Iron in blood linked to stroke brain damage
People with high levels of iron in their blood may have more severe neurologic deterioration after a stroke, according to Spanish researchers.
They recommend doctors ask for routine blood ferritin measurements when they order diagnostic blood work.
“Patients with ferritin levels higher than 275 ng/mL are 80% more likely to have progressing stroke,” said team leader Dr. Antoni Davalos, a neurologist at the Hospital Universitari here.
“Stored iron increases with age in normal people, but iron accumulation is accelerated among a small percentage of the population. For these people a diet low in iron should be recommended. Blood ferritin levels should be tested as we test cholesterol or glucose levels in patients with cardiovascular diseases or cardiovascular risk factors.” The study, which appears in the April 25 edition of Neurology, shows that stroke patients with elevated levels of iron are much more likely to experience more severe neurological symptoms and possibly increased brain damage.
The researchers measured ferritin concentrations in plasma and cerebrospinal fluid samples taken from 100 stroke patients within 24 hours of the onset of a stroke. Among the 45 patients who had progressing neurological decline due to stroke, the median plasma ferritin concentration was 391 ng/mL, compared with 148 ng/mL among patients who remained stable or improved. The median ferritin concentration in cerebrospinal fluid was 17.4 ng/mL among the progressing stroke patients, versus 4.8 ng/mL in those less affected.
Studies have shown blood ferritin concentrations do not change during the first 48 hours of stroke. Researchers assumed high ferritin levels obtained in their study were not the result of the body's reaction to stroke.
“High body iron stores might contribute to stroke progression by increasing the production of free radicals in brain cells and in the walls of brain microvessels,” Dr. Davalos said. “Free radicals destroy the cell components and promote other mechanisms of injury that might enlarge the damaged area of the brain.”
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