Dr. Keith Roach
DEAR DR. ROACH: Recently, I was rejected from donating plasma (not blood), since my iron that day was 57 mcmol/L and the maximum allowable was 54 mcmol/L. I am rescheduled to get retested in a few days. The technician said to eat beans and similar foods to lower my iron levels.
I checked my own records and found no results that fell below the cutoff. My red blood cell count was 5.15; my white blood cell count was 6.0; my hemoglobin level was 16.1 g/dL; and my hematocrit level was 48.5%, all within the healthy range.
Which test results could they be referring to, and how do I lower my iron? — S.L.
ANSWER: When donating, blood banks typically screen for anemia, which is frequently caused by iron deficiency. I’m confused as to why they are screening you with iron tests because that is typically not done. Moreover, they are telling you that your iron is too high, which is the opposite of the iron-deficiency anemia that is usually looked for.
I recommend that you see your own physician and get retested. If we take the blood bank at their word and your iron level is too high, that raises the possibility of hereditary hemochromatosis (HH), which is caused by a defect of iron absorption. Your body then absorbs as much iron as possible, even if it doesn’t need any. This causes iron overload, which damages the heart, liver, bone marrow, adrenal glands, skin and joints, just to name a few.
HH is easy to treat once the diagnosis is made. But making the diagnosis requires thinking about the possibility, and it’s uncommon enough that a lot of healthcare professionals don’t think about it right away. Your doctor should test your iron and iron-binding capacity, as well as your ferritin level, which tends to correlate with the total amount of body iron stores.
However, I don’t want to jump to conclusions, which is why I think your own doctor should test you to see if you really do have excess iron.
DEAR DR. ROACH: Like a lot of older men (I’m 74), I get up often at night to dribble a little urine. I have found that if I go downstairs, walk to the kitchen, then climb back upstairs, I can often urinate again as much as I did the first time. Can you explain?
Also, I’ve noticed that on nights that I have popcorn with salt, I get up less often. Could a person take a salt tablet before bedtime to reproduce this effect? — S.C.
ANSWER: Both men and women can have voiding problems due to bladder issues, but men can also have symptoms due to an enlarged prostate. I can’t tell which of these you might have because, for both, there are underlying reasons as to why you might be able to urinate again a few minutes after going the first time. But it’s more common in men with prostate trouble.
Exercise isn’t usually needed; just giving yourself a few minutes can often be enough to cause you to void again. I recommend voiding twice before bed if getting up at night is a problem. You may find that changing positions while urinating can be helpful to fully empty your bladder.
As far as salt goes, salt makes your body hold on to water. While you could take a salt tablet, you might get thirsty during the night. In addition, excess salt increases most people’s risk for heart attack and stroke, so I don’t recommend it.
* * *
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2023 North America Syndicate Inc.
All Rights Reserved
Send questions/comments to the editors.
