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cutlery-dining-dinner-109395.jpg            “Goldilocks was hungry.  She tasted the porridge from the first bowl. ‘This porridge is too hot!’ she exclaimed. So, she tasted the porridge from the second bowl. ‘This porridge is too cold,’ she said.  So, she tasted the last bowl of porridge. ‘Ahhh, this porridge is just right,’ she said happily and she ate it all up.”

The story of Goldilocks and the three bears fits the story of our relationship with the vital mineral, iron.  We don’t want to have too little, but we actually don’t want to have too much either; we want to have just the right amount.

Iron is an essential element for blood production. About 70 percent of our body’s iron is found in red blood cells as part of hemoglobin, which carries oxygen to the body, and in muscle cells, as myoglobin, which accepts, stores, transports and releases oxygen.  About 6 percent of body iron is part of certain proteins which are essential for respiration, energy metabolism, and nerve function. Iron also is needed for proper immune function.

Where do we get iron in our diet?  A wide variety of foods contain iron.  Red meat is a rich source of iron, and iron in animal products is absorbed better than iron from plant products.  Nevertheless, foods such as spinach, fortified breakfast cereals and even dark chocolate have substantial amounts of iron.  However, individuals vary a great deal in how well they absorb the food in their diet.

If iron consumption and absorption is chronically low, iron stores become depleted.  In the typical American diet, iron depletion from poor dietary intake alone is uncommon.  Most often, having low iron results from losing iron by blood loss.  In women who are still menstruating, blood loss from their monthly cycle is the most common cause of iron deficiency.  In non-menstruating women and in men, iron deficiency usually points to unrecognized persistent microscopic blood loss from the gastrointestinal (GI) tract.  Thus, a colonoscopy and upper endoscopy are usually carried out to search for a GI source of blood loss such as a colon polyp or cancer, or a bleeding ulcer.  There are numerous other causes of low iron, but the point is that, in addition to taking iron supplements, the reason for the iron deficiency must be thoroughly sought after.

What’s wrong with not having enough iron in our bodies? When iron is depleted over time, it begins to cause reduced red blood cell production and eventually results in a low red blood count, called iron deficiency anemia.  Other symptoms such as fatigue, shortness of breath with exertion, restless legs, paleness, headache, racing heart, and a desire to chew on ice (oddly enough) can accompany the low iron state.

So, should everyone take an iron supplement just to play it safe? No, indeed; in a healthy non-menstruating adult an iron supplement can cause iron overload, which has its own toxicity.  Likewise, children getting ahold of excessive amounts of iron-containing vitamins is a common cause of poisoning.

Besides taking too much iron in the form of supplements, there are also built-in genetic abnormalities which cause some adults to hold on to too much iron, even with a normal diet.  The best known of these hereditary conditions is called hemochromatosis.  It affects over 1 million Americans.  Iron overload from these causes can damage the liver, pancreas, joints and heart, and can even be fatal if left untreated.  Hemochromatosis is one of the few condiclose-up-idiomorphe-crystals-iron-56030tions that can benefit from an updated version of the old practice of blood-letting.

So, if you have symptoms that make you wonder if you have too little, or even too much, iron, get it checked out.  Iron is vital, but like Goldilocks, we want the amount to be just right.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835


Spring Sneezing


We can treat spring allergies!

Springtime is in Bloom!
For many of us, those beautiful blooms mean suffering from seasonal allergies.  Are you taking multiple medications to gain relief?  Do you have side effects from allergy medications? Do you suffer several months of the year?   Have you tried allergy shots but were not able to come so often for your therapy?  Come on in to see if you’re a candidate for in-office testing and at HOME immunotherapy?




As I leaned in, thirty-year-old Jim related his recent striking experience: “I’m sitting at my desk at work, when all of a sudden my heart starts pounding out of my chest for no good reason.  I’m thinking I’m having a heart attack.   My chest starts hurting and I get short of breath and lightheaded.  Then my fingers and around my mouth start tingling.  By this time, I’m so scared my co-workers dialed 911.  The frustrating thing is, at the hospital all the tests are normal.  They say my heart and lungs seem fine… that I must have had a panic attack.  Ever since then I keep getting anxious off and on at work.  I’m afraid it’s all going to happen again, or I’m just going to lose my mind next time.”

Jim’s description pulls together some of the symptoms and feelings one might experience while having a panic attack.  Panic disorder is one of the dozen or so recognized anxiety disorders.  With over 40 million Americans suffering from them, anxiety disorders are considered the most common mental health maladies.

Panic disorder is a type of anxiety disorder in which a person has repeated attacks of intense fear that something bad is about to happen. The cause is unknown but it is a bit more common if it runs in your family.  Panic disorder is also twice as common in women as in men. Usually symptoms begin before age 25, but sometimes not until one’s mid-30s.  At times, even children can have panic disorder.

            Panic attacks tend to strike rather suddenly and symptoms usually reach a peak in about 10 minutes and then may last up to an hour or so.  To fit the criteria, a panic attack will include at least 4 of the following symptoms:

  • Palpitations
  • Sweating
  • trembling or shaking
  • shortness of breath
  • feeling of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • dizziness or lightheadedness
  • feelings of detachment or unreality
  • fear of losing control or going crazy
  • fear of dying
  • numbness or tingling
  • chills or hot flashes

Not a pleasant list of symptoms to experience.  Also at least one of the attacks is followed by one month or more of either persistent concern about having additional attacks or worry about the consequences of another attack (like going crazy or really having a heart attack), or a significant change of behavior related to the attacks.

These unpredictable, frightening, and embarrassing episodes sometimes cause folks to more and more pull back from their normal activities.  Some sufferers end up barely able to leave the house.

So what can you do about them?  While there is no quick cure for panic attacks, there is much that can help.  See your doctor about them and they can first make sure your symptoms aren’t from something else like heart disease, thyroid disease or one of a few other mimickers. If your symptoms really do point to panic disorder, there are several treatment choices, including appropriate counseling and possibly, meds – options include both those that treat you at the moment of the attack and those that, when taken regularly, can help prevent the attacks altogether, or at least reduce them.

All this often takes some patience as one approach doesn’t fit everybody.  But it’s worth the effort to keep this frightening but non-deadly specter from haunting your thoughts and shrinking the boundaries of your life.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835


Easter Holiday Hours

Our offices will be closed Friday, March 30 in observance of Good Friday. Our Knoxville walk-in clinic will be open Saturday, March 31 from 8:30 to 11:30am for sick visits only. We will reopen on Monday, April 2 with regular office hours. If you need to reach our physician on call outside of business hours, please call our office at (865) 539-0270 and follow the instructions on the message.

Celebrate the risen Savior, Jesus Christ! Wishing you a blessed and joy filled Easter!banner-header-easter-cross-161188