have low
levels of oxidation and inflammation, not because I am deficient in
iron. Seems like my diet and supplement regimen are doing just what
I want them to.

Because of my low ferritin level I was rejected as a blood donor.
Below are the minimum values needed to be accepted as a first time
donor at the Icelandic blood bank.

Hemoglobin: 13,5g/dL
S-ferritin: 14ng/mL

My hemoglobin level was also too low but just barely though. A nurse
at the blood bank offered me to visit the blood bank again to get free
iron pills in case I wanted to increase my iron stores to be accepted
as a donor. But I am definitely not going to take any extra iron
since I am very happy about my current iron stores as indicated by my
ferritin and hemoglobin levels. Instead I plan to keep eating a low
iron diet in order to keep my iron stores low. But I will be on the
lookout for symptoms of anemia since iron deficiency can be just as
harmful as excess iron. Iron is f.ex. very important for
mitochondrial maintenance (PMID: 11795893) and iron deficiency just
like iron excess causes mitochondrial malfunction and mitochondrial
DNA damage (PMID: 11854522).

[After reading the Ames review paper that you sent me (PMID: 11854522), which
gives a very detailed listing of all the valuable functions of iron, and makes
the very clear point that iron deficiency for these functions may occur long
before any signs of anemia, I am not so sure now that I agree with your
reasoning here. My main concern is with your Hemoglobin which is as low as mine
has ever been and I am 50 years older than you. At the vigorous age of only 25
your hemoblogin should be much higher. At 13.4 I would say that with respect to
your age you have subclinical anemia, and from what the Ames paper states, you
may not have enough iron to enable those many valuable functions to be optimal.
I think that you should raise your iron and your hemoglobin to about that of
Egill's, which to me appears to a good low value but not so low that it may be
compromising the beneficial functions of iron. --Paul]



People with a too low ferritin or hemoglobin level to be accepted as
donors are advised to contact a doctor in order to seek an explanation
for the low levels and evaluate whether further research or treatment
is needed. Despite being pretty sure why I had such a low ferritin
level I decided to contact a doctor at the blood bank. The doctor
mentioned the surgery I had when I was younger as a possible
explanation for the low ferritin level. As I've mentioned before I
had a rare disease when I was only a few months old which resulted in
two thirds of my colon having to be removed. The doctor said this
might cause decreased iron absorption and possibly also decreased
absorption of other nutrients (she particularly mentioned vitamin B12).

[This could certainly be why your test values were different than Egill's,
However, if you are therefore absorbing less iron, then it means that you need
to take a little more in your diet than he does. --Paul]


She also said that I would be rejected as a blood donor cause of this
surgery I had regardless of my iron stores because donating might harm
me. But she did not give any reason why it could harm me. This is
probably just a rule at the blood bank, a very inefficient *one size
fits all* way to filter out donors that do not match some "perfect
donor" criteria judged by the blood bank employees.

[It would be a reasonable rule if they did not do a ferritin test, but if your
hemoglobin and ferritin are high, I cannot see how donating blood might harm
you. It is not as if the colon takes part in the creation of blood cells!
--Paul]


This is a good
example of the lack of individual valuation in the current society
where the government agents just go by the book and don't trust people
to make their own decisions. Did it never cross their mind that I
might be fully capable of making my own decisions in this regard?

[Yes it did and the government/medical elitists long ago decided that no one but
they are capable - that everyone else is like a child who had to be constantly
guarded, kept from harm and prevented from ever becoming self-responsible, so
they can maintain the need and the power to continue looking after them, of
course. --Paul]


And
who gave them the right to decide what I do with my own body, I
certainly didn't.

[They gave themselves the right to be your eternal "parent" and never to allow
you to mature to true adulthood. You were never consulted and have no say in the
matter. --Paul]

[Actually those citizens who voted in agreement with such government
"protection" or did not object sufficiently when it was initially (or
periodically) raised for discussion are also responsible for it being in place.
They were aiders and abettors of your enslavement! **Kitty]


I personally cannot think of a good reason why I
should not donate blood if my iron stores were sufficiently high. If
the doctors knew of any good reason why I should not donate I would
be glad to know that reason, I welcome advice but don't go making
decisions for me.

