“Hemochromatosis is a type of iron overload disease that’s caused by a gene change passed down in families. Iron overload disease is any condition that causes the body to hold onto too much iron. Hemochromatosis can be the primary cause=hereditary or due to a secondary cause=other than hereditary.”

MAYO CLINIC (Hemochromatosis – Symptoms and causes – Mayo Clinic)

Hemochromatosis is a disorder where too much iron builds up in your body. Sometimes it’s called “iron overload.”   Hemo meaning blood and chromatosis means pigmentation specifically : deposit of pigment in a normally unpigmented area or excessive pigmentation in a normally pigmented site.

Normally, your intestines absorb just the right amount of iron from the foods you eat. But in hemochromatosis, your body absorbs too much, and it has no way to get rid of it. So, your body stores the excess iron in your joints and in organs like your liver, heart, and pancreas. This damages them. If it’s not treated, hemochromatosis can make your organs stop working.

There are two types of this condition — primary and secondary.

Primary hemochromatosis is hereditary, meaning it runs in families. If you get two of the genes that cause it, one from your mother and one from your father, you’ll have a higher risk of getting the disorder.

Secondary hemochromatosis happens because of other conditions you have. These include:

• Certain kinds of anemia
• Liver disease
• Getting a lot of blood transfusions
• White people of northern European descent are more likely to get hereditary hemochromatosis. Men are 5 times more likely to get it than women.
  

  Symptoms

  Up to half of people who have hemochromatosis don’t get any symptoms. In men, symptoms tend to show up between ages 30 and 50. Women often don’t show signs of this condition until they’re over 50 or past menopause. That may be because they lose iron when they get their periods and give birth.

  Symptoms of hemochromatosis include:

  • Pain in your joints, especially your knuckles
  • Feeling tired
  • Unexplained weight loss
  • Skin that has a bronze or gray color – pigmentation
  • Pain in your belly
  • Loss of sex drive
  • Loss of body hair
  • Heart flutter
  • Foggy memory

  Sometimes people don’t get any symptoms of hemochromatosis until other problems arise. These may include:

  • Liver
  • Diabetes
  • Abnormal heartbeat
  • Arthritis
  • Erectile dysfunction (difficulty having a erection)

  If you take a lot of vitamin C or eat a lot of foods that contain it, you can make hemochromatosis worse. That’s because vitamin C helps your body absorb iron from food.

  White people of northern European descent are more likely to get hereditary hemochromatosis. Men are 5 times more likely to get it than women.

   

“The focus of the 2024 global campaign is on sex and gender disparities in pain. It seeks to highlight how sex/gender-related inequalities and inequities in pain occur, to better understand why this happens, and consider the implications for how we manage pain.

This fact sheet focuses on the key questions often asked: “Are there sex differences in pain?” and “Who is more sensitive to pain, men or women”? This reflects the focus of most research in this area, which has been to explore the differences and similarities between men and women.

Evidence suggests that women are generally more sensitive to pain, have a greater vulnerability to many painful conditions, and generally experience more pain across the lifespan. However, there is also variation in patterns, which need to be understood. [5-8; 10; 11]

Reasons reflect the complex interplay between the biological, psychological, and social influences thought to be involved. More recently, we are also recognizing the need to move beyond binary comparisons, and why we need to take an integrated sex and gender approach to pain.”

International Association for the Study of Pain –  IASP (Overview of Sex and Gender Differences in Human Pain – International Association for the Study of Pain (IASP))

The nervous system’s dials for communicating chronic pain to the body work differently in male and female mice, according to a study published today in Nature Neuroscience. If this difference is also found in humans, it could lead to chronic pain treatments that are better tailored to the patient. But the most immediate impact might be in basic research — the earliest stages of work — since right now, the mice being used are almost exclusively male.

Chronic pain affects more than 100 million people in the US, which is more than heart disease, cancer, and diabetes combined. And many pain conditions occur more often in women than in men, according to the FDA. That’s why figuring out how male and female mice deal with pain — and whether they do so differently than humans — is so important. After all, most medical research — including pain research — starts with mice.

