Season 5, Episode 6: Iron Overload and Hemochromatosis with Dr. Christy Sutton – Part 2

Evelyne: Interesting. So I think that a normal range of iron saturation is 15 to 45% right around there?

Dr. Christy Sutton: I don’t like 15.

Evelyne: Oh, okay.

Dr. Christy Sutton: I think fifteen’s a little bit low, but yes, fifteen’s okay. I like things to be a little bit more in the middle, like maybe 25 to 30.

Evelyne: Okay.

Dr. Christy Sutton: But forty-five’s definitely too high. Yes.

Evelyne: Interesting.

Dr. Christy Sutton: Even though labs allow you to go higher.

Evelyne: Yeah, well, I was looking at some of my old results, I mean, I really, when I tell you I went down a rabbit hole with these. I have all these printouts here of lab results going years back, and my iron saturation levels have been at 97%, 78%, 54%, super, super high, high.

But interestingly, I’ve had low ferritin at the same time. And before I ask you another question about that, I just want to share something that just happened this week. So because I was preparing for the show and I last donated blood because I now officially can. In February, I have been meaning to or needing to get everything checked again. So I had it checked in April, I believe, and things had normalized. Well, my ferritin in April was 15, which is a little too low. But I wanted to see with my doctor, how long do I need to go between blood donations, because that’s something that I’ve never figured out in all the years that I’ve known that I’ve had this.

Interestingly, so this week I had new blood work done and I wanted to be able to share it with you. And for some reason, this iron deficiency anemia cascade panel was ordered, so it had all the CBCs and all the anemia panels and ferritin and everything actually looks great, anemia wise better than it has. My ferritin is at 43 now. But what’s so interesting is because I don’t have anemia, they didn’t run the iron and the TIBC and the UIBC and the saturation, which was the whole point of this. So anyway, I’m trying to get those markers next week, but it’s just so interesting to me. And I can see exactly what you said about, oh, we’re running all these markers, but then we’re not running those. So if I was just doing this and I didn’t know, I wouldn’t know that it potentially is an issue.

I wanted to jump in and add something here. So shortly after this recording, I was able to get those additional lab markers from core. And great news, my total iron binding capacity, my unsaturated iron binding capacity, my iron and my iron saturation all look excellent along with that entire anemia panel, after my blood donation in February. So I will continue to test these markers per Christy’s recommendation every few months to see how they change.

And even back in 2011, so I had just taken my first blood chemistry course, so of course I wanted to look at my own lab work. And I learned based on my markers then that I had B12 deficiency anemia, but I got my lab work run through Kaiser, all of my anemia markers, of course, no iron on there. So the nurse who called me back to tell me that I was anemic said I would just take some iron. And I got so mad because then I had to tell her I am a carrier for hemochromatosis, so no, I should not take iron. And I wonder how often that happens in conventional medicine where based on hemoglobin and hematocrit, a patient is told to take an iron supplement when maybe they need B12 or there’s something else going on, like an infection or something else. So that just blew my mind.

Dr. Christy Sutton: Yeah, it’s good. I mean there’s so many different things to dissect with what you just said. I think it’s great for people to hear these stories because I feel like this is one of those topics where if you don’t really start diving into it and looking at it, you don’t understand how common of a problem it is and how we’re really allowing people to have health problems that they have no business having and we’re giving bad advice. They shouldn’t have these problems. We’re giving bad advice, because we just didn’t collect the extra $30 iron panel. So I personally believe that the CBC and the iron panel should just be one lab. Every time you order a CBC, there should be an iron panel as a part of it. Because to me, we’re all looking at the blood here, okay, what’s in the blood? What is making up the red blood cells? Hemoglobin, iron. Shouldn’t we know what that is if we’re looking at hemoglobin?

And then as far as the B12 issues, there’s so many different types of anemias, and I try to talk about all of them in the book because if you’re looking at labs and you’re looking at iron levels and you’re looking at a CBC, you’re going to see a combination of different things because not everybody fits in one box and you can have a hemochromatosis gene and become anemic and need to take iron, or you can have no hemochromatosis gene and become too high in iron and need to donate blood to get iron levels lower, because as much of a genetic predisposition as we’re talking about with these genes. This is really an environmental issue, so we have to be looking at the whole labs and the whole environmental situation. But the B12, what I’m wondering is this like a pernicious anemia? Why is she low in B12? Because there’s so many different things. And if you have low B12, that’ll often show up as a high MCV.

