How to treat hemochromatosis

Iron is one of the most important minerals in your body. It helps send oxygen through your bloodstream to your lungs and muscles, helps you grow, and produces many other essential hormones. However, too much iron can lead to uncomfortable symptoms and future complications such as organ damage. This is a disorder called hemochromatosis. 

As serious as it sounds, hemochromatosis is treatable. In this article, we’ll explore hemochromatosis types, treatments, and risks, and why you should see a healthcare provider if you have a family history of the condition. 

What is hemochromatosis?

In hemochromatosis, too much iron is absorbed in the intestines from the food you eat. The extra iron is stored in your heart, liver, and pancreas. Iron is crucial for your body—but excess iron can lead to a range of dangerous complications. Symptoms of hemochromatosis include:

• Joint pain
• Abdominal pain
• Tiredness or fatigue
• Decreased liver function or liver failure
• Sexual dysfunction
• Memory loss
• Darker skin color

“The signs of hemochromatosis can vary and may not be apparent in the early stages,” says Rosmy Barrios, MD, a medical adviser at Health Reporter. “These symptoms and complications highlight the importance of early detection and management of the condition.” 

The most common type is hereditary hemochromatosis (sometimes called primary hemochromatosis), so it’s important to contact your healthcare provider about testing options if you have a family history. The other type is secondary hemochromatosis, which is not inherited and is also known as iron overload—typically from blood transfusions. Your provider can determine the best way to treat you after a few blood tests to determine the type.

How is hemochromatosis treated?

Depending on the type and cause of your disorder, there are a few ways a healthcare provider may treat hemochromatosis. They include phlebotomy, chelation therapy, and diet and supplements.

Phlebotomy

Therapeutic phlebotomy is a process of removing red blood cells, similar to donating blood, to lower iron levels. Iron is carried by the hemoglobin in red blood cells, so the removal of these cells reduces iron levels. Unlike blood donation, individual phlebotomy appointments are quick—but to be effective, your appointments will need to be frequent and consistent. 

“The frequency of these sessions varies depending on individual needs,” Dr. Barrios says. “Regularly removing excess iron from the body helps prevent or reduce organ damage and manage symptoms associated with hemochromatosis.”

It may take time, but therapeutic phlebotomy can relieve fatigue, abdominal pain, and skin discoloration brought on by hemochromatosis. If started early, it can also help slow or prevent some of its more severe complications. 

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Chelation therapy

In some cases, your healthcare provider may recommend chelation therapy to help remove extra iron stored in the body. This is more common in patients with anemia and secondary hemochromatosis, which phlebotomy would not help. 

Iron chelators are medications meant to bind to metals in your bloodstream. There are a few forms of chelators available a healthcare provider may prescribe: 

• Deferoxamine, which is administered subcutaneously through a pump worn for eight to 12 hours a day
• Deferasirox, which can be taken as a tablet (Exjade) dissolved in liquid once a day or as a pill (Jadenu) taken with a light meal  

Once bound to iron in your bloodstream, chelators allow iron to pass through and leave your body when you urinate. This is important because the body can’t expel or get rid of iron on its own.

Chelation therapy has been tested in clinical trials and shown to be very effective, but it’s recommended you talk to your healthcare provider about the potential risks of both chelators. Some patients report vision and hearing difficulties after taking deferoxamine and deferasirox, so be sure to report any side effects to your healthcare provider if you start iron chelation therapy. 

Diet and supplements

Dietary changes and supplements may be recommended by your healthcare provider if you are diagnosed with hemochromatosis. There is no one diet that works across the board for patients, but there are a few popular suggestions that may make a difference if followed regularly. 

For example, you’ll want to focus on adding lower-iron food options into your diet, such as: 

• Beans, lentils, peas, and other legumes
• Dairy products, such as cheese or yogurt
• Low-iron fish, such as tuna, pollock, and salmon 
• Leaner meats, such as turkey or chicken
• Eggs
• Fruits and vegetables

Although the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that most people with hemochromatosis don’t need to drastically alter their diet, watching what you eat can help you avoid additional complications. For example, you may want to avoid red meat, which is high in iron, and excess alcohol, which can cause liver damage. 

Instead of alcohol, opt for tea and coffee, recommends Kevin Huffman, DO, a bariatric physician and founder of Bariatric Food Source. Tannins (and tannic acid) in tea and coffee can inhibit iron absorption, making them a favorable choice for patients with hemochromatosis. 

Additionally, you should avoid iron and vitamin C supplements—on their own or in multivitamins. Like iron supplements, vitamin C can improve iron absorption. If you have iron overload, these supplements may prove dangerous. 

What is the outlook for hemochromatosis?

If you have the gene mutations that cause hereditary hemochromatosis, you won’t be able to prevent it. That said, if you’re aware of a family member with hemochromatosis, you can get ahead of complications with genetic testing. If diagnosed early, phlebotomy can decrease the risk of liver disease brought on by excess iron stores. 

The same can be said with secondary hemochromatosis. If you’re starting to experience an overload from blood transfusions, your healthcare provider can monitor your iron and ferritin levels and figure out a treatment plan. 

Most people who are treated for hemochromatosis have a normal life expectancy. But if you develop cirrhosis or heart disease that may change. These complications may even lead to the need for a liver transplant, which involves its own risks.

Hemochromatosis takes years to present symptoms (around age 40 in men and 60 in women), so it may not be clear there’s an issue until excess iron builds up—which is why it’s important to get tested if you do have a family history so you will get an early diagnosis. Contact your healthcare provider if you think you may be at risk for hemochromatosis.