Haemochromatosis

Dalkeyboy

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I'm surprised that the site's information on the causes of type 1 diabetes, particularly its genetic causes, omits any reference to hereditary haemochromatosis. This is one of the most common genetic diseases among northern European populations. It can lead to iron overload in the body which, if left untreated (by simple phlebotomy), can result in severe clinical complications and organ damage - diabetes being just one probable consequence.
Given my own experience I would urge any newly diagnosed insulin-dependent diabetics over the age of 30 to ask for an iron studies blood test (ferritin and transferrin saturation) and, if the respective results are above normal range, to request a gene study test for haemochromatosis. Treatment will not reverse diabetes but it could help to address other possible impacts e.g. liver cirrhosis and heart disease.
 

kitedoc

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I'm surprised that the site's information on the causes of type 1 diabetes, particularly its genetic causes, omits any reference to hereditary haemochromatosis. This is one of the most common genetic diseases among northern European populations. It can lead to iron overload in the body which, if left untreated (by simple phlebotomy), can result in severe clinical complications and organ damage - diabetes being just one probable consequence.
Given my own experience I would urge any newly diagnosed insulin-dependent diabetics over the age of 30 to ask for an iron studies blood test (ferritin and transferrin saturation) and, if the respective results are above normal range, to request a gene study test for haemochromatosis. Treatment will not reverse diabetes but it could help to address other possible impacts e.g. liver cirrhosis and heart disease.
Thank you @Dalkeyboy, you make a good point. And as you say the effect can be on multiple organs and organ systems in the body. Treatment of cause and effects. Any change in the Home page information, moderators?
 

DCUKMod

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Thank you @Dalkeyboy, you make a good point. And as you say the effect can be on multiple organs and organ systems in the body. Treatment of cause and effects. Any change in the Home page information, moderators?

Kitedoc, as you would expect the site Home and informational content pages are created in HO, overseen by the DCUK Medical Advisory Board. Like any very high level summary, there is only so much detail that can be achieved, within a succinct article, and covering the major bases. Applying the "benefitting most" measure is likely to come into play, and with all things in life, there will be exceptions to every "rule".

I will take an action to forward these comments to HO.

Finally, on a matter of detail, neither Moderators nor myself have editing rights to those pages.
 

urbanracer

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Thank you @Dalkeyboy, you make a good point. And as you say the effect can be on multiple organs and organ systems in the body. Treatment of cause and effects. Any change in the Home page information, moderators?

My 'logic' would dictate that in the case of an hereditary condition, you would have learnt about it from your parents and already know that such tests are required.

To me it doesn't follow that the rest of us should be routinely asking for these tests.
 

Brunneria

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Hi and welcome @Dalkeyboy

The diabetes.co.uk main information pages have this page, explaining Bronze diabetes, and its cause.
https://www.diabetes.co.uk/hemochromatotis-bronze-diabetes.html
We very rarely get in mentioned on the forum. Would you be willing to give more information about your experiences? There may be others out there who have been diagnoses with an other type of diabetes, but who may recognise themselves in your story.
 
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Dalkeyboy

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Many thanks for that link Brunneria. Perhaps it could be given more prominence on the site? My own experience has served to show that awareness of hereditary haemochromatosis is limited, even in practice. The reasons are perhaps understandable given that the initial symptoms of HH mimic a range of other illnesses -
elevated liver enzymes, for example, are invariably misattributed to alcohol consumption.Even in secondary care there is a high threshold of suspicion in regard to the disease.
I can see where Urbanracer is coming from but the logic is flawed to the extent that it assumes both parents are aware they carry the defective gene.The reality is that carriers will not develop symptoms by and large and have no knowledge that transmission of the gene from both will result in HH and its associated risks in any offspring.
My only concern here is to raise awareness because given the prevalence of the condition and the numbers signed up to DCUK, it seems a statistical certainty that the diabetes of a small minority will have been caused by HH and, if undiagnosed and untreated, damage to other organs will follow or be present already.
 