In the study, researchers focused on microglia, a type of immune cell that can be found in the brain and the spinal cord. These cells are known to play a role in the “volume knob” for pain, explains Jeffrey Mogil, a pain researcher at McGill University and a co-author of the study. The knob turns way up after an injury. A genetic study done in Mogil’s lab a few years ago had indicated that microglia weren’t as important in the pain circuit of female mice. So, the scientists decided to find out if interfering with the microglia would have the same effect in male and female mice.

Male mice had no pain, whereas female mice did

The researchers used mice that were suffering from a hypersensitivity to pain. The scientists gave them drugs that target the microglial cells in the spinal cord, in the hopes that this would prevent the animals from feeling pain. But only male mice responded to the drugs — the female mice still had an increased sensitivity to pain.

When the researchers repeated these experiments in mice under varying conditions, they saw the same results: male mice had no pain, whereas female mice did. “Whatever the manipulation is, in every case, blocking microglia or some part of the microglial system brings the pain sensitivity back to normal in male mice, and doesn’t do anything in female mice,” Mogil says.

Now looking at the human we see this: There is a growing body of literature that indicates women are more likely than men to be undertreated for their pain.

It appears that gender affects not only pain perception, pain coping, and pain reporting, but also pain-related behaviors, including use of healthcare and the social welfare system. It is also probable that men and women differ systematically in their responses to pain treatments, although further research is needed in this area.

For many common pain conditions, including migraine and tension-type headache, facial pain, and abdominal pain, population-based studies indicate higher prevalence rates in adult women than in adult men.

Despite the difficulties with human laboratory experiments on pain sensitivity, many investigators are willing to draw the inference from these studies that women are, in general, more sensitive to painful stimuli than men, and that this difference is biologically based.

Whatever the pain prevalence differences for men and women, most studies show that women seek healthcare for pain at a higher rate than men:

• • One study indicated that women are more likely to be given sedatives for their pain, while men are more likely to be given pain medication.

  • Faherty and Grier studied the administration of pain medication after abdominal surgery and found (after controlling for weight) that physicians prescribed less pain medication for women than for men ages 55 or older, and that nurses administered less pain medication to women than to men ages 25-54 years.

  • Beyer et al examined pain medication given to children and found that, after surgery, boys received significantly more codeine than girls, and girls were more likely than boys to be given acetaminophen.

  • In a 1994 study of 1,308 outpatients, Cleeland and colleagues found that women with metastatic cancer were significantly more likely than men with the same diagnosis to receive inadequate pain medications.

  • In a study of several hundred AIDS patients, Breitbart and colleagues found that, based on the WHO analgesic ladder guideline, women were significantly more likely than men to receive inadequate analgesic therapy.

  • A study by Weir and colleagues found that women are less likely than men to be referred to a specialty pain clinic, at least upon initial encounters with their physicians.

  • A study reviewing cancer care at seven outpatient clinics in California found that female cancer patients were prescribed half the pain medication as male patients with the same pain intensity scores.

  • Males outnumber females two to one in the burn population. This is related to male household and job roles, which increase the risk for burn injury. Furthermore, males more commonly engage in risk-taking behaviors involving chemicals, flammable materials, or electricity.So what do we see so for at this point:

• We feel pain more intensely than men, according to a new study of 11,000 men and women who were patients at the Stanford Hospital and Clinics.

• Researchers analyzed electronic medical records of patients’ reports of pain across a range of different diseases, and found a distinct gender-driven difference in how much discomfort patients say they felt. The study included 47 disorders — from cancer to back conditions and infectious diseases — and more than 161,000 patient-reported pain scores. The patients were all asked by nurses or other health personnel to rate their pain on an 11-point scale, with 0 representing “no pain” and 11 signifying the “worst pain imaginable”.

• Not surprisingly, most responses clustered around either the two extremes of very little pain or extreme pain or the middle score of 5. But overall, women were more likely to indicate higher pain levels than men, says lead author Dr. Atul Butte, chief of systems medicine in the department of pediatrics at Stanford University School of Medicine. And that was true across almost all of the different diseases. “That was the most surprising finding,” says Butte. “We completely wouldn’t have expected such a difference across almost all disorders, where women were reporting a whole pain point higher on the 0-to-10 scale than men.”

• Of course, self-reports can’t account for the fact that people may define tolerable and intolerable pain in vastly different ways, says Butte, but the fact that a gender difference emerged from such a large number of patients suggests that the effect is real.