So the red blood cells will get too large. When you have a high MCV, it means your red blood cells are too large and you need B12 to get the red blood cells smaller. And so if you have that high MCV, it can mean you’re low in B12 or B9 and B6. It can also mean that you’re just drinking too much alcohol. That’s also a common cause of high MCV. But one thing I think is interesting is that a lot of people that have hereditary hemochromatosis have pernicious anemia. Pernicious anemia is an autoimmune disease where your immune system attacks basically the intrinsic factor, the pyloric cells in your stomach that make intrinsic factor and hydrochloric acid, pernicious anemia, it attacks those cells and then you do not absorb B12 because there’s no intrinsic factor to bind to the B12 and get absorbed in the last foot of your small intestine.

So it’s very common for people that have hemochromatosis to also have pernicious anemia. And I have a couple thoughts about that. One of those thoughts is that hemochromatosis can cause autoimmune diseases because of all the inflammation in the body and it causes leaky gut. And once you get inflammation and leaky gut, you’re just more likely to get autoimmune issues. The other thing is that a lot of people that have a hemochromatosis gene are Caucasian and they also have a celiac gene, which is very common, especially for people that have an Irish heritage. Very common. Celiac gene is very common in Ireland in the Caucasian world as well. Northern European, not that we should just pigeonhole it to Caucasians because Caucasians colonize the whole world. So they took their celiac gene and their hemochromatosis with them. And so a lot of people I think that have hemochromatosis and get pernicious anemia, I think they often have a celiac gene too, and it’s just another autoimmune thing, and that’s just a part of it.

And so the way that I like to look at B12 is I like to look at, I know a lot of people like to do methylmalonic acid. I think it’s an overpriced overrated test. I just get the cheaper B12 test, and then I just ignore the range that they give me. If anybody is ever in the two hundreds of B12, that’s horrible, even if it’s within the range, because the range for B12 is often like 250 to 1,000 or whatever, 950. I don’t ever like B12 to be really below 1,000. And if somebody’s taking all this B12 and their B12 is in the 500s, they have an absorption issue. Either they have an autoimmune issue going on or something’s happening, they’re not absorbing that B12, and then they need to figure out what’s going on and maybe take some sublingual B12 or get a B12 shot, so.

Evelyne: Yeah, thank you for all those clinical pearls. And I know I also tested intrinsic factor at the time and didn’t have any issues, but thankfully now I don’t have the B12 deficiency anemia or any of that. And at the time, it’s interesting that you mentioned the alcohol because maybe that was the reason. It was in my 20s, I’m not sure. You made me think of one other thing with the anemia, how people with iron overload can get anemic. And this is the last story I’ll share, but a few years ago in 2019, I decided with my doctor that we would do a series of therapeutic phlebotomies and we went a little too hard and too fast. And so I remember after the first one, I felt awesome and it was quite a bit of blood. I mean, it was like one of those big mason jars of blood, and I just remember thinking, “Oh my gosh, I feel so good.”

And then we did a few weeks in a row, but it was just too much. And unfortunately, we didn’t test with each one. So I think we did five or six treatments and it was just way too much. I knew I felt it after that last one, I got up and I thought, “Oh no, I’m anemic.” I just knew it. And interestingly, it took a long time for things to normalize again after that because then I had the anemia panels and then my iron saturation dropped to eight, my ferritin dropped to nine. And then even four months after that still was like iron, 24 of ferritin, 6. So it has since obviously swung back up. But I think it also points to how I haven’t always been on top of managing it. And I know that we get busy and at times based on different insurances, I have switched between doctors. And so everything’s always monitored differently.

But after reading your book, thank you, and talking to my doctor and making sure that I did get this additional blood work run this week, and just also getting older, I just feel very inspired and I’m grateful to you that we can talk about this because I don’t want this to be an issue for me as I get older. So I always want to stay on top of it. And I do want to get to what do we do about it other than phlebotomies or blood donations? But I want to go back to the ferritin for a moment because I mean at the time that those last two ferritin measurements that I shared with you, those were really low. The iron was also low. But many times I have had ferritin on the lower end, but iron and iron saturation super high. I guess I’m having trouble understanding if there’s so much iron in my blood and if the problem is that my body’s over-absorbing it, why isn’t my ferritin than higher?

Dr. Christy Sutton: I’d have to have a better understanding to what was going on around the time of the lower ferritin. Was that coming off the end of having a bunch of blood removed?

Evelyne: Not necessarily.

Dr. Christy Sutton: Had you donated?

Evelyne: No, because I really, I’ve only since 2022 when I could donate blood. I’ve actually only donated one single time, and prior to that it was just the therapeutic phlebotomies in 2019. So between those in 2019 to just at the beginning of this year, I didn’t do anything about it. And ferritin was still low and iron was elevated, which is why in February I did go to donate blood.

