Iron Overload and the Metabolic Horse

It has only been in more recent times that iron levels have become routinely measured in the horse, specifically in the horse with metabolic syndrome.  It appears to have become a popular test, leading many owners to making radical decisions due to misunderstanding to a degree.  High iron levels in the metabolic horse, termed iron overload, often occur and can contribute to their already high state of chronic inflammation.  However, there are better ways of managing the condition that may prove more useful and beneficial to your horse.

High iron levels in the horse or iron overload is a common secondary condition which often follows metabolic problems.  The condition is present in humans as well, termed hemochromatosis, and can be an isolated or genetic problem, or associated with metabolic and inflammatory changes.  The precise correlation with high iron levels in the metabolic horse are unknown and the exact cause still evades us at this time. Despite this, I will try to explain from my alternative medicine point of view.

The metabolic horse is a pit of ongoing inflammation, stemming more often from digestive concerns and inflammatory changes in that region of the horse’s body.  These ‘gut’ associated inflammatory changes are related to microbiome imbalances.  The inflammatory events in the gut of these horses carry over into the entire body, leading to chronic inflammatory and cellular changes which impact the immune response, metabolism, glucose regulation, and insulin function, amongst other things.

Iron overload can be a common problem in many of these metabolic horses but not all horses are routinely tested, so we really do not know the scope of the issue.  Iron overload in the horse can happen due to a variety of reasons from my point of view.

1. Gut dysfunction with increased intestinal permeability due to microbiome imbalance and inflammatory changes which then leads to increased absorption of iron.
2. Chronic inflammatory changes in the body which impair iron utilization and elimination from the body of the horse, contributing to a buildup of iron levels.
3. Feeding of high levels of synthetic pure iron in the form of vitamin-mineral supplements, ration balancers, and other synthetic or artificial based supplements.

Iron, when in high levels in the horse’s body, can contribute to many health ailments, including ongoing chronic inflammation and cellular changes.  Iron itself, is a metal, and will catalyze many reactions, which are not always favorable, and contribute to toxicity and damaging many organs in the horse.  There is no question that a high iron level in the horse are potentially harmful, but is our approach the right one?

In most situations where a metabolic horse demonstrates a high iron level, the approach to remedy the problem is to reduce or eliminate high-quality forage.  Then, the horse is placed on a dry lot with no pasture access and supplemented a grain of some type along with a ration balancer or vitamin-mineral supplement.  Does this approach work?  Simply put, no it does not.  If it did, then we wouldn’t have a problem but the truth is that this approach has been used in the metabolic horse for the past 30 years with no further benefits today than then.

There are two types of iron present in the diet being heme and non-heme iron.  There is a really nice explanation found on this page for humans with hemochromatosis.  Heme based iron is more readily absorbed in the body while non-heme iron is slower to absorb.  Heme based iron is found in meat, which is common to the human diet, but given that horse’s do not consume meat or fish, you have to question the source of heme-based iron.  To me, this source is plainly evident in the vitamin-mineral supplements and ration balancers that owners are using as the iron form utilized in these blends is the heme-based form.  Additionally, most owners are using a vitamin-mineral supplement, but then are often also using a ration balancer, or even a joint or anxiety supplement that may contain the same heme-based iron.  In truth, from my perspective, most horse owners are overloading the average horse with iron just through these supplements.  The form of iron found in these supplements is readily absorbed and when given in the presence of digestive issues and increased permeability (leaky-gut syndrome), the issue is compounded.

The solution here is something which we have talked about for some time, and that is altering the diet by cleaning it up, moving to more whole-foods and higher quality forages, and addressing gut health in the horse.  Essentially, your horse will get their nutrients from real food and forage, rather than from a synthetic-based supplement.  This approach applies to all horses, not just to those with metabolic syndrome, after all, almost every metabolic horses starts off physiologically as being perceived as healthy.

In my clinical experience, by stopping the ration balancers, the vitamin-mineral supplements, and all other synthetic based supplements, we are able to reduce the intake of the heme-based iron dramatically.  Now, the only other real source would come from contaminated water sources, but this can usually be resolved or at least dramatically improved by installing a whole-house water filter.

Then, after removing these synthetic based supplements, the horse is moved to a higher-quality forage, such as alfalfa or an alfalfa mix, which will provide high levels of non-heme iron.  This form of iron is available to the body but slower to absorb, which means it has less of a tendency to increase iron levels.  Additionally, by feeding a higher quality forage, especially alfalfa and other whole foods, the horse will be receiving other nutrients, protein, and phytochemicals that can impact their health and inflammatory status positively.  It is a win-win situation.

Going one step further, digestive health must be addressed.  The years of feeding the grains and synthetic based supplements, along with a depressive lifestyle, have negatively impacted your horse’s digestive microbiome.  This is contributing heavily to the ongoing chronic inflammation and metabolic changes.  Correct this and you are one huge step closer to helping your horse.  After removing all of the synthetic based supplements, the grains, and improving forage quality, I usually recommend a supplement like Cur-OST EQ Tri-GUT as a starting point to helping to restore and rebalance digestive health in the horse.  It is a great supplement and can impact many pathways in the horse, even if they are not the metabolic type…yet.

Additionally, one more perspective to convey the connection between inflammation, digestion, metabolism, and iron overload.  In a research article, it was noted that the combination of Curcumin, which is a phytochemical from Turmeric, with Resveratrol, which is a polyphenol from grapes and other fruits, iron overload could be greatly reduced.  It was also noted that body mass and bone health were additionally improved, which is also a problem noted in metabolic horses.  This research further substantiates the connection between chronic inflammation, oxidative stress and iron overload, not to mention metabolic syndrome.  When we look further into research, it is also noted how Curcumin and Resveratrol, amongst many other herbs, also influence digestive health and the microbiome.  An herbal formula such as the Cur-OST EQ Inflammend, which combines high levels of Curcumin with Resveratrol, could prove very beneficial in these cases of iron overload in the horse.

Iron overload in the metabolic horse is a problem, but with the right approach, the issue can be greatly improved, along with the overall health of the horse.  The approach is not complex, but does require a certain level of understanding and willingness to step outside the traditional box of therapies offered or accepted by others.  Just remember, the definition of insanity is doing the same thing over and over, but expecting a different result.  We’ve been using this standard approach in the metabolic horse for over thirty years, its time for a change.

Author:  Tom Schell, D.V.M, CVCH, CHN