Could Randy Travis be suffering from hereditary hemochromatosis?

PLEASE NOTE: This article does not say Randy Travis has hemochromatosis.

As you may know, Randy Travis is a successful American country music singer, songwriter and actor (if you didn't know, check out the Randy Travis page on Wikipedia).

You may also know that Mr. Travis has had some serious health problems of late, notably a stroke and brain surgery after being admitted to hospital in Texas with presumptive cardiomyopathy and congestive heart failure. Naturally, I was saddened to hear of Mr. Travis' health problems, particularly since they are pretty severe for someone who is relatively young (when you get to 6o, as I did recently, then 50-something is relatively young). However, what made me sit up and pay close attention was three pieces of information:

  1. An article I had recently read, about cardiomyopathy and hemochromatosis.

  2. Mention of a family history of heart problems by one of the doctors treating Mr. Travis.

  3. The Wikipedia reference to the fact that Mr. Travis is of Cornish ancestry.

Taken together, these three items add up to reasonable grounds for considering hereditary hemochromatosis, which causes excess iron to be deposited in various organs, to be a potential factor in the poor health of Mr. Travis.

PLEASE NOTE: I am not saying Randy Travis has hemochromatosis.

I have a great deal of respect for the privacy of others, even celebrities. I would not speculate about the health of Mr. Travis if I thought it was an invasion of his privacy, but failure to raise the possibility of hereditary hemochromatosis playing a role in his health problems in the light of those three items strikes me as a bigger sin than speculation could ever be.

Let me address item 3 first. Wikipedia states that Mr. Travis is a descendant of an immigrant from the county of Cornwall in England by the name of Robarde Traweek, "whose son Robert was born in 1700 in Stafford County, Virginia and died in 1788 in Onslow County, North Carolina, establishing the North Carolinian roots of the Traywick family."

As regular readers of this blog will know, hereditary hemochromatosis is particularly prevalent in people of Celtic ancestry (hence the phrase Celtic Curse). I think I am correct is saying that in Ireland, 1 in 10 people are thought to carry at least one HFE mutation, and 1 in 83 are homozygous, which means they have two copies of the mutation, compared to 1 in 200 in the general population of Europe and around 1 in 250 among North Americans.

What some readers may not realize is that Cornwall is considered one of the six Celtic nations: Ireland, Scotland, Isle of Man, Wales, Cornwall and Brittany. In other words, people from Cornwall may have a higher than average incidence of genetic hemochromatosis (to be honest, I could not find any studies which specifically studied HFE in people of Cornish descent, but I think there is sufficient basis for supposition).

Now for item 1, the medical literature which discusses connections between cardiomyopathy and hereditary hemochromatosis. Fortunately there is a very detailed article available online: Iron Overload Cardiomyopathy: Better Understanding of an Increasing Disorder, published in the September, 2010 issue of the journal of the American College of Cardiology. Here's part of the abstract:
The prevalence of iron overload cardiomyopathy (IOC) is increasing. The spectrum of symptoms of IOC is varied. Early in the disease process, patients may be asymptomatic, whereas severely overloaded patients can have terminal heart failure complaints that are refractory [resistant] to treatment. It has been shown that early recognition and intervention may alter outcomes.

Not all cases of iron overload cardiomyopathy are due to hereditary hemochromatosis, but when dealing with cardiomyopathy it makes sense to bear in mind the presence of other risks factors for HH, like Celtic ancestry, family history, and as well as elevated iron and ferritin levels.

And now to item 2, which comes from statements reported in the press, to the effect that images of Mr. Travis' heart do not display "the appearance of either drugs or alcohol causing the heart condition." This is in the same article that reports "Mr. Travis does have a family history of cardiomyopathy, and it is more likely related to that."

So, why write about all this?

1. Awareness and education: The popularity enjoyed by Mr. Travis means that a lot of people are following his recovering very closely, particularly if they or a loved one has similar health problems. That strikes me as an opportunity to raise awareness of hemochromatosis as a possible factor in such cases. I know plenty of people who, in hindsight, wish they had heard of hemochromatosis when a loved one was suffering with severe heart problems.

2. Illumination: As we have noted before on Celtic Curse, hemochromatosis can cause heart and liver problems that might appear to come from drinking. For example, HH can cause liver problems that doctors ignorant of HH ascribe to drinking. I know of cases in which doctors have told relatives that a patient is a secret drinker when he is not, and the problem is actually undiagnosed HH. Of course, Mr. Travis has had well-documented problems with alcohol, and excessive alcohol consumption is never good, particularly if you have HH and are experiencing iron overloading. However, drinking my not be the cause of Mr. Travis' health problems.

3. Finding the good in the bad: We wish Mr. Travis a speedy recovery, and if it should turn out that he does have hereditary hemochromatosis, we hope he uses his fame to educate more people about this under-diagnosed condition. Remember, "early recognition and intervention may alter outcomes."




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