請教各路神仙：血液中的鐵含量超標幾倍會怎麼樣？

我最近兩年來，每隔兩個月驗一次血，血中的鐵離子含量從800直至最近的1400（正常值要小於250），總鐵含量也一直居高不下，但是沒有不適的感覺，做了X光、CT檢查，除了有脂肪肝（六年前就有）外，沒有其它毛病。

請教各位西醫或者中醫，哪位知道血液中的鐵含量超標有什麼危害？會有什麼癥狀？如何治療？

多謝了！

Possibly, you may have a disease called hemochromatosis, when the body accumulates excessive amounts of iron -- up to 100 times as much as in a normal person. Interestingly, one of the treatments for this condition is to have blood removed. By frequently donating blood, you may actually have kept signs of this problem from showing up sooner.

Iron plays a crucial role in the body: It's a component of hemoglobin, which is responsible for helping red blood cells transport oxygen to tissues. However, if too much iron, which results in hemochromatosis. The most common form of the disease is genetically inherited and affects as many as one in every nine people. It can also occur in patients who require repeated blood transfusions.

Symptoms of hemochromatosis may not surface until age 40 or 50 and can include noticeably darker, more pigmented skin, joint or arthritis pain, and shortness of breath. Your will may have joints stiffness which may be directly related to extra iron deposited in the joint linings. Excess iron can also severely damage your organs: An accumulation in the pancreas can result in diabetes-like symptoms or diabetes mellitus itself, while extra iron in the liver can lead to cirrhosis (scarring of the liver) and possibly cancer.

Hemochromatosis can be controlled, but it can also cause a lot of damage, so be sure to get to your doctor's office soon for proper diagnosis and treatment. A simple blood test allows your doctor to determine if your iron levels are higher than they should be. If so, you may need to have blood withdrawn repeatedly (a process called phlebotomy) until your iron levels are back to normal. Your physician may also treat you with drugs that remove iron from the bloodstream.

In the meantime, it's probably a good idea to pass up foods high in iron, such as red meat, and to avoid iron supplements unless prescribed by your physician. Because this condition can affect the liver and pancreas, it's also wise to limit or avoid consumption of alcohol.

Please notice  that above is for information only, please consult your own doctor for further diagnosis and treatment plan.

[ 本帖最後由 goodoctor 於 2006-11-23 04:20 編輯 ]

還是找西醫吧，中醫根本就沒有什麼血液裡面的鐵含量高的概念。

估計叫他們一看，又是上火，下火的一頓胡扯。

Recommendations for patients trying to cut down on iron absorption:

Limit red meat consumption to three or fewer portions per week: meat contains the most easily absorbable form of iron: heme iron but red meat is also an excellent source of protein, B12, and zinc. Eliminating red meat from the diet entirely is not necessary providing a patient is compliant with therapy and routinely seeing a physician who is monitoring iron levels.

Drink tea or coffee with a meal-unless there is evidence of liver damage or disease. Tea and coffee tannin which inhibits iron absorption

Limit alcohol consumption or abstain altogether if there is liver damage: alcohol enhances the absorption of iron. For those without liver damage moderate consumption of alcohol is allowed.

Avoid consumption of vitamin C supplements with the meal: vitamin C enhances the absorption of iron. Limit doses of supplemental vitamin C to 200 milligrams if possible. Vitamin C should not be eliminated from the diet.

Eat plenty of fresh fruits and vegetables regardless of the vitamin C content: fruits and vegetables contain antioxidants which protect a person from free radical damage. Iron is a know trigger of free radical activity.

Maintain a good schedule of blood donation: many hemochromatosis patients forget to have a phlebotomy. Keeping a schedule or note in a prominent place is helpful. If ferritin levels get too high, a person may have to move from routine maintenance back into therapeutic frequency.

