SCD and Iron Overload

It is often said that sickle cell disease does not kill. What kills a warrior are the complications from sickle cell. This series will focus on breaking down and understanding each of the complications that might develop from sickle cell, so that you can know how to prevent this, and how to catch it early.

When people hear that you have any anemic condition, the first question they often ask is, “Why don’t you take iron?” Public perception is that iron is the cure-all for anemia, but those with anemia have sometimes found out that hard way that this is not true.

I never really understood why I didn’t take iron, I just knew that it was not recommended for sickle cell patients. So I never took iron supplements or devoured a high-iron diet. But this year, I made it a desire to research every single complication of sickle cell to it’s fullest intent, in the hope of being more knowledgeable and self-aware of my disease process.

For every blood transfusion that you get, there is a risk of iron overload (or toxicity). Except during pregnancy, a healthy body actually produces it’s own iron, and does not need iron from external sources. So when you get a blood transfusion, you are getting the iron of the donor in addition to the iron you already have in your body. Add this up, over multiple units and several years, and you have a recipe for iron overload.

See, the body does not get rid of iron when it’s not in use. The kidneys and liver cannot secrete it, so the iron just goes round and round, floating about in your bloodstream. Eventually, the metallic ions can wreck damage to every single organ you have in your body, leading to other complications like strokes, heart problems, diabetes, kidney failure, liver failure, osteoarthritis…and the list goes on and on.

If you have had more than 10 blood transfusions in your lifetime, I highly recommend you get your iron levels (sodium ferritin) checked at your next doctor visit. A result of more than 1000mcg/dl is a definite cause for alarm, and you might have to be put on Desferal or a similar drug (which you might have to be on for several months or years). Apparently, these Desferal is a chelator, which means that it binds to the iron, thus allowing your kidneys to be able to excrete it from your body. Desferal has a list of side effects, tastes really nasty, and is a hassle to have to use.

So to avoid getting iron overload, do not accept routine blood transfusions. Personally, I only get a blood transfusion when my Hemoglobin is less than 6.5 (which means I’m almost passed out at that point). Anything more than that, and I refuse those packed red blood cells. I’ve had 15 blood transfusions in my life, and my ferritin level is in the 300s, so I wanna keep tabs on my level as well as be judicious with how much blood I get.

I hope this has illuminated your mind a tad on one of the complications of sickle cell. Remember, it often isn’t the disease that kills, but it’s the complications of having sickle cell that often does warriors in. So please, learn those complications and watch out for the first warning signs. Be aware of your body, check your iron levels and stay well.

Blessings.