Behind Hemingway’s Martini: The Hidden Risks of Hemochromatosis You Should Know About

Sixty-two years ago this week, the world bid farewell to one of its most acclaimed literary geniuses. Ernest Hemingway, a Nobel and Pulitzer laureate, an adventurer, and a craftsman of words, tragically ended his own life in the foyer of his home, leaving behind a legacy that would inspire generations to come.

Hemingway’s life, much like his stories, was imbued with a potent mix of a boundless love for life and an unwavering affinity for alcohol. His penchant for finely balanced cocktails and ice-cold martinis was legendary, their descriptions often pouring into his narratives and becoming the drink of choice for his characters, matching the locale of his writings.

Hemingway’s signature martinis were a constant motif, each seemingly drier than the last. Take for instance Colonel Richard Cantwell in “Across the River and Into the Trees,” who asked for a Montgomery Martini, a staggering blend of 15 parts gin to one vermouth. Or Frederic Henry in “A Farewell to Arms,” who found something “civilized” in the cool and clean taste of a martini.

However, beneath this seemingly romanticised façade, lauded often as commendable bravado, Hemingway was trapped in a life of suffering. Haunted by severe depression, paranoid delusions and bipolar disorder, his physical and mental deterioration was marked by relentless pain and memory loss. Suicide tragically ran in his family, claiming his father, three siblings, and more recently, his granddaughter.

The allure of renowned figures like Hemingway often has us romanticise or downplay their heavy-drinking habits. We either shroud these tortured souls in a veil of misguided valour or hastily label them as victims of addiction, lacking in character. As a performance and wellbeing professional, working with clients battling a spectrum of addictions—from alcohol, gambling, food, to drugs—I find it deeply disheartening that much of Hemingway’s suffering may have been preventable had he been accurately diagnosed with a genetic condition, hemochromatosis, during his lifetime.

Why is Hemochromatosis Significant?

Hemochromatosis, often termed a silent destroyer, involves the excessive accumulation of iron, a crucial element for carrying oxygen and facilitating various chemical reactions within our bodies. But, in abundance, iron can precipitate in and damage various cells throughout the body through a process of oxidation.

Individuals with hemochromatosis can’t regulate iron absorption, leading to its accumulation and consequent damage. Elevated iron levels can disrupt brain function, trigger diabetes, cause cirrhosis of the liver, result in skin discolouration, lead to vision loss and induce debilitating arthritis. These symptoms are often mistakenly attributed to ageing, causing this condition to remain frequently undiagnosed.

Men tend to exhibit symptoms of hemochromatosis earlier than women due to less iron loss. Conversely, women often store less iron because of menstrual and pregnancy-associated losses. However, post-menopause, a woman’s risk of active hemochromatosis increases significantly.

What To Look For

Through routine testing of executives, I frequently encounter hemochromatosis.

Alarmingly, many men and postmenopausal women exhibit elevated stored iron, excessive fatigue, and depression – hallmarks of this under-recognised genetic disorder.

Genetic testing often identifies many of these individuals as carriers of hemochromatosis genes. Despite being the most prevalent genetic condition in Australia, affecting one in 200 individuals, hemochromatosis remains largely under the public radar.

This obscurity is in stark contrast to its high incidence.

To better understand and recognize this condition, look out for the following key indicators:

  • Chronic fatigue: Persistent, excessive tiredness is a common symptom.
  • Joint pain: Often mistaken for arthritis.
  • Abdominal pain: This typically occurs in the upper right quadrant, where the liver resides.
  • Elevated liver enzymes: These are often detected during routine blood tests.
  • Bronze or gray skin color: This can result from iron deposits in the skin. Usually present in advanced hemochromatosis.
  • Loss of libido or impotence: This could be an early sign in some men.
  • Heart problems: Serious complications like arrhythmias or heart failure can occur in severe cases.
  • Endocrine problems: These can result in conditions such as diabetes, thyroid issues, or adrenal insufficiency.
  • Blood testing: Look for elevated blood cells, increased hemoglobin (when not undergoing testosterone replacement therapy), increased hematocrit and serum iron, decreased total iron-binding capacity and elevated ferritin alongside increased transferrin saturation.
  • Iron Saturation: Iron saturation or serum transferrin saturation is the most specific and sensitive blood test for hemochromatosis. A positive test can strongly indicate the presence of the condition.

You can look at recent blood testing to see if any of the above apply to you.

Genetic testing also plays a crucial role in diagnosing hemochromatosis.

This test not only confirms the presence of the condition but also helps understand how efficiently your body absorbs iron and assesses the risks of iron overload issues.

If you have a history of unexplained fatigue and mental health challenges – especially if you’re a middle-aged man or postmenopausal woman, I urge you to rule out this condition as it could literally save your life.

As many of us commit to the common Dry July practice, Hemingway’s tragic tale of depression and alcohol addiction invites us to reflect on our health. Who knows how many of us might be unknowingly carrying a burden similar to his?

Remember, knowledge is our first line of defense.

Understanding the risks and potential symptoms of hemochromatosis can significantly alter our health trajectories, potentially offering life-changing results.