For more information, please click below:

http://www.irondisorders.org/Disorders/about.asp

　　研究人員通過對血液中將鐵元素結合在一起的鐵蛋白的測量發現，鐵蛋白每增加l％患心臟病的危險性就相應地增加4％以上。大多數患有心臟病的人每一升血液中鐵蛋白的含量超過200微克，而一般人的血液中的鐵蛋白含量只在150—200微克之間．

　　主要是容易引起血管硬化。建議多運動、少葷腥、多果蔬，經常注意血壓。患脂肪肝參加體育鍛煉是第一位的。堅持每天跑步一小時，半年以後准沒事。

The Complications of hemochromatosis for the heart:

Congestive heart failure. This potentially life-threatening condition may occur when excess iron in your heart which will interferes with its ability to circulate enough blood to meet your body's needs. Untreated congestive heart failure can be fatal disease, but the condition may be reversible when hemochromatosis is treated and excess iron stores reduced.

Heart arrhythmias. Abnormal heart rhythms can cause chest pain, heart palpitations, and lightheadedness. In some cases, they may be life-threatening. Like congestive heart failure, arrhythmias can often be reversed with treatment for hemochromatosis.

充血性心力衰竭？沒那麼嚴重吧。

Probably not in this case at this stage, but will develop CHF if the diagnosis is right and patient is not treated correctly.

As I stated clearly that CHF and cardiac arrhythmia are  the cardiac complications of hemochromatosis. If you are interested in the iron overload cases, you may click below:

http://www.clevelandclinic.org/h ... 1198.asp?index=5875

http://www.webmd.com/hw/health_g ... 99.asp?pagenumber=2

[ 本帖最後由 goodoctor 於 2006-12-3 07:00 編輯 ]

謝謝gooddoctor給了這麼多信息，可惜俺英文太糟，看不懂，若是能翻譯以下就太好了，不過還是謝謝了！

對不起, hemochromatosis中文叫作血色素沉著症, 請看下面這個有趣的故事:

http://www.5ijk.net/show.aspx?id=19065&cid=503

血色素沉著症的診治

美國布朗剋期圭兵醫療中心曾發生這樣一幕慘劇：一名受精神刺激的患者，狂怒地掏出手槍向醫生和護士開槍。從此以後，醫院要求每一位前來就診的患者，按一定的順序接受探測器的檢查，以便發現是否攜帶金屬器具。有一天，來了一位47歲的男子，掏出衣袋裡的所有東西，甚至取下了帶有鐵扣的皮帶，站在電子儀器前接受檢查。儀器當即顯示他身上還有鐵質物品。後來才查明，這名患者確實沒有攜帶任何金屬製品，而是血色素沉著症遺傳性新陳代謝紊亂。他的小腸里存積了大大超過人體所需的鐵。鐵在人體內長年累月積聚，慢慢會損傷人體組織。由於產生胰島素的胰腺細胞受損，會使血色素沉著症患者併發糖尿病，鐵還會損害肝細胞，引起肝硬化，也可使關節組織解體而患關節炎，金屬的毒性還會想起心肝病。

前不久，人們還以為此病十分罕見。然而據美國猶他州立大學科學家柯爾溫•愛德華茲及其同事的研究結果，情況恰恰相反。美國有1百多萬人吸取的鐵都超過人體的正常需要，他們面臨著此病很快加劇的危險.

血色素沉著症引起的器質性損害在女性身上出現的機會大大小於男性，甚至幾乎不發生，月經起到的作用不可低估——周期性的失血正好消耗掉了過量的鐵.

[ 本帖最後由 goodoctor 於 2006-12-6 13:35 編輯 ]

HI 新鮮人, as you said you are both China and US trained the physician, We will really appreciate should  you give us some of your opinions on ths case.

原帖由 goodoctor 於 2006-12-7 06:55 發表
HI 新鮮人, as you said you are both China and US trained the physician, We will really appreciate should  you give us some of your opinions on ths case.

對不起,   我不是內科醫生也不是家庭醫生(全科醫生)而是個專科醫生.   我說過.   世界上沒有萬能的科學家.  如自認為萬能,  就是一個偽科學家.   醫生當然也一樣.  沒有必要自認為萬能.  老年人戒煙可能引起Parkinson"s Syndrome 你就不一定知道.  否則就不會無條件的號召戒煙了. 已有那麼多醫生出主意,    用不著我這個非本專業的醫生出點子了. 隔行如隔山,  不是有點多餘和自尋煩惱嗎?