• What accounts for the gender gap? Hormones may explain some of the difference — studies have shown that estrogen in women can help dampen the activity of pain receptors, helping them to tolerate higher levels of pain. That means, however, that they may become more sensitive to pain during low-estrogen parts of the menstrual cycle.

• There may also be explanations that have nothing to do with biology. Men, for example, may feel compelled by cultural stereotypes to be tough, and therefore report feeling less pain than they really do —especially when asked by the mostly female nursing staff.

Still, even if non-biological factors are influencing how much pain men and women report, Butte says the difference is worth noting. “The reasons may be biological or they may not be, but we should still be aware of the bias that patients have in reporting pain,” he says. He is hoping to continue the research by following up these results with surveys of patients’ ratings after they were treated for pain. That may help doctors to better address the real pain patients may be feeling.

Through the National Library of Medicine in 2022 (https://pubmed.ncbi.nlm.nih.gov/36038207/) They state; “Chronic pain affects 20% of adults and is one of the leading causes of disability worldwide. Women and girls are disproportionally affected by chronic pain. About half of chronic pain conditions are more common in women, with only 20% having a higher prevalence in men. There are also sex and gender differences in acute pain sensitivity. Pain is a subjective experience made up of sensory, cognitive, and emotional components. Consequently, there are multiple dimensions through which sex and gender can influence the pain experience. Historically, most preclinical pain research was conducted exclusively in male animals. However, recent studies that included females have revealed significant sex differences in the physiological mechanisms underlying pain, including sex specific involvement of different genes and proteins as well as distinct interactions between hormones and the immune system that influence the transmission of pain signals. Human neuroimaging has revealed sex and gender differences in the neural circuitry associated with pain, including sex specific brain alterations in chronic pain conditions. Clinical pain research suggests that gender can affect how an individual contextualizes and copes with pain. Gender may also influence the susceptibility to develop chronic pain. Sex and gender biases can impact how pain is perceived and treated clinically. Furthermore, the efficacy and side effects associated with different pain treatments can vary according to sex and gender. Therefore, preclinical and clinical research must include sex and gender analyses to understand basic mechanisms of pain and its relief, and to develop personalized pain treatment.”.

“Chronic pain affects the lives of more than 60 million Americans—not to mention the countless people who care for them.

They span all ages. They live with countless diagnoses. Their stories number in the millions. Yet despite the enormous impact of chronic pain, too many people still feel isolated, misunderstood, dismissed, or unheard.

This Pain Awareness Month, we’re bringing together those millions of stories to create #OneVoiceForPain. Because no one with pain has to face it alone. And no one is going to create a better future for those living with pain by working alone.”

U.S. Pain Foundation (This Pain Awareness Month, Let’s Change Pain – U.S. Pain Foundation)

In most instances, painful sensations arise from tissue injury in the body. Sensitive nerve endings pick up pain signals and carry these messages along nerves to the spinal cord and then onto the brain. All along these complex pathways, there are biological “gates” that can be either opened or closed. When these gates are closed, pain is reduced or eliminated. When open, pain messages continue through the circuit. It is when these gates are jammed open that chronic pain cycles begin.

As you recall, acute pain is short lived and serves as a warning signal. When you fix whatever is wrong, the pain usually goes away. In the case of chronic pain, pain does not necessarily signal that the body is undergoing more damage. Most chronic pain is caused by a malfunction of the nervous system, either in nerves or the brain. The malfunction or opening of the pain gates causes and endless barrage of pain signals to cycle. Chronic pain then becomes a disease itself, taking on a life of its own.

How can we close the gates of pain?

The gates are affected by several factors, most importantly by the pattern of nerve impulses which reach the spinal cord from the rest of the body, and nerve impulses coming from the brain. Sometimes the nerve impulses traveling through the spinal gates can be affected by other forms of physical stimulation. Giving your nervous system a competing source of input can fool the nervous system and alter your perception of pain.

There are many ways to accomplish this. You may have noticed that rubbing or massaging a painful area may have relieved your pain in the past. Applying electrical stimulation (e.g. TENS), applying heat or cold, acupuncture, or nerve blocks may also provide a competing source of input. It is also important to realize that certain mental activities or thoughts taking place in the brain can help to close the spinal gates.