Dr. Christy Sutton: Yeah. So when you have a low ferritin and a high iron saturation, that’s not really the best scenario for donating blood.

Evelyne: Interesting.

Dr. Christy Sutton: Because that’s where you’re more likely to get too low. There’s different reasons and theories for why people can have a low ferritin and a high iron saturation. I can tell you what I see. I see it happens more in people with a hemochromatosis gene. The high iron saturation happens more in people with… I just think what’s going on here with a lot of people is that for whatever reason, heavy period, too much blood removed, whatever, there might be some environmental factor where they are losing blood and then their body is either absorbing more iron, which is part of the high iron saturation, because people with the hemochromatosis gene are really good at absorbing iron, and so they can absorb a lot of iron quickly. That’s part of their genetic superpower. So they’re absorbing more iron or they’re mobilizing more iron out of the tissues because so many people… I mean we store iron in tissues for a rainy day, and so hemochromatosis people, they have a lot of iron to mobilize out of the tissues.

That’s what I think is happening a lot there. It’s hard for me to dissect exactly without looking at the whole lab pattern and everything that was going on to know what’s going on. So I can’t exactly say what’s going on there. Now sometimes, I don’t think this is probably what was going on with you, but sometimes you’ll see a high iron saturation with a low ferritin if there’s a hemolytic anemia, which can be because of an autoimmune issue, or if somebody has a thalassemia gene or a sickle cell gene or something where they’re just getting a lot of red blood cells are rupturing. I don’t know that that is what was going on with you. Probably not. But certainly one thing that I really thought was interesting about giving your story is that you’re trying to find out how often you should have blood removed.

And this is something so many people are trying to figure out. And the only solution to that is you have to look at the labs to tell you to guide you. There’s no like, oh, you have this genetic combination, have blood removed once a year of this much or that doesn’t work because everybody’s different as far as their environmental situation and their numbers. You just have to look at the labs. And if you have labs that show that you should have blood removed, then have blood removed to lower iron, but also do the other things that will help lower iron like the diet and the supplements and the lifestyle and that type of stuff. So for you having a lower ferritin with a high iron saturation, that’s where I would say, okay, let’s look at what supplements you’re taking. Are you taking vitamin C? Because that can increase your iron absorption? Are you taking NAC? Because that can increase iron absorption. Let’s get rid of things that are hyper-increasing absorption. And then let’s look at what are you eating? Are you eating a lot of red meat? Maybe that’s not the best thing for you. Okay. And then I look at, okay, supplements, what are some supplements that you can take that would make sense for you based on your personal history that can support lower levels of iron?

And everybody’s different as far as that, but I try to outline the best options in the book.

And the other thing I thought was really interesting before I forget, I want to say it, is that you had this experience where you had too much blood removed. And that happens a lot too. So a lot of people that are going through treatment for hemochromatosis, they become anemic, they have too much iron in their body often, or sometimes they even just get low in iron because they have so much blood removed, but they get anemic, they will get low red blood cells, low hemoglobin, their body is drained and it can be devastating. And so that’s another reason I wanted to include the part about low iron and the iron curse because people that have hemochromatosis, yes, they’re more likely to have high iron, but the treatments that they go through can make them low, and then they need to know what that looks like and feels like and what to do about it also.

Evelyne: Yeah, let’s dive into all of that stuff because we talked so much about labs and diagnosis, which is all super fascinating. So the first question that actually comes to my mind when we’re talking about iron. So somebody with iron overload or at risk of it, we all know we need to eat sufficient protein. And a lot of the recommendations that I see nowadays do include red meat, and I don’t think red meat is bad per se. I like red meat now. I don’t eat it very often, but with so many people walking around undiagnosed, I’m so curious. And people drinking alcohol, eating red meat on a regular basis and people don’t maybe find out they have an issue until there’s liver cirrhosis or hopefully before that they would see elevated liver enzymes. But what are your thoughts on getting sufficient protein but also being cautious about red meat intake?

Dr. Christy Sutton: You can easily get sufficient protein without eating red meat. You can eat fish, you can eat eggs, you can eat chicken, you can eat turkey, you can eat pork, which is going to have some, all of these things are going to have some iron in them. Red meat, shellfish tend to be the highest iron and a really absorbable form of iron. So there’s two forms of iron. There’s heme iron and non-heme iron. And the heme iron is only found in animal products. And the foods that have the most heme iron in them are things like red meat, so beef, bison. So if one decides to be on a really high protein diet, that diet is like a carnivore diet where they’re just eating meat, then I personally think that’s a pretty extreme diet. And you are absolutely need to get your iron levels checked. And you should know if you have a hemochromatosis gene going into that diet because you are at a very high risk for going too high. Even if you don’t have a hemochromatosis gene and you go on a carnivore diet where you’re eating just tons of red meat, you are more likely to go high in iron just because of your diet.

