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Iron Myeloma and Bone
According to the study linked below iron, myeloma and bone health are linked. While MM patients almost universally suffer from decreased serum iron levels, I am posting this study simply to give MM patients and understanding of dysregulated iron metabolism.
After reading the study about iron overload, it occurred to me that MM patients might benefit from learning about both sides of the issue.
Rather than iron overload, MM usually causes iron deficiency anemia.
What health problems occur when iron levels are either too high or too low?
Low Iron Levels (Iron Deficiency)
Low iron levels typically lead to iron deficiency anemia, which occurs when your body doesn’t have enough iron to produce adequate hemoglobin in red blood cells. This can result in:
Symptoms:
- Fatigue and Weakness: Due to decreased oxygen delivery to tissues.
- Pale Skin and Mucous Membranes: Caused by reduced hemoglobin.
- Shortness of Breath: Especially during physical activity.
- Cold Hands and Feet: Poor circulation due to reduced red blood cells.
- Headaches and Dizziness: Reduced oxygen delivery to the brain.
- Brittle Nails and Hair Loss: A result of insufficient nutrients reaching hair and nail cells.
- Pica: A craving for non-food substances like ice, dirt, or chalk.
Causes:
- Poor dietary intake (e.g., low consumption of iron-rich foods like red meat, spinach, and beans).
- Blood loss (e.g., heavy menstrual bleeding, gastrointestinal ulcers, or surgery).
- Increased demand (e.g., during pregnancy or growth spurts).
- Malabsorption (e.g., due to celiac disease or certain medications).
Complications if Untreated:
- Severe fatigue and decreased physical performance.
- Weakened immune function.
- Developmental delays in children.
- Complications during pregnancy, such as preterm delivery.
High Iron Levels (Iron Overload)
Excessive iron, often due to a condition like hemochromatosis, can lead to iron accumulation in organs, causing damage.
Symptoms:
- Joint Pain: Common in early stages.
- Chronic Fatigue: Due to organ dysfunction.
- Bronze or Gray Skin Tone: From iron deposits in the skin.
- Abdominal Pain: Often linked to liver issues.
- Loss of Libido or Menstrual Irregularities: Due to endocrine involvement.
Causes:
- Genetic conditions (e.g., hereditary hemochromatosis).
- Repeated blood transfusions.
- Overuse of iron supplements or iron-rich diets.
Complications if Untreated:
- Liver Damage: Cirrhosis or liver cancer.
- Heart Problems: Arrhythmias, cardiomyopathy.
- Diabetes: From pancreatic damage.
- Arthritis: Due to joint damage from iron deposits.
- Organ Failure: In extreme cases.
I am a long-term MM survivor. It has helped me manage my long-term side effects and fear of MM relapse by learning about both sides of MM challenges.
Email me at David.PeopleBeatingCancer@gmail.com with questions about MM.
Thanks,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
IRON IN MULTIPLE MYELOMA
“Multiple myeloma is a non-curable B cell malignancy in which iron metabolism plays an important role. Patients with this disorder almost universally suffer from a clinically significant anemia, which is often symptomatic, and which is due to impaired iron utilization.
Recent studies indicate that the proximal cause of dysregulated iron metabolism and anemia in these patients is cytokine-induced upregulation of hepcidin expression. Malignant myeloma cells are dependent on an increased influx of iron and therapeutic efforts are being made to target this requirement.
The studies detailing the characteristics and biochemical abnormalities in iron metabolism causing anemia and the initial attempts to target iron therapeutically are described in this review…
An additional potential disruptor of MM cell iron metabolism is curcumin…. Curcumin is a polyphenolic extract isolated from the spice turmeric (Curcuma longa). This plant extract is lipophilic, readily permeates cell membranes, and has been shown to have many beneficial properties including anti-inflammatory, antioxidant, and chemotherapeutic activity due to its complex structure and its ability to influence multiple cell signaling pathways.55 It can also bind iron and has been shown to be an iron chelator.55,56..”
Iron Overload: The Silent Bone Breaker
TOPLINE:
Patients with serum ferritin levels higher than 1000 μg/L show a 91% increased risk for any fracture, with a doubled risk for vertebral and humerus fractures compared with those without iron overload.
METHODOLOGY:
- Iron overload’s association with decreased bone mineral density is established, but its relationship to osteoporotic fracture risk has remained understudied and inconsistent across fracture sites.
- Researchers conducted a population-based cohort study using a UK general practice database to evaluate the fracture risk in 20,264 patients with iron overload and 192,956 matched controls without elevated ferritin (mean age, 57 years; about 40% women).
- Patients with iron overload were identified as those with laboratory-confirmed iron overload (serum ferritin levels > 1000 μg/L; n = 13,510) or a diagnosis of an iron overloading disorder, such as thalassemia major, sickle cell disease, or hemochromatosis (n = 6754).
- The primary outcome of interest was the first occurrence of an osteoporotic fracture after the diagnosis of iron overload or first record of high ferritin.
- A sensitivity analysis was conducted to check the impact of laboratory-confirmed iron overload on the risk for osteoporotic fracture compared with a diagnosis code without elevated ferritin.
TAKEAWAY:
- In the overall cohort, patients with iron overload had a 55% higher risk for any osteoporotic fracture than control individuals (adjusted hazard ratio [aHR], 1.55; 95% CI, 1.42-1.68), with the highest risk observed for vertebral fractures (aHR, 1.97; 95% CI, 1.63-2.37) and humerus fractures (aHR, 1.91; 95% CI, 1.61-2.26).
- Patients with laboratory-confirmed iron overload showed a 91% increased risk for any fracture (aHR, 1.91; 95% CI, 1.73-2.10), with a 2.5-fold higher risk observed for vertebral fractures (aHR, 2.51; 95% CI, 2.01-3.12), followed by humerus fractures (aHR, 2.41; 95% CI, 1.96-2.95).
- There was no increased risk for fracture at any site in patients with a diagnosis of an iron overloading disorder but no laboratory-confirmed iron overload.
- No sex-specific differences were identified in the association between iron overload and fracture risk.
IN PRACTICE:
“The main clinical message from our findings is that clinicians should consider iron overloading as a risk factor for fracture. Importantly, among high-risk patients presenting with serum ferritin values exceeding 1000 μg/L, osteoporosis screening and treatment strategies should be initiated in accordance with the guidelines for patients with hepatic disease,” the authors wrote.
iron myeloma and bone iron myeloma and bone