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NicoleC1971

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FYi Dr Chris Masterjohn PhD gives quite a lot of info about the condition on his podcasts (he is a sufferer in addition to being a nutrition researcher). This is the light version for anyone who wants further info. I think he is talking about the same thing. was interested as I had a client who's type 2 was caused by the condition.
 

Brunneria

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Many thanks for that link Brunneria. Perhaps it could be given more prominence on the site? My own experience has served to show that awareness of hereditary haemochromatosis is limited, even in practice. The reasons are perhaps understandable given that the initial symptoms of HH mimic a range of other illnesses -
elevated liver enzymes, for example, are invariably misattributed to alcohol consumption.Even in secondary care there is a high threshold of suspicion in regard to the disease.
I can see where Urbanracer is coming from but the logic is flawed to the extent that it assumes both parents are aware they carry the defective gene.The reality is that carriers will not develop symptoms by and large and have no knowledge that transmission of the gene from both will result in HH and its associated risks in any offspring.
My only concern here is to raise awareness because given the prevalence of the condition and the numbers signed up to DCUK, it seems a statistical certainty that the diabetes of a small minority will have been caused by HH and, if undiagnosed and untreated, damage to other organs will follow or be present already.

We are in an interesting state of flux in my family, since a family member has recently been flagged as having high ferritin (which is a warning sign of haemochromatosis). He has a diagnosis of T2 and has had very slow developing glucose dys-regulation for the past 20 years.

Unfortunately, it now turnes out that he has had raised ferritin for several years, but not flagged by his doc.
His levels are significantly above the normal range, but not up into the kind of level which would have triggered investigation.

When asked about it, some tests were done, but just ‘for monitoring’ and no genetic testing has been done, despite it being requested by the family.

I have always been curious about the ‘T2’ history on one side of our family. It goes back 4 generations and 7 people. All slim. All developing ‘T2’ in their 50s, 60s or 70s. Up until now, I had assumed it was just that our family wears out its capacity to cope with carbs. But now? I have begun to wonder about a genetic predisposition to haemochromatosis.

From the reading I have done on the subject, it looks like there are several different genes in play, some have a severe effect, some mild, and they can stack together. I am assuming that if haemochromatosis is present in my family, then it is a mild form.

My own ferritin levels are slightly above the normal range, and have climbed steadily, every test, for the last few years. I am currently 51, and entering menopause, which is when ferritin levels rise for a lot of women, but they still should not be rising out of the ‘normal’ post menopausal level. Of course, I already have severe glucose dysregulation, but I don’t want additional organ damage from haemochromatosis in addition, do I? So am keeping a watching brief. :)

Definitely something to keep an eye on!
 

Dalkeyboy

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Absolutely right Brunneria. I was diagnosed with diabetes two years ago, aged 63, following a full blood count. The fbc results also showed amongst other things that my ferritin level was over 5000 - massively in excess of normal range. This was completely missed by my gp and it was only after several weeks and my own research that I persuaded the gp to refer me for a specialist opinion. Only then and after three outpatient consultations over nine months was a gene study test performed. It confirmed HH and weekly phlebotomy was initiated.
Regrettably the absence of diagnosis over many years has led to a number of other conditions aside from diabetes - principally but not exclusively liver cirrhosis. On a brighter note though this has regressed as a consequence of phlebotomy and, combined with my diabetes regime, I feel healthier than I have for a long time.
I guess the essential message is be aware, be mindful that gps may miss altogether or misinterpret the reasons underlying high ferritin and transferrin saturation results, and (as you say) keep a watchful eye where you have grounds for believing you might be at risk.
 
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Bluetit1802

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Blimey, @Dalkeyboy how in the name of god, any god, can a GP miss levels that high? My lab report indicates the normal range is 10 to 160, and any blood count above or below the standard is highlighted on the report, so no excuse for a doctor to miss it.

It just shows how vigilant we all must be, and never ever accept the doctor's opinion without seeing the results for ourselves either on print outs or on-line if the surgery puts them on line. Then, anything highlighted we can research for ourselves.