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What Is The Difference Between Hemachromatosis And Fibromyalgia ?
Question: ? relationship of fibromyalgia, and palm and sole of foot and intertriginous and some varied skin itching to hemochromatosis. I have been diagnosed with fibromyalgia for many years ( confirmed during Duke Univ. drug study participation 2009), recently found to have HFE gene for hemochromatosis, ferritin 1759 and iron saturation of 76%. How may these all be related and should I be beginning weekly blood unit withdrawal soon? Age 67, wt 180, ht. 5'2", otherwise healthy nl fasting blood sugar, nl liver enzymes (sgot, sgpt) nl thryoid function studies. Mitral valve prolapse (?asymptomatic), take BP meds with usual BP 140/80 pulse about 85, sleep flat.
Hi,
Thanks for your query.
In pure medical terms, fibromyalgia is entirely different to hemachromatosis; in terms of cause and treatment plan. Hemachromatosis is hereditary disorder associated with HFE gene while fibromyalgia a chronic condition producing unexplained bodily aches and fatigue secondary to somatic / functional causes. "Fibromyalgia technically is not related to hemochromatosis / HFE genes."
But with respects to clinical presentation; both the conditions present with myriad of symptoms which considerably overlap. The possibility that your symptoms were due to hemachromatosis cannot be ruled out.
I hope, I have answered to your first part of the query.
Now, to answer the second half of your question - if you need to start of weekly blood withdrawl (therapeutic plebotomy)
As per as guideliness; Yes, you will need it. You may need weekly plebotomy untill the ferritin levels come down to 35 ng/dl and thereby once in 2-3 months to keep the ferritin levels below 20ng/dl. You may asked to use chelating agents and keep away from iron XXXXXXX foods including supplements.
Along with this, your doctor would monitor the liver functions. Perhaps a liver biopsy is also recommended as the ferritin values are above 1000.
Lastly asymptomatic mitral valve prolapse can be seen in many women and doesn't warrant further testing.
Hope you find my answers adequate and informative. I am available to clarify yfollow up doubts too.
If you find my answers useful request you to accept it.
Regards
Thanks for your query.
In pure medical terms, fibromyalgia is entirely different to hemachromatosis; in terms of cause and treatment plan. Hemachromatosis is hereditary disorder associated with HFE gene while fibromyalgia a chronic condition producing unexplained bodily aches and fatigue secondary to somatic / functional causes. "Fibromyalgia technically is not related to hemochromatosis / HFE genes."
But with respects to clinical presentation; both the conditions present with myriad of symptoms which considerably overlap. The possibility that your symptoms were due to hemachromatosis cannot be ruled out.
I hope, I have answered to your first part of the query.
Now, to answer the second half of your question - if you need to start of weekly blood withdrawl (therapeutic plebotomy)
As per as guideliness; Yes, you will need it. You may need weekly plebotomy untill the ferritin levels come down to 35 ng/dl and thereby once in 2-3 months to keep the ferritin levels below 20ng/dl. You may asked to use chelating agents and keep away from iron XXXXXXX foods including supplements.
Along with this, your doctor would monitor the liver functions. Perhaps a liver biopsy is also recommended as the ferritin values are above 1000.
Lastly asymptomatic mitral valve prolapse can be seen in many women and doesn't warrant further testing.
Hope you find my answers adequate and informative. I am available to clarify yfollow up doubts too.
If you find my answers useful request you to accept it.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My hematologist who tested me on 5/2/11 found ferritin 1050, iron saturation 86% and HFE positive at UNC clinic lab, Chapel Hill, NC. I feel like I'm living with a time bomb inside me (told his answering machine and nurse that today 6/2); but therapeutic phlebotomy has not been started yet and my next appointment is for 7/11/11. I am a pathologist and think that phlebotomy should be started as soon as possible. What is your opinion; including, should I just go to another hematologist? Thank you for your first answer. I look forward to your answer to my second query. XXXXXXX Bradford MD
Hi and thanks again,
Being a pathologist, you are aware that both serum ferrritin and iron saturation levels are beyond normal. Though the symptoms produced in hemachromatosis is mainly due to iron overload, the serious complications occur when liver is involved.
It is difficult to predict liver status without liver function / liver biopsy reports. I advice you to get these test done, if they aren't done yet.
Therapeutic phlebotomy are useful both in reducing iron overload as well as preventing liver effects. Since ferritin values are high, "I would advice you this treatment as early as possible while further tests go on". Dietary modifications to avoid iron XXXXXXX diet are absolutely necessary. As mentioned in my first reply, you would need one or two phlebotomy with weeks while ferrtin levels are monitored.
Discuss about this with your hematologist. You can consider getting a second opinion from an hematologist.
Hope my answer is informative and adequate. Also hope that both you and hematologist accept this answer.
Wish you good health
Regards
Being a pathologist, you are aware that both serum ferrritin and iron saturation levels are beyond normal. Though the symptoms produced in hemachromatosis is mainly due to iron overload, the serious complications occur when liver is involved.
It is difficult to predict liver status without liver function / liver biopsy reports. I advice you to get these test done, if they aren't done yet.
Therapeutic phlebotomy are useful both in reducing iron overload as well as preventing liver effects. Since ferritin values are high, "I would advice you this treatment as early as possible while further tests go on". Dietary modifications to avoid iron XXXXXXX diet are absolutely necessary. As mentioned in my first reply, you would need one or two phlebotomy with weeks while ferrtin levels are monitored.
Discuss about this with your hematologist. You can consider getting a second opinion from an hematologist.
Hope my answer is informative and adequate. Also hope that both you and hematologist accept this answer.
Wish you good health
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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