[As long as you are using the government services, you have no choice but to
abide by their rules. Since they are the monoply agent for blood donations, you
have no way to actually donate except by those rules. However, could you not go
to a private clinic and have the same amount bled from you? If not then you and
Egill have no choice but to procure some equipment and learn how to bleed each
other. Except that as I have said before, I no longer favor bleeding as a method
of reduction of iron, since there are many valuable blood components lost in
addition to the iron in hemoglobin. It does not make logical sense to me to
waste all those other components, including stem cells and immune memory cells
(just to name a few), for the sole purpose of getting rid of iron. It makes far
more sense to reduce iron intake until iron levels are down to what you want and
then increase intake a little to maintain the levels. --Paul]


Anyways she advised me to contact another doctor to get a blood test
to check levels of various vitamins and minerals in my blood. I
actually think I have taken such a blood test before. The thing is I
had digestive problems some 5 or 6 years ago which resulted in me
going to a doctor who specializes in digestive problems in children.
I remember that he took a blood sample from me and checked for some
nutrients but I don't know what nutrients he checked for or what the
results were. All I know is that nothing suspicious came out of the
test and that I wasn't deficient in whatever he checked for. I am
going to contact this doctor again when he returns from his summer
vacation to take a blood test and hopefully I can get him to dig up
the results of that old blood test I took for comparison, if he
hasn't thrown them away.

[That is a good idea. It is always valuable to have old test results. Most
records are kept for at least 10 years, so they are likely still there, but,
under your highly socialized system, he may not be willing to give them to you.
--Paul]

[I would suggest that you make it clear that you take a strong interest in your
own health history and future. Tell this party that you are creating a record
for yourself for as far back as you can get health history because you also plan
to travel in the future and want to have all your records easily accessible to
you wherever you may be. This may be persuasive where simply demanding the
records may not. (Also obtain the technical label for the disorder that resulted
in your partial colonectomy.) **Kitty]


Just for the record I had not started taking any
supplements when I took that blood test so if I didn't have any
deficiencies then I probably don't have any now given my currently
extensive supplement regimen.

[Except that taking some minerals (as well as dietary phytates, green tea, etc)
can have the effect of reducing your iron. --Paul]


But testing doesn't hurt and could give
me some useful information and I'm definitely not going to miss a
free blood test that's for sure;-)

[Except you should not look upon it as "free" since you (and other Icelanders)
are already paying for it with your taxes. If you were not paying all the taxes,
then you would have the money to pay for it yourself. --Paul]


One thing that might help shed light on the reason for my low ferritin
level is my twin brothers ferritin level. We are fraternal twin
brothers but I have described our high similarities both physically
and mentally before (in MoreLife message no. 604) and we both eat a
similar diet and take the same supplements. Since he as opposed to me
has a completely normal digestive system comparing his
hemoglobin/ferritin levels to mine would be a good way to check if my
low levels are caused by decreased iron uptake or simply our diet and
supplement regimen. He went to the blood bank shortly after I did and
here are his results:

Hemoglobin: 16,6g/dL
S-ferritin: 23ng/mL

As you can see his ferritin level is also very low, although not as
low as mine. Egill my twin brother consequently was allowed to donate
blood and will continue to do so to keep his iron stores low as long
as he has sufficient iron stores to donate. Interestingly his
hemoglobin level is quite higher than mine perhaps mine would be as
high as his if my iron stores were a bit higher. My iron stores might
be just barely sufficient to prevent anemia.