Also, you get no vitamin C in a carnivore diet naturally. So it’s not like a diet that’s really designed for health and longevity. And on the other side of that coin is the vegan diet, which also there’s no B12 naturally found, and lots of things are missing from a vegan diet. So these are extreme diets. If you choose an extreme diet, you’re more likely to have health problems, period. Now the carnivore diet, you’re setting yourself up for more issues with high iron. And anybody that says to do a carnivore diet and doesn’t say before and during this process, you need to have your iron labs and your CBC and your hemochromatosis genes figured out and dialed in because there is a side effect to everything that’s extreme. And one of the side effects to a carnivore diet is high iron. And high iron can cause a lot of health problems as we’ve talked about.

So I don’t feel like this idea that they’re mutually exclusive. I don’t feel like we live in a world where you can’t eat a lot of protein and not… You can still get plenty of protein without eating red meat. Okay? That’s what I’m trying to say.

I also think if you have hemochromatosis, if you have a hemochromatosis gene, you can still eat red meat. You just have to do it more in moderation potentially. And, or you need to include some of those supplements to take at the same time as eating the high iron rich foods like red meat or shellfish, and then that will decrease the iron absorption so that you’ll be basically saving yourself from all that extra iron absorption. Now having said that, people that have really bad hemochromatosis and they just get diagnosed and they’re trying to get their iron levels lower because sometimes people can have a ferritin like three, four or 5,000 really high.

Evelyne: What? Oh, my gosh.

Dr. Christy Sutton: Some of these people that have… The people that have 2C282Y genes, they get into the thousands often before they get diagnosed. This is a very serious situation that they’re in. They don’t need to be eating red meat, they just need to avoid red meat and basically get that iron down as fast as possible. Now, most people are not in that situation. Most people, they’re much milder whenever they get diagnosed with hemochromatosis. Actually that’s not true. Most people I see are much milder. But most people I see, they’re much milder. They’re like in the twos, threes, four, 500, 600 range, and then they can usually eat red meat, but thoughtfully while taking the supplements that can lower iron, doing things like maybe drinking green tea while they’re eating that food so that there’s less iron absorption.

Evelyne: Yes. Let’s talk more about that. So what are the supplements that will help reduce iron, like you just mentioned green tea, I know coffee is one as well. And also alongside that, do you recommend that your patients also take extra antioxidants? Can you review both of those?

Dr. Christy Sutton: So in The Iron Curse, I go through the supplements that have really strong research behind them to show that they can lower iron and how they lower iron. And the nice thing about what I include in here as far as the supplements is that they are largely antioxidants too. So for example, I love curcumin for people with hemochromatosis because people with hemochromatosis often have a lot of joint pain and pain and inflammation, and curcumin is both something that can bind to iron and lower the iron, but it can also decrease inflammation. And so you can’t go wrong with that. You’re both helping them with pain and inflammation while getting their iron levels lower. And they can do that every day of their course rather than blood removal, which you can only do so often. So they’re doing something every single day that’s going to help get their iron levels lower.

Curcumin is great. It is an antioxidant. It’s been shown to help get iron out of the brain, get excess iron out of the spleen, get excess iron out of the liver, and really help heal up these parts of your body, the organs that get damaged by iron because it binds to the iron, but it also has all these other wonderful properties. So that’s a great option.

So silamerin is the extract from milk thistle and silamerin can also bind to iron and remove it, remove it’s been shown to. And it’s an antioxidant that is well known for its properties for being good for the liver. It’s been shown to increase sperm count, sperm motility. It’s a wonderful option for people that are trying to lower iron and have hemochromatosis because it’s going to protect their liver, give them antioxidants, also help lower iron quercetin.

Quercetin. Quercetin is an antioxidant that has a lot of properties that help lower iron. It doesn’t bind iron, quercetin increases hepcidin. So people that have a hemochromatosis gene, the reason that they get high in iron and that they absorb more iron is because their body, their liver, their body makes less hepcidin. And hepcidin is basically like the brakes on iron absorption. So anybody that has a hemochromatosis gene is going to make less hepcidin. And if you have a hemochromatosis gene and you want to absorb less iron, then you can take quercetin or berberine or even melatonin to help increase your hepcidin levels. And by increasing your hepcidin levels, you will decrease your iron absorption. And the nice thing about quercetin and berberine and melatonin, not only do they decrease iron absorption, but they’re also wonderful antioxidants and have lots of other wonderful properties that the list can go on.

