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Have pulmonary hemosiderosis. Blood test showed low iron level. Safe to donate blood?

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Pulmonologist
Practicing since : 2003
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I have pulmonary hemosiderosis from exposure to toxic mold (stachybotrys). This indicates that there is excess iron in my lungs. My blood tests show that my iron levels are low due to blood loss in lungs (despite having been taking iron tablets for the last five months).

Most people diagnosed with pulmonary hemosiderosis have anemia as one of the main symptoms. I have irregular heartbeat, palpitations and difficulty breathing.

My chest X-Ray showed that there is "subtle opacification adjacent to the right heart border. And that this may reflect active reflection".

Would donating blood to lower iron levels from my lungs make me better in this case?

Thanks
Posted Mon, 24 Dec 2012 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,
Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following:

1. You seem to be suffering from adthma with pulmonary hemosiderosis.

2. Since Long term oxygen therapy, chest physiotherapy, avoidance of trigers, inhaled medications, steroids, etc.

4. I would like to know as to how was pulmonary hemosiderosis diagnosed in your case? also 2d echo, HRCT scan thorax , pulmonary function tests, bronchoscopy are the investigations generally required in a case of pulmonary hemosiderosis.

5. Was serum Ige levels done? Do you have any other symptom like blood in sputum, leg swelling?

Please do let me know the details, so that I can advise accordingly.

Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant chest physician
Above answer was peer-reviewed by
 
Follow-up: Have pulmonary hemosiderosis. Blood test showed low iron level. Safe to donate blood? 1 hour later
Thank you for your swift reply. I'm very pleased. Ill comment on the following points that you wrote:

2. Is Pulmonary Hemosiderosis not based upon having high iron levels in the organs? Would chelating iron from the body not then help lower these levels from the organs? Even if it wasn't through blood donation but rather through known powerful iron chelation supplements that bind free iron such as Quecertin, Curcumin, Green-Tea, IP-6?

4. I have yet to do a lung-function test. My doctor hypothesized that this could be the most possible case with regards to my symptoms: sharp pain near lung, palpitations, irregular heartbeat, difficulty breathing whilst walking, low iron levels.

I however did have a chest X-Ray done which stated "Mediastinal including heart size is normal. There is some subtle opacification adjacent to the right heart border. This may reflect active reflection". I do not fully know what this means. Could you perhaps expand?

5. A serum Ige level was not done. Does the 'subtle opacification' represent blood in sputum?

Thank you

 
 
Answered by Dr. Gyanshankar Mishra 7 hours later
Hi,
Thanks for the follow up.
After going through the follow up query, I would like to comment the following:

1. In pulmonary hemosiderosis there is accumulation of hemosiderin in the lungs. Remember this is an irreversible process, and blood donation or iron chelation therapy will not help selectively reduce the local levels of iron.

2. I suggest you consult a pulmonologist for substantiating the diagnosis of pulmonary hemosiderosis. Investigations required are pulmonary function test, DLCO(if available), HRCT scan thorax, 2d echo and bronchoscopy. Serum Ig E levels may be required to rule out alternative diagnosis.
Subtle opacification adjacent to right heart border needs further evaluation as described above.

3. Blood in sputum is a clinical finding. Pulmonary hemosiderosis most of the times presents as diffuse alveolar hemorrhage which is bilateral and not localised as in your case.

4. Immunosppresants, steroids, oxygen therapy are some of the treatment options of pulmonary hemosiderosis.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
Follow-up: Have pulmonary hemosiderosis. Blood test showed low iron level. Safe to donate blood? 4 hours later
Is it recommended that I take iron tablets because my iron levels are low?
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,
Thanks for the follow up query.

Yes, if serum iron levels are low together with evidence of iron supplements can be started in consultation with pulmonologist.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
Follow-up: Have pulmonary hemosiderosis. Blood test showed low iron level. Safe to donate blood? 5 hours later
But would this then not raise the level of iron in my lungs and other organs? Isn't the point to help remove free iron from the lungs?
 
 
Answered by Dr. Gyanshankar Mishra 1 hour later
Hi,
Thanks for the follow up query.