[As I stated above, my reading of the Ames review paper cited strongly suggests
that if your iron stores are lowering your hemoglobin then they are already too
low for optimal benefit of other valuable functions. Egill's values are exactly
where a young man's values should be and I would strongly suggest that neither
you nor him should donate blood at all. He should merely continue on your low
iron diet and you should supplement a little iron to see if it raises your
hemoglobin.
The hemoglobin value will only rise to a certain maximum level (depending on GH
and other hormones, etc). Thus, it will not be proportional to iron if the iron
is too high, but it will be if the iron is too low. If you can raise your
hemoglobin by suppplementing iron then it was definitely too low. In fact, if
you could have relatively frequent tests, I think that the optimal point to aim
for would be to have your ferritin level at a little above the value where
anything lower would cause your hemoglobin to decrease. --Paul]


But Egill also had a
little bit higher body fat than I did when he went to the blood bank
which could cause him to have higher levels of inflammatory cytokines
consequently raising his ferritin level.

[That may be so, but I think the most important indicator by far is his much
higher hemoglobin. --Paul]


Anyways I will probably
report back on the results of that blood test I plan to take which
should give a more direct measure of my iron stores.

BTW I just stumbled on this recent abstract showing an association
between regular blood donations and better insulin sensitivity.
Notice how much lower the insulin secretion was in the donation group.

[Olafur, I think you have misinterpreted this study. The whole purpose of the
study was "investigated the relationship between iron stores and insulin
sensitivity" and the conclusion was "Stored iron seems to impact negatively on
insulin action even in healthy people". Therefore this study does *not* show
that blood donations per se increase insulin sensitivity. Instead what it shows
is that high iron causes reduced insulin sensitivity. Since neither you nor
Egill have high iron stores, you are not going to benefit your insulin
sensitivity by donating blood. As I described above, I used to think that
donating blood was good, but I now think that keeping one's blood iron and
ferritin levels low by some other means is far better. Egill is already
accomplishing that, and yours is likely too low for optimal iron function. If
you can find evidence for the benefit of blood donations (directly for the
donor!) other than for reducing iron, I would certainly like to see it. --Paul]


Clin Chem. 2005 Jul;51(7):1201-5.
Iron stores, blood donation, and insulin sensitivity and secretion.
Fernandez-Real JM, Lopez-Bermejo A, Ricart W.
Section of Diabetes, Endocrinology and Nutrition, University Hospital
of Girona
Dr Josep Trueta, Girona, Spain. uden.jmfernandezreal@...

BACKGROUND: Epidemiologists have observed that blood donation is
associated with decreased risk of type 2 diabetes and cardiovascular
disease. METHODS: We investigated the relationship between iron
stores and insulin sensitivity, after controlling for known
confounding factors, and compared insulin sensitivity between blood
donors and individuals who had never donated blood (nondonors). In
181 men, insulin sensitivity and insulin secretion were evaluated
through frequently sampled intravenous glucose tolerance tests with
minimal model analysis. Men who donated blood between 6 months and 5
years before inclusion (n = 21) were carefully matched with
nondonors (n = 66) for age, body mass index, waist-to-hip ratio, and
cardiovascular risk profile, including blood lipids, blood pressure,
and smoking status. RESULTS: Frequent blood donors (2-10 donations)
had increased insulin sensitivity [3.42 (1.03) vs 2.45 (1.2) x 10(-4)
x min(-1) x mIU/L; P = 0.04], decreased insulin secretion [186 (82)
vs 401.7 (254) mIU/L x min; P <0.0001], and significantly lower iron
stores [serum ferritin, 101.5 (74) vs 162 (100) microg/L; P = 0.017]
than nondonors, but the 2 groups had similar blood hematocrits and
blood hemoglobin concentrations.
CONCLUSIONS: Blood donation is simultaneously associated with
increased insulin sensitivity and decreased iron stores. Stored iron
seems to impact negatively on insulin action even in healthy people,
and not just in classic pathologic conditions associated with iron
overload (hemochromatosis and hemosiderosis). According to these
observations, it is imperative that a definition of excessive iron
stores in healthy people be formulated.

PMID: 15976100