And then alpha-lipoic acid, EGCG, bergamot, these are things that can bind to iron and lower it. And then I think it’s really important that anybody, period, but especially people with hemochromatosis, do take a lot of antioxidants because when you have high iron, you deplete your antioxidants like your vitamin C and your glutathione and your CoQ10. And that’s a dangerous situation because when you have high iron, then that iron will damage the cells and you get more DNA damage. And what happens is you get this cell death called ferroptosis, and ferroptosis is basically when you don’t have enough glutathione and you have too much iron, the cells will basically commit suicide because they have now been corrupted and they’re going to be damaging to your body. So the body basically says, “Well, this cell’s not going to go on. We’re going to have an apoptotic event and kill this cell because there’s too much iron and not enough glutathione.”

What happens is the iron goes around and damages the cell membrane. And so if you have a cell membrane that’s filled with lots of seed oils and you have an unhealthy cell membrane and then you add a bunch of iron in there and then the iron depletes all the glutathione and destroys your liver so that you’re not making glutathione in the first place. And it depletes all of your cellular mitochondria, all of your cellular glutathione, and then you have high iron, unhealthy cell membranes and low glutathione, that is a recipe for ferroptosis. So I think anybody that has haemochromatosis should seriously consider looking at taking something like glutathione because that’s going to help decrease ferroptosis while working to lower the iron. There’s other things that can help decrease ferroptosis, and it’s a long list that CoQ10, alpha-lipoic acid, any antioxidant, vitamin E, all of these things I include in the protocols as antioxidants because people with haemochromatosis, people without haemochromatosis, everybody needs antioxidants because oxidative stress is everywhere. Free radicals are everywhere. But people that have haemochromatosis dramatically deplete those antioxidants and it creates a lot of damage.

So there’s other options, like even just taking a probiotic. Taking a probiotic can actually decrease iron absorption because those bacteria need iron to survive. And if you take a probiotic, then they’re eating up that iron and leaving less of it for you. So this is one reason that people that take an antibiotic, their iron levels will often go high because they’re absorbing more iron on that antibiotic because there’s less bacteria in their gut to compete for the iron. So there’s lots of different ways around it.

I should mention that when I say take glutathione, I’m saying take glutathione, not NAC. So glutathione like liposomal glutathione, acetyl glutathione, those are wonderful. NAC is a great option for people that don’t have haemochromatosis, but there is some research where the NAC can actually cause damage, because it can increase iron absorption. So don’t take NAC, I love NAC personally. It’s great. Just don’t take it, especially in high doses if you have haemochromatosis and you’re high and then be careful about vitamin C.

And then the other supplements I include is resveratrol. Resveratrol doesn’t affect your iron levels, but it does have very protective effects for the heart, and it’s been shown to dramatically decrease the risk for heart issues in people that have haemochromatosis. So that’s something. So it’s helpful to really understand these nutrients, and I try to really break it down in the book and give the goods and the bads of everything because basically a lot of people are struggling with low iron and they’re taking a lot of supplements that are causing them to maybe become lower in iron, and they don’t understand that they need to either stop taking that for a little while and get their iron levels back up or separate it from the iron. So if you’re taking iron to get your iron levels up, don’t take calcium at the same time because that’s going to bind to iron, don’t take curcumin at the same time because that’s going to bind to iron. Anything that binds to iron, don’t take that at the same time as taking iron, if you’re trying to get your levels up, if you’re trying to get your levels down, take the iron binders with the iron. With the iron and the food, not the supplements.

Evelyne: Yeah, Christy so many amazing nuggets in there. Thank you for such a thorough overview of all the nutrients. I’m glad I’m taking some of those. I also did not know that prior to reading your book about the NAC. So it’s very interesting. And I think this also is a great reminder as a practitioner to really know everything that your patient or client is taking, including outside of your recommendations because you might be trying to treat an iron deficiency anemia, but maybe they decided to start taking curcumin because I don’t know, something happened and they decided to buy it from the store. So very great tidbits. So thank you.

Dr. Christy Sutton: One of the things I think is really important is that I don’t want people to be afraid of taking iron if they need iron.

Evelyne: Absolutely.