Another way we can work to close the gates of pain is to affect the release of several chemicals that help pain signals travel to the brain. Neurotransmitters are biochemical messengers that carry pain signals from one nerve cell to the next. The three main neurotransmitters that send pain signals to the brain are substance P, NMDA (n-methyl-d-aspartate), and glutamate. Excess amounts of these chemicals, especially substance P, make it easier for pain signals to reach the brain.

Therefore, another way of stopping pain involves manipulating pain provoking neurotransmitters. This can be accomplished by prescription or over the counter medications, acupuncture, injections, hypnosis, or biofeedback.:

The role of the Endorphins:

The endorphins are another class of chemicals which are produced in the brain and serve an important role in the pain experience. These chemical are naturally occurring pain relieving substances, similar to morphine or other opiates, produced in the body. Endorphins work on special receptor sites in the brain. They act as keys which unlock receptors thus generating nerve impulses to shut down pain. Morphine and other opiates have similar chemical structures which turn off pain.
Several situations or conditions raise endorphin levels in the brain thus reducing pain. They include thinking with a positive attitude, happiness, and regular exercise.

The Role of Stress:

It is natural to connect a physical stress to the body, such a broken arm, to the perception of pain. The role of psychological stress may not seem as obvious. The brain structures involved in stress can affect the production of key hormones in the body, suppress the body’s immune system, and activate the autonomic nervous. These are the same biological changes that may occur from physical stresses on the body-the body may not differentiate between physical and psychological stress. The net effects of these changes on the body are to lower our internal resistance to pain, thus further encouraging the chronic pain cycle.

Many sources of stress feed into the chronic pain cycle. First off, as you would expect, pain itself is stressful. Pain sensations are perceived as undesirable and are at very least annoying. Pain creates tension, both physical and emotional. Physical tension may show itself as muscle tension or affect the cardiovascular, gastrointestinal, or immune systems. Emotional tension may reveal itself as anger, frustration, worry, depression, or frustration. Both physical and emotional tension, initially set in motion by pain, worsen pain. Thus the vicious cycle of pain is begins-pain leads to tension and tension leads to more pain.

A second source of stress comes from all the negative consequences that occur as a result of a chronic pain condition. Chronic pain may create difficulties with family relationships, social or recreation activities, self-esteem, and employment.

Yet another source of stress arises from the hardships that can be encountered from the stresses of everyday living. Everything from difficulties putting on your shoes in the morning to difficulties standing long enough to go grocery shopping are added on top of pain-related stressors. In the end, an individual not only suffers from chronic pain, but from chronic stress.

The consequences of chronic stress:

Whatever the type of stress, either physical or psychological, the outcome on pain is to worsen it. Chronic stress also may result in other physical ailments such as tension headaches, muscle spasms, gastrointestinal problems, and elevated blood pressure. It can also lead to fatigue, depression, and a sense of hopelessness.

The key is how to prevent chronic pain:

Chronic pain can’t always be prevented But rememeber if you have pain go to a MD to help you get to your optimal level of function and hopes you get to PAIN FREE.

1-  ONE is staying in good physical and mental health may be the best way to prevent it or help you cope with it.
2-  Treat your health problems early.
3- Get enough sleep every night. Learn to alternate activity with rest throughout each day.
4- Exercise.
5- Eat a balanced diet.

Try to reduce stress in your life.

“In Celiac disease – The intestinal damage often causes symptoms such as diarrhea, fatigue, weight loss, bloating or anemia. It also can lead to serious complications if it is not managed or treated. In children, malabsorption can affect growth and development in addition to gastrointestinal symptoms.

There’s no definite cure for celiac disease. But for most people, following a strict gluten-free diet can help manage symptoms and help the intestines heal.

Celiac disease tends to run in families. If someone in your family has the condition, ask a member of your healthcare team if you should be tested. Also ask about testing if you or someone in your family has a risk factor for celiac disease, such as type 1 diabetes.”

