Iron Overload  

Iron Overload





Too much blood iron has been associated with an increase in heart disease. (1) On the other hand, a study published in the New England Journal of Medicine (2) by the National Center for Health Statistics and Centers for Disease Control "reported that high transferrin saturation levels are not associated with an increased risk of cardiovascular heart disease or myocardial infarction. On the contrary, it was found that there is an inverse association of iron stores with overall mortality and with mortality from cardiovascular disease." (3)

In other words, high iron does not cause cardiovascular disease, but low iron actually might. Health is somewhere in the middle.  

Twenty years ago, always a shameless promoter of vegetarianism, I taught my clinical nutrition students that there were two types of dietary iron: heme, and non-heme. That basically means "blood," and "non-blood." Heme iron is from meat.

Your body can soak up and accumulate excessive heme iron even if it already has plenty of iron on hand. 

But the really good news is that your body has an automatic shut-off system to limit its absorption of non-heme, or vegetarian, iron. Yes, this includes practically all iron supplements on Earth (and those that may someday be made from meteors as well).  

Do I think you should take an iron supplement, or a multiple vitamin containing iron? If you are a child, yes. Iron deficiency remains a major public health problem for kids, because they are making lots of blood as they grow. If you are a reproductive aged female, yes again. Women lose about a half a cup of blood in every menstrual cycle. That's like giving a unit of blood three times a year, ladies. 

But this is no reason to stuff women and children with the muscles of dead animals. A simple, cheap multivitamin with iron will do the trick and save a cow. Vegetarianism (or in my personal opinion, what I call "near-vegetarianism") has always been a good idea. Now it is better than ever. 

For men, iron supplementation is generally unnecessary. For heme-heavy "meat and potatoes men," it is positively a bad idea. Guys, if you give blood a lot, persistently do excessively heavy exercise, or lose blood from injury, take any average-dose iron supplement for a while. 

Caution: These above comments, while valid for the great majority of people, do not apply to persons with hereditary hemochromatosis, which is a severe iron-buildup problem. Next time you have your blood checked, you can bring this up with your doctor of choice. 


1. Ascherio A et al. Dietary iron intake and risk of coronary heart disease among men. Circulation 1994; 89:969-74.

2. Sempos CT et al. Body iron stores and the risk of coronary heart disease. NEJM 1994; 330:1119-24

3. Carl Germano, M.A., R.D.  Iron status and cardiovascular heart disease.



Hemochromatosis (HC) is underdiagnosed and should get more attention. We should also take into consideration its relationship to high dosages of vitamin C. I looked at your website (as I often do when I need some clinical practical data), but you do not pay much attention to it. Dr. Thomas Levy in his book ( ) uses the term 'unlikely', but cannot be 'ruled out'. No studies are available on the subject and - until then - high C users should probably include at least an annual check on ferritin and iron. Do you consider HC a non-issue?”

Good topic and a good question. A known hemochromatosis (HC) patient should not take megadoses of C. As for the rest of the population, I recommend a low heme-iron diet, which is a low-meat or meatless diet. Vegetarian diet provides non-heme iron, and even with mega-C, there seems to be a normal iron absorption shut-off. (1) I think excess dietary heme iron may be the real problem, not vitamin C. The body can relatively easily absorb more heme (meat) iron than it needs. When and if vitamin C has a negative effect in HC patients, it is probably due to release of stored iron, not new absorption. (2) 

In my opinion, one should beware the questionable work of outspokenly anti-ascorbate hematologist Victor Herbert, the voice behind claims that vitamin C is a public problem due to looming dangers of iron overload. Herbert's papers grossly overstate a statistically slight danger. There are no deaths per year from vitamin C; by Herbert's logic, hundreds if not thousands of C users should be dropping dead from HC. Herbert was the author of the “vitamin C destroys B-12 myth,” which has been proven to be unfounded. 

I append a comment by Dr Steve Hickey, a vitamin C expert at U Manchester, and author of Ascorbate: The Science of Vitamin C ( ):

“There is a theoretical danger but the actual reports are sparse and unclear. I expect that if vitamin C really did have such a side-effect, its detractors would have had a field day. Having read much of the available evidence, I consider the benefits of high dose vitamin C to exceed greatly any (largely theoretical) side-effects.”


1) Bendich A, Cohen M. Toxicol Lett. 1990 Apr;51(2):189-201. Ascorbic acid safety: analysis of factors affecting iron absorption. “Three parameters associated with iron absorption were identified: (1) a relatively shallow slope for the dose-response curve relating ascorbic acid dosage (1-1000 mg) and percent iron absorption; (2) no significant effect of ascorbic acid on the absorption of high (60 mg) iron doses; and (3) an inverse relationship between iron absorption and plasma transferrin saturation. Ascorbic acid did not increase the incidence of 'high' iron absorbers (greater than 2 SD from population mean) above control levels; limited data for ascorbic acid doses greater than 100 mg/d indicated no change in the distribution of iron absorption values.” PMID: 2184546  

2) Rowbotham B, Roeser HP. Aust N Z J Med. 1984 Oct;14(5):667-9. Iron overload associated with congenital pyruvate kinase deficiency and high dose ascorbic acid ingestion. PMID: 6597712


Andrew Saul is the author of the books FIRE YOUR DOCTOR! How to be Independently Healthy (reader reviews at ) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at )

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