My first recollection that I have on the importance of the word iron is when my mom would get up at 4 a.m. and begin to wash and “iron” clothes for the elite, to supplement my father’s hard earned but meager wages. I could hear her knuckles rhythmically rubbing clothes on a washboard, sometime humming the sacred song, “Precious Lord Take My Hand.” After the washed clothes were bright as the sun that dried them, she would have to “iron” them to all perfection. My brother and I would deliver the refreshed clothes to her customers when we returned from school. In return, we would pick up bags of soiled clothes to bring back home so that she could start the ritual of busting suds for survival the next morning. My mom and dad came to my graduation when I finished medical school. We survived.

The next time iron became important to me was when I studied this very important element in medical school and found that it could lead to disease if it was deficient, causing iron deficient anemia, or over absorbed, causing hemochromatosis. Iron is necessary for the production of red blood cells in the bone marrow. Iron can be found abundantly in foods such as beef, beans, kale, whole-wheat bread, chick peas, fortified cereals, tonics, over the counter vitamins and even from that old iron skillet or pot. Iron is especially needed during pregnancy and in young growing children. However, a good thing can also be dangerous if absorbed in high quantities. It is estimated that the average person needs 10 mg to 18 mg daily, the recommended daily allowance.

When iron is absorbed from the intestines in excessive amounts because of a genetic defect, it is deposited in the skin (bronzing), pancreas, liver, muscles and heart. This condition leads to organ failure. Patients with hemochromatosis will experience fatigue, abdominal pain, immune dysfunction, irritable bowel syndrome, hair loss and explosive diarrhea. Often, this condition is misdiagnosed and a simple blood test will confirm it. It is treated by periodically removing blood, a process known as phlebotomy (the surgical opening of a vein to remove blood in the treatment of polycythemia).

The eating of Argo laundry starch was a great cause of iron deficiency anemia in African-American women. This craving for the starch was related to eating red and white clay in the southern U.S. and Africa. After the dangers of eating starch was revealed, the company placed on its box, “Not Recommended for Food Use,” and the product was produced in powder form and could not be chewed.

Excess iron can also become toxic to the body because it encourages the growth of bacteria, parasites, protozoa and cancer cells. It appears that anemia might have played an evolutionary role in keeping a body healthy from these organisms. Recently, iron has also been connected with cardiovascular disease and might be more important than elevated cholesterol. We shall see!

It is important to read labels of all health products to control the amount of iron that is ingested. Too much or too little of a good thing can be destructive. In other words, keep “your eye on the iron” that you take into your body.