[ 本帖最後由 新鮮人 於 2006-12-8 10:40 編輯 ]

原帖由 新鮮人 於 2006-12-8 02:17 發表


對不起,   我不是內科醫生也不是家庭醫生(全科醫生)而是個專科醫生.   我說過.   世界上沒有萬能的科學家.  如自認為萬能,  就是一個偽科學家.   醫生當然也一樣.  沒有必要自認為萬能.  老年人戒煙可能引起 ...

新鮮人說他不是內科醫生也不是家庭醫生(全科醫生)而是個專科醫生， 我倒認為新鮮人是個「全科醫生」---- 中醫全科。新鮮人的中醫知識遠遠高於他的西醫專科。新鮮人說「老年人戒煙可能引起Parkinson"s Syndrome」，這倒是挺新鮮的。不過新鮮歸新鮮，只是認不得真。新鮮人有意誤導大眾，希望大家不要上當才是正經。

原帖由 小草民 於 2006-12-8 10:57 發表



新鮮人說他不是內科醫生也不是家庭醫生(全科醫生)而是個專科醫生， 我倒認為新鮮人是個「全科醫生」---- 中醫全科。新鮮人的中醫知識遠遠高於他的西醫專科。新鮮人說「老年人戒煙可能引起Parkinson&qu ...

那你去請教一下你信得過的老年神經科專家,  老年病學專家也行,  好嗎?  我就不信你一個搞神經科學的人會不認識一二個老年神經病專家?
不要以為自己不知道的都不是科學,  你的毛病就在這裡.

[ 本帖最後由 新鮮人 於 2006-12-8 12:25 編輯 ]

本來不想在這裡討論新鮮人的戒煙問題,  不過他或她不知深淺的偏要在人家討論別
的問題的時候, 把自己那點兒事拿出來說, 我只好回應:

當然了, 是新鮮人的身體, 抽不抽煙, 是新鮮人的自由.  新鮮人不在乎長期吸煙而
導致的急性心肌梗塞, 中風, 或是肺癌, 而不願意忍受Parkinson"s Syndrome 的症
狀, 也是他或她的自由. (相信新鮮人帖子上的能治療晚期肺癌的老中醫,  一定會
在新鮮人性命攸關的關鍵時刻, 幫他或她一把).

我在這裡想說的是:  一個自稱受過中國和美國醫學訓練的神經科醫生, 一個中醫,
現代醫學通吃的"全才" 卻如此喜歡, 珍愛一張不僅自己噴雲吐霧, 而且給別人造成
二手煙污染的像片. 大家是不是覺的很滑稽?

我不想說新鮮人的智力有問題, 也不想懷疑他或她自己說的學歷有假. 我們只是要
求新鮮人能不能有一些 COMMON SENSE!

另外, 如果新鮮人還要談他或她的戒煙, 或Parkinson"s Syndrome 的問題, 希望大
家到<健康生活>里去談.

最後, 送新鮮人一幅畫:
  

長期抽煙會引起男士陽萎, 有上圖為證
(如果新鮮人是女士, 在這方面就安全了)

[ 本帖最後由 goodoctor 於 2006-12-8 22:16 編輯 ]

Beneficial effects of nicotine
http://www.blackwell-synergy.com ... 0443.1991.tb01810.x
MURRAY E. JARVIK1

  Abstract

Nicotine in tobacco brings illness and death to
millions of people. Yet nicotine in its pure form has
the potential to be a valuable pharmaceutical agent.
Nicotine fairly specifically binds to the cholinergic
nicotinic gating site on cationic ion channels in
receptors throughout the body. This action stimulates
the release of a variety of neurotransmitters
including especially catecholamines and serotonin.
When chronically taken, nicotine may result in: (1)
positive reinforcement, (2) negative reinforcement,
(3) reduction of body weight, (4) enhancement of
performance, and protection against: (5) Parkinson's
disease (6) Tourette's disease (7) Alzheimers disease,
(8) ulcerative colitis and (9) sleep apnea. The
reliability of these effects varies greatly but
那你去請教一下你信得過的老年神經科專家,  老年病學專家也行,  好嗎?  我就不信你就不會不認識一二個老年神經病專家?
不要以為自己不知道的都不是科學,  你的毛病就在這裡
也可在用 google 以parkinson as a Nicotine withdrawal  syndrome , smoking and parkinson's syndrome就能查到很多文獻.