Dr. Christy Sutton: If you need iron, then you need to take iron to get your levels up and you need to figure out why you’re low. And fix the underlying cause. And in the book, The Iron Curse, I talk about how important iron is for pregnancy because women that have low iron while they’re pregnant, their children are more likely to have a lower IQ, significantly lower IQ, they’re more likely to have ADHD. So you know, these are serious issues. And in my opinion, I think often women become much too low in iron before there’s a real doctor conversation, doctor, patient, conversation. I personally really like women to go into pregnancy with a nice robust ferritin. If a woman’s trying to get pregnant, I would love to see their ferritin 75 to 100 or so, and I would not at all try to get it lower because I know that if they’re going to get pregnant, if they do get pregnant, then that’s going to drop their iron levels for them. And if you have a low iron level going into and during pregnancy, then that is bad, not just for the mother, but it’s also bad for the baby and it can have lifelong issues.

Now, there’s also a lot of issues with kids not being properly diagnosed, and this is where I think pediatricians, I am inviting and asking pediatricians to look closer at iron levels. And not only will they diagnose the occasional hemochromatosis patients like my colleague’s daughter that I write about in my book, but they will also diagnose a lot of low iron children, which is more common in children. And unfortunately there’s a lot of kids that have ADHD because they’re low in iron and they could potentially not need that drug for ADHD if their underlying low iron was just fixed because we need iron to make dopamine. And if you don’t have iron, you don’t make dopamine, and if you don’t have dopamine, you can’t focus.

So it’s not fair to kids to put them in a situation where they’re deficient in what they need and then they’re getting all these neurotoxins from food coloring and all this stuff, and then just put them on a medication, they’re not getting enough exercise and then just put them on a medication to make them be able to hyper-focus on something that is maybe just boring. Maybe they’re just not excited about looking at it, paying attention. Maybe that teacher’s boring. So I digress. But yes, so much so to look at. And look, we got through this. I didn’t even talk about copper.

Evelyne: So I want to talk just a little bit more about other things that can increase iron absorption. So for the people who have hemochromatosis to avoid, I briefly mentioned alcohol, and I am so glad that I stopped drinking because this is one of the reasons why it was important to me for my brain health, for my liver health, but because my body already it is better at absorbing iron, I don’t want to encourage that more. So I did want to just mention the alcohol, but then one thing that I also see is to avoid cooking in cast iron, and I would love to be able to cook in cast iron. And I’m curious.

Dr. Christy Sutton: Oh, you can?

Evelyne: I can? Okay, tell me more about that.

Dr. Christy Sutton: I love cast iron. I will never let anybody take my cast iron out of my hand. And I do all the cooking. And so when I cook, I largely cook in cast iron. And my husband actually has two hemochromatosis genes. That’s a story. His hematologist thought he had one, but then they only checked for two of them, and then he actually had the third one. When I finally went back and dated my genetic detoxification report, I realized he had the third hemochromatosis gene, and I was like, “Oh, you do have two hemochromatosis genes.” But the hematologist, when he got diagnosed years ago, only looked at the first two because they’ve added the third one since then. So anyways, my husband has two hemochromatosis genes. My daughter has one hemochromatosis gene, she got one, the H63D from my husband, and I cook everything in cast iron.

And I do that for a couple of reasons. One is because at this point in time, everybody in my house, I don’t have anybody with high iron in my house. Okay, we’re watching it. My daughter’s getting watched, my husband’s getting watched. Everything’s good. But two, and I think very important fact is that cast iron pans don’t leach a large amount of absorbable iron. The iron that they do leach it’s non-heme iron. And non-heme iron is not a very absorbable iron. If you add a bunch of vitamin C to non-heme iron, it will become more absorbable. And the foods that tend to leach out the most in a cast iron pan are like acidic foods. So if you look at the studies that look at how much iron is actually in food, extra iron comes leached out of the iron pan in food that’s cooked in a cast iron pan, they often reference making spaghetti.

They’ll make spaghetti. And what is spaghetti? Spaghetti is filled with acidic vitamin C rich foods. It’s tomatoes with lots of acidity and vitamin C. and so that’s going to leach more iron out of it. Plus, the spaghetti sauce is just sitting there in the pot for a long period of time. So a lot of people when they cook with cast iron, it’s just a couple of minutes on each side or whatever. I haven’t found it to be a great problem. I think you’re fine. And if it does concern you, I think just adding a little bit of those supplements when you’re eating the foods that have been cooked in the cast iron should be just fine. I mean, the goal here is that everybody’s iron levels are in a good range to the point where they don’t have to micromanage every single part of their life. The real problem is the people that go a decade or two or three and don’t get diagnosed and then they start freaking out about everything, the cast iron pan, everything that could potentially be a problem. And if you don’t let it get to that point, you don’t have to freak out about everything. You just have to be mindful.

