#Middlebury #Health
DEAR DR. ROACH: I was hoping that you could answer a quick question. I am a 46-year-old female and have hemochromatosis. I can’t get very good medical care where I live. It’s a small town where I can’t switch doctors, and mine is subpar. Anyway, I just had a blood test, and my ferritin is 39 and my saturation is 0.76. I don’t know if I need a phlebotomy. The doc likes to have me do it when my ferritin is in the 50-75 range. He has NEVER mentioned saturation before. Can you shed some light on this? – A.R.
ANSWER: Hemochromatosis is iron overload caused by the body being unable to reduce iron absorption even when it doesn’t need iron. The high iron saturation is a good test for diagnosing hemochromatosis. However, it’s the ferritin that best approximates total body iron stores.
A large proportion of the body’s iron is in the red blood cells, so by removing these through phlebotomy (literally, “bloodletting” – usually the blood is donated), iron is taken out of the body. Most experts remove iron through phlebotomy until ferritin levels are below 50. Someone with a ferritin of 39 probably doesn’t need treatment, since the total body iron is nearly normal.
Women who are still menstruating have some degree of protection against iron overload, although it certainly still is possible to develop problems if the iron intake is greater than iron output, in which case phlebotomy is necessary.
DEAR DR. ROACH: My problem is that I am losing my hair. I am a 63-year-old gal in relatively good health who walks for exercise, eats a healthy, balanced diet and takes a pill each day to manage cholesterol and blood pressure. I do not have a thyroid problem, nor do I have diabetes. My dermatologist told me I do not have alopecia, as some of my siblings do. Instead, he suggested that my hair loss – and specifically the thinning of the hair on top of my scalp – is due to heredity; male pattern baldness runs through both sides of my family.
So here’s the question: Is it safe and/or effective to take 5,000 mcg of over-the-counter biotin supplements to lessen the effect of hair loss, or is this product ineffective and just being pushed on women by pharmaceutical and vitamin manufacturers to increase sales and profits, and to manipulate the consumer into believing that this expensive vitamin product is essential to our well-being? Thank you. – C.W.R.
ANSWER: Biotin has been studied for both male pattern and female pattern baldness, and has had limited success, especially when combined with other vitamins and nutritional supplements (60 percent effectiveness versus 11 percent in one placebo-controlled trial). It might be worth a try, since it is very safe.
As far as expense goes, I found biotin tablets for 6 cents each at an online retailer. It certainly isn’t essential to well-being; in fact, with a healthy diet, I believe no supplement is essential. Vitamin and supplement manufacturers may try to make you think supplements are essential, but there is no good evidence for this. Taking it to try to improve a problem like male-pattern baldness is reasonable, but if it doesn’t help significantly, save your money.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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