[ 本帖最後由 新鮮人 於 2006-12-9 00:10 編輯 ]

http://aje.oxfordjournals.org/cgi/content/abstract/88/2/149
A RETROSPECTIVE STUDY OF SMOKING IN PARKINSON'S DISEASE1
M. DEAN NEFZGER2, FRED A. QUADFASEL3 and VIRGINIA C. KARL4
2Follow-up Agency, National Research Council, 2101 Constitution Avenue N. W., Washington, D. C. 20418
3Neurology Division, Psychiatry, Neurology and Psychology Service, Veterans Administration Central Office Washington, D. C. 20420
4Administrative Standards and Services Division, Social Work Service, Veterans Administration Central Office Washington, D. C. 20420

Nefzger, M. D. (Nat. Research Council, Washington, D. C. 20418), F. A. Quad-fasel and V. C Karl. A retrospective study of smoking in Parkinson's disease. Amer. J. Epid., 1968, 88: 149–158.—Reports that tobacco smokers are at a lower risk of incurring Parkinson's disease (PD) than are nonsmokers were reinvestigated by study of 198 VA hospital patients with PD and 198 other patients. A retrospective design was advantageous in this instance because case finding did not depend on the occurrence of death or the uncertain reporting of PD on death certificates. Smoking habits, particularly as they existed before the onset of PD, were assessed by personal interview. In contrast to control patients, fewer PD patients ever smoked cigarettes, cigars, or pipes and fewer chewed tobacco or used snuff. Before age 40 there were fewer regular daily cigarette smokers among PD patients than among controls. PD patients tended to start smoking cigarettes at an older age and to stop at a younger age than did controls. Diseases that are positively associated with smoking were infrequently reported in PD patients, suggesting that selective mortality from other diseases may explain the negative association between smoking and PD.
你不是神經科醫生, 不知道不足為奇,  小草民先生作為一個神經科學者不知道就有點不像話了.

[ 本帖最後由 新鮮人 於 2006-12-8 19:30 編輯 ]

[ 本帖最後由 新鮮人 於 2006-12-8 19:49 編輯 ]

International Journal of Epidemiology, Vol 26, 328-339, Copyright &copy; 1997 by International Epidemiological Association

http://ije.oxfordjournals.org/cgi/content/abstract/26/2/328
-----------------------------------------------------------------------------
ARTICLES


Smoking and Parkinson's disease: a case-control study in Germany
W Hellenbrand, A Seidler, BP Robra, P Vieregge, WH Oertel, J Joerg, P Nischan, E Schneider and G Ulm
Institute of Social Medicine, Faculty of Medicine, Otto-von-Guericke University, Magdeburg, Germany.

BACKGROUND: In a hospital based case-control study, we investigated the role of environmental factors in the aetiology of Parkinson's disease. This paper describes our results on smoking habits. METHODS: The smoking histories of 380 Parkinson's disease (PD) patients recruited from nine German clinics were compared to those of age- and sex-matched control subjects (379 neighbourhood controls and 376 controls from the same region). Detailed information on smoking behaviour was collected in structured personal interviews in order to calculate the number of pack-years smoked up to the time of diagnosis. Conditional logistic regression was used to calculate odds ratios (OR) and control for potential confounders. RESULTS: Among PD patients, 44% had ever smoked, as compared to 59% in both control groups. Among ever-smoking patients, 74% quit prior to the date of diagnosis, as compared to roughly 45% of the ever-smoking control subjects. The OR for ever having smoked was 0.5 (95% confidence interval [CI]: 0.3-0.7), P trend < 0.00005). CONCLUSIONS: The results are considered in terms of criteria for causality. Plausible explanations for the observed inverse association between smoking and PD include: 1. A genetic predisposition that increases the risk for PD (such as defective detoxification enzymes) simultaneously decreases the likelihood of smoking. 2. Inherently lower dopamine levels in predestined PD patients cause them to be less prone to addiction. 3. Smoking is neuroprotective.
是你沒有在美國受過正規教育還是我?

[ 本帖最後由 新鮮人 於 2006-12-9 00:49 編輯 ]

小草民原來是小草包.
goodoctor原來是個庸醫.

[ 本帖最後由 新鮮人 於 2006-12-9 00:38 編輯 ]