MAYO CLINIC (Celiac disease – Symptoms and causes – Mayo Clinic)

The symptoms of Celiac Disease can be:

The signs and symptoms of celiac disease can vary greatly and differ in children and adults. Digestive signs and symptoms for adults include:

• Diarrhea
• Fatigue
• Weight loss
• Bloating and gas
• Abdominal pain
• Nausea and vomiting
• Constipation

However, more than half the adults with celiac disease have signs and symptoms unrelated to the digestive system, including:

• Anemia, usually from iron deficiency
• Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
• Itchy, blistery skin rash (dermatitis herpetiformis)
• Mouth ulcers
• Headaches and fatigue
• Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
• Joint pain
• Reduced functioning of the spleen (hyposplenism)

Children

Children with celiac disease are more likely than adults to have digestive problems, including:

• Nausea and vomiting
• Chronic diarrhea
• Swollen belly
• Constipation
• Gas
• Pale, foul-smelling stools

The inability to absorb nutrients might result in:

• Failure to thrive for infants
• Damage to tooth enamel
• Weight loss
• Anemia
• Irritability
• Short stature
• Delayed puberty
• Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures

Some patients may have no symptoms yet but if this disease is in your family definitely get checked for it!  You get on top of it before the celiac disease gets you first!

Treatment:

There’s no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing.

Currently, the only treatment for celiac disease is lifelong adherence to a strict gluten-free diet. People living gluten-free must avoid foods with wheat, rye and barley, such as bread and beer.

Ingesting small amounts of gluten, like crumbs from a cutting board or toaster, can trigger small intestine damage.

Celiac disease is also known as coeliac disease, celiac sprue, non-tropical sprue, and gluten sensitive enteropathy.

“Celiac disease (also called non-tropical sprue, celiac sprue, gluten intolerance, and gluten-sensitive enteropathy) is an intestinal disorder in which the body cannot tolerate gluten. Gluten is a natural protein in many grains, including wheat, barley, rye, and oats.

People with celiac disease have an immune reaction that is triggered by gluten. The immune reaction causes inflammation at the surface of the small intestine where it damages small structures (villi) on the surface of the intestine. It also damages smaller, hair-sized protrusions called microvilli. Healthy villi and microvilli are needed for normal digestion. When they are damaged, the intestine cannot absorb nutrients properly and you can become malnourished.

A tendency to develop celiac disease is genetic (inherited). Celiac disease is most common among people of northern European descent. Celiac disease is not always recognized because the symptoms can be mild and can be wrongly blamed upon other common intestinal issues. Celiac disease can be diagnosed at any age.”

Harvard Health Publishing (Celiac Disease (Non-Tropical Sprue) – Harvard Health)

Celiac disease, sometimes called celiac sprue or gluten-sensitive enteropathy, is an immune reaction to eating gluten, a protein found in wheat, barley and rye.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications. Celiac Disease Foundation states “It is estimated to affect 1 in 100 people worldwide. Two and one-half million Americans are undiagnosed and are at risk for long-term health complications.”.

When the villi get damaged, nutrients cannot be absorbed properly into the body.

• Intestinal villi are tiny, finger-like projections made up of cells that line the entire length of your small intestine. Your villi (villus is the singular, villi is the plural) absorb nutrients from the food you eat and then shuttle those nutrients into your bloodstream so they can travel where they’re needed.

Celiac disease is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease.

Celiac disease can be difficult to diagnose because it affects people differently. There are more than 200 known celiac disease symptoms which may occur in the digestive system or other parts of the body. Some people develop celiac disease as a child, others as an adult. The reason for this is still unknown.

Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, celiac disease can lead to additional serious health problems.  Some people with celiac disease have no symptoms at all, but still test positive on the celiac disease blood test. A few others may have a negative blood test, but have a positive intestinal biopsy. However, all people with celiac disease are at risk for long-term complications, whether or not they display any symptoms.

Long Term Problems that can arise from celiac disease are the following:

• Iron deficiency anemia
• Early onset osteoporosis or osteopenia
• Infertility and miscarriage
• Lactose intolerance
• Vitamin and mineral deficiencies
• Central and peripheral nervous system disorders
• Pancreatic insufficiency
• Intestinal lymphomas and other GI cancers (malignancies)
• Gall bladder malfunction
• Neurological manifestations, including ataxia, epileptic seizures, dementia, migraine, neuropathy, myopathy and multifocal leucoencephalopathy