Evelyne: Absolutely. Well, that is great news. I’m about to go by myself a cast iron pan maybe for Christmas. Christy, I feel like we could talk for two more hours because I really did have so many more questions. But I really would love to ask you about the high iron and low copper connection. Can you talk more about that?

Dr. Christy Sutton: This is an important topic because when you are low in copper, that can cause a couple of things. That can cause you to not be able to absorb iron as well. And so you get more of an…. Actually low copper, copper deficient anemia, which is its own separate type of anemia. Copper deficient anemia will cause iron deficient anemia. If you don’t have enough copper, then you cannot absorb and transport iron throughout the body because there’s really two main enzymes that absolutely need copper for iron’s absorption and transportation. There’s hephaestin in the gut, which needs copper to be able to transport iron across the intestinal lining. And then ceruloplasmin, which allows you to take the iron from the intestinal lining and put it onto the transferrin in the blood so that the transferrin can take the iron wherever it needs to go.

Okay. Why is that important? That’s important because if you don’t have enough copper, you cannot absorb the iron with the hephaestin enzyme, but you also cannot transport the iron. And so it’s confusing because what you can get is you can actually get low iron, but then you can get iron building up in the tissues in the brain and the retina and throughout the liver. And the reason that that happens when you don’t have enough copper is you don’t have… The ceruloplasmin cannot transport the iron onto the transferrin and then the iron cannot leave the airport. The iron is stuck at the airport because the planes are not loading up with iron. So you can get iron overload in your tissues, which is much different then what we’re talking about with hemochromatosis. Where if you have iron overload in your tissues due to having low copper, then it’s going to create a lot of the same problems, but in more specific areas, like mostly in the retina and the brain and somewhat in the liver. But eventually if you’re low in copper, you’ll just stop absorbing iron and you’ll just look like low iron on paper.

Evelyne: Interesting.

Dr. Christy Sutton: And then you’ll start taking all of this iron to try to get your iron levels up, and you can’t get your iron levels up because you don’t have enough copper to help you absorb the iron. So it is to have plenty of copper. I get a lot of people that say haemochromatosis is just low copper, and I don’t agree with that. I think that’s missing the point and a bit simplistic, but at some point in time it is very important that you’re not low in copper for sure. Nobody needs to be low in copper. If you’re low in copper and you have high iron, then you’re going to end up with a lot of iron getting stuck in the tissues.

Evelyne: Very interesting. Thank you for sharing that.

Dr. Christy Sutton: Oh, I was just thinking, that’s a lot of verbal mumbo jumbo. I have some good pictures in the book and then I teach a workshop about all of this where I have visuals to help explain it. I think that helps. I’m a visual person though, so that’s why I like the workshop because you can actually look at the pictures as I talk about it.

Evelyne: Yeah, I agree with you. Iron metabolism, copper metabolism, all of it is very complicated. But I appreciate you using the airport analogies because we can still picture it. And I think this once again just shows how many different things we have to consider when it comes to iron metabolism or iron anemia, iron deficiency, anemia and all of those things. And how also with so many of these issues, chronic diseases take such a long time to develop. And so the earlier that we can look at all of this, the better. So Christy, I just have some final questions for you. The first one is, what are your top favorite supplements for yourself?

Dr. Christy Sutton: I really like curcumin, but I can’t take it as often as I’d like because it makes me low in iron. But I have Crohn’s and celiac, so the things that I take the most often and are like my, I can’t live without. I take digestive enzymes that have the DPP-4, the digestive that helps you digest gluten in casein. I don’t eat gluten, but they also have all the other enzymes in there. I take digestive enzymes pretty regularly. And I take hydrochloric acid, because I tend to be low in hydrochloric acid. And I’m pretty regular about taking probiotics and I change it up. I like to get different things in, and I tend to take things that have a lot of glutamine in them because leaky gut, and I just find that it’s crucial for me. And then I am pretty good about, I know this is, I’m going to go over five here, but I’m pretty good about taking vitamin D3, K2 most days, and glutathione.

I also like those a lot as well. But yeah, I mean there’s just so many different options. And I think where a lot of us get hung up, I see this a lot with patients is they’ll hear about something and they’ll be like, “Oh, I want to take that.” And then they come in with two bags full of supplements and you’re like, “We just need to start over here.” This is just like you have a lot of things in here, and they might be doing you some good, some of them might be doing some harm, but you are like, you have so many things here and you’re not even hitting your highest priorities. You know what I’m saying? You have 50 supplements here and none of them are addressing your problem today.