1. I have therefore said that if iron deficiency anemia develops and serum iron levels are low than iron supplements may be required since maintaining normal iron levels in blood is extremely important for blood oxygenation. If the hemoglobin levels are too low then blood transfusion may be indiacted. All of this has to be done under supervision of a pulmonologist. Pulmonary hemosiderosis is not the deposition of iron but it is a deposition of iron pigment hemosiderin in the lungs.

2. Till now we haven't developed a modality where we can selectively decrease the hemosiderin content of lung and keep blood iron levels normal. How the hemosiderin deposits in the lung is exactly not known but we cannot allow the blood iron levels to drop dangerously low.

3. Steroids and immunosuppresive agents have greater role in the management as it is postulated that they decrease the progression of disease process.

4. Q. "Isn't the point to help remove free iron from the lungs?"
Ans: Till now there has been no medicine which can do this process selectively. The point is to decrease the progression of disease process or try to reduce it.

5. I would once again advice you to consult a Pulmonologist regarding diagnosis of this condition.

I will more than happy to resolve any query you have regarding this condition. It is indeed a pleasure to interact with a "logical thinking" patient like you.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
Follow-up: Have pulmonary hemosiderosis. Blood test showed low iron level. Safe to donate blood? 8 days later
Thank you. You've been very helpful and thorough. I wish you were my doctor instead.

There is a supplement called IP-6 (Inositol Hexaphosphate or more commonly known as Phytic Acid). IP6 is unique as it will only remove excess iron & not iron from within your blood cells as this is protected by hemoglobin. IP6 will also remove excess calcium & other metallic minerals that our bodies have accumulated down through the years. There is tons of medical literature published on this supplement that has been written about with hemochomatosis and hemosiderosis if you were interested in knowing more. However doctors themselves wont prescribe it due to it not being certified by the FDA.

This is what I am thinking of taking. My haemoglobin levels are fine. Just my Iron count is low. However this supplement should help in removing free Iron and not lower my normal levels.

__________________________________________________________

The second thing I wanted to talk to you about, since you seem quite knowledgeable is mold and fungus in the lungs. How can mold and fungus be removed from the lungs?

My X-ray shows some shading in the lungs which may be an infection. Most likely from the mold. Every time I go near mold or breathe it in my breathing becomes really bad. My acupuncturist and reflexologist say that they think this is it too.

But I need an actual GP to verify. How can I get my GP to check for mold / fungus in the lungs and what is the best protocol to removing it?

Thank you so much
 
 
Answered by Dr. Gyanshankar Mishra 22 hours later
Hi,
Thanks for the follow up query.

1. IP6 is a chelator. Remember it will remove free iron "from blood". But it depends on whether the free iron is increased or not. In pulmonary hemosiderosis the serum iron levels may be depleted (like in your case) or normal hence chelators do not help and are not recommended. Pulmonary hemosiderosis is localised hemosiderosis which can present as transfusion hemosiderosis) where iron overload is present in blood. Hence please do not take the chelators without medical consultation.

2. Mold is a fungus. Fungal involvement of lungs may be of 2 forms - allergic or infective. The allergic form is something like ABPA (Allergic bronchopulmonary aspergillosis) and presents in long term asthmatic patients. Diagnosis is by spirometry, serum Ige levels and other investigations including radiological evidence of bronchiectasis or fleeting shadows. Treatment is inhalers and oral steroids. The infective one may present as lung infection. Best diagnostic clue are to isolate the fungus either from sputum or more reliably via a procedure known as bronchoscopy (Bronchial lavage) and screening it for fungus stain and culture. Treatment of infective fungal lesion is anti fungals.

Thus you need to get yourself evaluated by a pulmonologist in detail.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB


Above answer was peer-reviewed by
 
Follow-up: Have pulmonary hemosiderosis. Blood test showed low iron level. Safe to donate blood? 3 hours later
1. Oh okay, thats interesting. I was thinking of taking IP6 because I thought it would remove excess Iron from the lungs. Also because I had heard that Deferoxamine was prescribed as an Iron chelator in Pulmonary Hemosiderosis.

I am going to get checked up soon. I will let you know how things go.

Thanks
 
 
Answered by Dr. Gyanshankar Mishra 4 hours later
Hi,
Thanks for the follow up.

There is no recent data on use of chelator therapy in pulmonary hemosiderosis.

It was nice interacting with you.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Above answer was peer-reviewed by
 
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