New York City, September 8, 2024 / Rahul Gupta, MD
Despite overwhelming evidence, the medical community still underestimates the critical difference between ferritin-bound iron (essential) and 'non-transferrin bound iron' NTBI (toxic). A biological axiom holds that NTBI forms exponentially once transferrin saturation exceeds 50%. Yet, this is widely ignored, leaving patients vulnerable to oxidative damage and systemic complications.
Now read carefully and remember if you don't want to commit malpractice:
NTBI is undetectable through standard imaging (MRI, CT, PET) and cannot be eliminated from the body through any available techniques, including chelation. Detection is possible only via B-mode transcranial sonography (TCS), primarily in individuals under 50, limiting diagnostic accuracy in older populations.
The homozygous H63D mutation’s relationship with NTBI and its broader implications for chronic disease, especially neurodegenerative conditions like Parkinson’s, demands urgent clinical attention. This mutation, combined with iron mismanagement, exacerbates the toxic effects of NTBI. However, many practitioners remain entrenched in outdated practices, focusing solely on ferritin levels and overlooking NTBI’s pathogenic role.
A comprehensive reevaluation of iron metabolism diagnostics is essential, particularly in those with suspected iron overload or genetic predispositions like H63D. Physicians must adopt a nuanced approach that goes beyond classical metrics, acknowledging the biological certainty of NTBI formation and its irreversible damage. Failure to do so perpetuates misdiagnosis and inadequate treatment, exacerbating patient morbidity.
The continued disregard of these clinical realities reflects an outdated view of iron overload disorders, to the detriment of patient outcomes. As evidence grows, it is not only a scientific necessity but a moral obligation to integrate NTBI awareness into everyday clinical practice.
The time for medical complacency has passed; the harmful consequences of NTBI must be recognized and addressed through improved diagnostics, education, and an interdisciplinary approach to care.
To make it simple:
1) Low or normal ferritin + transferrin saturation chronically over 50% = you need to address this to your doctor. If he/she is not familiar with the basics of medicine, see another one.
2) Low or normal ferritin + transferrin saturation chronically over 50% + homozygous HFE H63D mutation = You might quite likely suffer from H63D Syndrome. Address this to your doctor. If he/she has no clue and stupid answer, see another one.
THE LEAST YOU SHOULD EXCEPT OF YOUR DOCTOR KNOWING NTBI AND IT'S DISASTROUS EFFECT!