Evelyne: And I did want to make one note on curcumin because I’m such a fan of curcumin for so many reasons. It’s just an amazing anti-inflammatory, and I don’t want to scare anyone away from using it because I think it’s such an amazing supplement. But I think it’s just good to be aware if you are treating someone for iron deficiency anemia, just to have it in the back of your head, or if they’re taking lots of different things that may potentially deplete iron a little bit to just be aware of it. But I love curcumin. The second question is-

Dr. Christy Sutton: Yeah, it’s amazing.

Evelyne: Yeah. What are your top health practices to keep you balanced as a busy practitioner and mom?

Dr. Christy Sutton: Sleep. Lots.

Evelyne: Yes.

Dr. Christy Sutton: Definitely get good quality sleep. And I recently had to start taking progesterone to sleep better, so I guess I’m in perimenopause, but I also like to take melatonin and sometimes L-theanine and magnesium to help me sleep. I know that wasn’t your question, but sleep is crucial.

Definitely exercise. When I just need a mental break, I’m just going to go for a walk or get some exercise in. And if I’m sleeping and I’m exercising, and it’s really just the little boring things that you make yourself do every day. Like, “Okay, I’m going to make that homemade salad dressing instead of buy the store-bought one that I like because I don’t want the seed oils.” It’s those little things that you’re like, “Oh, that’s annoying. I have to do it, but I’m just going to do it.” And I feel like so much of health is just the small battles that we make from minute to minute and hour to hour like, “Okay, I’m just going to do this. I’m going to exercise today. I’m going to go to the grocery store. I’m going to buy the stuff that I need to eat, not what I want to eat, and I’m going to make the healthy food and I’m going to make my family eat it.” And that’s it.

Evelyne: Yes. Christy, last question for you. What is something that you’ve changed your mind about through your years of practice? And I feel like it was in here throughout the podcast, but I don’t know if you have anything additional you want to share.

Dr. Christy Sutton: Yeah. My first few years of practice, I wasn’t looking at genes at all because they were not readily available like they are now. So then when I was introduced to 23andMe, I realized, oh wow, this is really… There’s something to this. And I really started looking at it closely, and I was looking at patients with their genes and making the connections through what I was seeing plus what I was researching and confirming it with what I was seeing. And I could not imagine providing a high level of healthcare without that tool. Not all of my patients come in and get genes and labs, but the ones that do, there’s just so many amazing things that you can do with those tools. Adding the layer of genetic testing and lab testing. Because I don’t like to look at genes alone. I don’t like to look at labs alone without genes.

I like to look at them together layered. And adding that to what’s the family history? `And now, I’m just putting all these connections together like, “Oh, this is why this is happening in your family. Please tell your family member.” And sometimes that’s frustrating because then their family member’s like, “I’m not interested in that. “And I’m like, okay, it’s okay. It’s their battle to fight. But it would be so much easier if they would just learn from this piece of information. So using the genetic testing. Really understanding that with the labs, I think is crucial for providing a high level of quality preventative personalized care.

Evelyne: Absolutely. And where can practitioners learn more about you?

Dr. Christy Sutton: Well, I’m on social media @drchristysutton for Instagram, and I’m on Facebook and TikTok. And then I have my website Drchristysutton.com, where I have all my workshops, and there’s more about my Iron Curse book at ironcurse.com.

Evelyne: Wonderful. And we will definitely include those in the show notes. So thank you so much, Christy, this was amazing, so informative, and I really appreciate you putting all of this information in your book too, which is so comprehensive. So thank you.

Dr. Christy Sutton: Thank you.

Evelyne: Yeah. And thank you for tuning into Conversations for Health today. I have felt this responsibility to share about hemochromatosis, just having known about it for so long and not hearing people talk about it often. So I appreciate you listening, and I’d love to hear what you thought of today’s show. So please feel free to reach out on LinkedIn and Instagram.

And I wanted to share one additional resource. So on this podcast, we’ve talked about the Designs for Health Metabolomics and GI Spotlight functional tests, but not the genomic Spotlight. And the HFE gene, which is the most common for hemochromatosis, is included on there. So that SNP is included in both the inflammation and cognition sections. And you can reach out to your local functional medicine consultant, that’s your Designs for Health rep. We also have trainings on those tests at spotlight.designsforhealth.com, and I just wanted to make sure I mentioned that because we do have so many amazing resources for practitioners like you to learn more about topics that are hopefully relevant to your practice and your patients. So please share this podcast with your colleagues, follow, rate, or leave review, wherever you listen or watch. And thank you for designing a well world with us.

Voiceover: This is Conversations for Health with Evelyne Lambrecht, dedicated to engaging discussions with industry experts exploring evidence-based, cutting edge research and practical tips.