The Truth About Iron Overload

Symptoms, Diagnosis, and Treatment

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As women, we are often reminded about our special need for iron, and so iron overload may seem like the last potential we need to consider. For most of us, it is. Many women consume iron supplements to bridge the gap with no issues. However, for more than 1 million Americans, iron supplementation can have devastating consequences.

According to the Centers for Disease Control (CDC), these individuals have a gene mutation that can cause iron overload, which can lead to hemochromatosis -- a disorder that can result in organ damage due to significant and excessive absorption and storage of iron.

What Iron Overload Is

Iron overload occurs when, after many years, the body absorbs an abundance of iron that builds up in organ tissues such as the heart and/or liver. Iron overload is a serious chronic condition that must be properly diagnosed and treated. Undiagnosed iron overload can lead to hemochromatosis, which is potentially life-threatening.

While the majority of hemochromatosis cases are genetic in origin, as mentioned, other non-genetic causes may be to blame. These can include complications from other blood disorders, chronic transfusion therapy, chronic hepatitis, and excessive iron intake.

The Symptoms of Iron Overload or Hemochromatosis

While there is no distinct set of symptoms that indicate iron overload, early symptoms of iron overload or hemochromatosis include:

  • Fatigue
  • Weakness
  • Weight loss
  • Joint pain
  • Abdominal pain

As iron overload progresses, patients often experience:

Certain conditions are associated with the advanced stages of hemochromatosis. These conditions include:

  • Arthritis
  • Abnormal liver function
  • Glucose intolerance
  • Diabetes
  • Severe fatigue
  • Hypopituitarism
  • Hypogonadism
  • Cardiomyopathy and arrhythmia
  • Liver cirrhosis
  • Liver cancer
  • Heart failure
  • Gray or bronze skin pigmentation

Other factors may influence the progression of hemochromatosis. These factors include:

  • Excess iron in the diet
  • Alcohol consumption
  • Vitamin C intake
  • Infections
  • Iron lost through menstruation or blood donations
  • Environmental factors

How Iron Overload Is Diagnosed

Diagnosing iron overload or hemochromatosis early is essential for preventing many of the disease's potentially life-threatening consequences. Although routine medical checkups do not include testing for iron overload, diagnosis is as simple as running two simple, inexpensive blood tests.

Fasting is required for both the transferrin saturation and serum ferritin blood tests. If you have a close blood relative who has been diagnosed with hemochromatosis, ask your healthcare provider to run these simple and life-saving tests today.

The Treatment for Iron Overload or Hemochromatosis

The preferred treatment for reducing iron levels in hemochromatosis patients is called therapeutic phlebotomy. Phlebotomy is simply the removing of blood from the body. Begun early, phlebotomy prevents much of the damage that is caused by iron overload.

Patients who have no evidence of tissue or organ damage when diagnosed can often expect a full and normal life. Patients who already have organ or tissue damage can stop the progression of hemochromatosis and expect no further damage, a reduction in symptoms, and improved life expectancy once phlebotomy begins.

The usual course of treatment involves the removal of one unit of whole blood once or twice weekly. Phlebotomy continues until all excess iron is removed. Iron levels in the blood are monitored continuously throughout treatment. The length and frequency of treatment are determined by patient age, gender, the reason for diagnosis, and severity of symptoms.

Once normal iron levels are achieved, the frequency of phlebotomy may be reduced to three or four times a year according to individual patient symptoms and levels of hemoglobin and serum ferritin.

Important Note About Iron Supplements

Do not take iron supplements without your doctor's recommendation. Usually, they will be recommended after blood tests show that you are iron deficient. If you are on supplements, make sure to have your iron and hemoglobin levels followed by your doctor.

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Article Sources

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  1. U.S. National Library of Medicine. Hereditary hemochromatosis. Updated February 2019.

  2. Centers for Disease Control and Prevention. Hereditary Hemochromatosis. Updated July 5, 2019.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Hemochromatosis. Updated March 2014.