Iron overload can have primary or secondary causes. The primary cause is most often hereditary hemochromatosis, a genetic disorder of metabolism that causes too much iron to be absorbed from food . Secondary causes include excessive oral intake of iron and repeated blood transfusions. Iron accumulates in endocrine organs, liver and heart. The result is organ damage. Laboratory investigations show an increase in stored iron (ferritin) and a high saturation of the protein that carries iron (transferrin).
Observe your body and energy levels carefully. There is no specific symptom that indicates you have too much iron in your body. Organ damage develops slowly and early symptoms may be subtle. Watch for weakness, increased skin pigmentation and joint pain. Liver tests are useful in assessing the progression of the condition.
While you do not have symptoms, you only need to see your doctor periodically. He or she will recommend that you have blood drawn for assessment of serum iron, ferritin and transferrin saturation.
If you have symptoms associated with hereditary hemochromatosis, increased serum ferritin levels or high transferrin saturation, you need to undergo treatment. The simplest, most effective way to eliminate iron excess is through serial phlebotomy, also known as bloodletting. Blood banks and labs that use the latest equipment are the best settings for this treatment. Usually, 250 mg iron (approximately 500 ml blood) is removed each week. Drink water and rest before and after the procedure.
Be diligent about this series of simple procedures. The overall duration of the treatment varies, depending on your iron levels. The phlebotomy is repeated until iron levels are normalized. It can take weeks or months. After this, it will be done intermittently, just to maintain transferrin saturation levels under 30 percent. This maintenance regimen is essential.
If your iron overload is due to secondary causes, chelation (binding) therapy with deferoxamine or deferasirox will be used. Phlebotomy might not be an option, due to the risk of anemia.
Undergo specific treatment for diabetes, heart abnormalities or erectile dysfunction, if present. These are potential complications of iron overload.
Eat balanced meals. No restriction of iron-containing foods (e.g., red meat) is usually necessary. Alcohol, however, should be avoided, because it increases iron absorption and may further damage your liver.
Tip
If your disorder is hereditary hemochromatosis, advise your family members to get tested, too. Genetic testing is available.
Warning
Never delay receiving treatment for hemochromatosis. Do not take supplements that contain iron.
