Iron overload occurs when there’s too much iron in the body. The surplus of iron is stored in the liver, heart, pancreas, and other organs. Your body naturally stores some iron, but it can be harmful to have too much. Some people have a genetic condition that causes them to build up too much iron in their bodies. Iron overload disorder can be primary or secondary. Primary hemochromatosis is more common. Secondary hemochromatosis can result from anemia, liver disease, etc.
People who receive multiple blood transfusions may also be at risk of iron overload. If iron overload lasts a long time or goes untreated, it can damage organs and joints. It may also cause other conditions such as diabetes and fatigue to occur. Your doctor may choose to use a specific treatment depending on the type or cause of your iron overload.
People with hereditary hemochromatosis may absorb up to 30 percent of the iron they consume. The body is not then able to expel the extra iron fast enough, so it builds up.
People with hemochromatosis may eventually build up between up to 20 times the amount of iron they should have. Over time this excess iron can destroy organs, resulting in organ failure and chronic diseases, such as diabetes or heart disease.
Signs and symptoms are often mild. Nowadays, people with hemochromatosis are less likely to develop symptoms, as diagnosis tends to happen earlier than it did in the past.
If the condition advances, the main symptoms include:
- Abdominal pain
- Females may stop menstruating
- High blood sugar levels
- Loss of libido
- Reduction in size of testicles
- Skin becomes bronzed, like a suntan
- Weight loss
In time, other conditions may develop, such as:
- Cirrhosis of the liver
- Enlargement of the liver
- Heart disease
Hemochromatosis can be difficult to diagnose from the symptoms, because these can overlap with symptoms of other conditions.
Blood tests can reveal whether iron levels are too high.
The doctor may refer the patient to a hepatologist, or liver specialist, a or a cardiologist, a heart specialist.
A bronze skin color will be visible in 70 percent of patients with symptoms.
Some tests can help to diagnose hemochromatosis.
Two blood tests can detect iron overload, even before symptoms appear.
- Serum transferrin saturation: Transferrin is a protein that carries iron in the blood. This test measures the amount of iron bound to transferrin. Saturation values over 45 percentare too high.
- Serum ferritin: This blood test measures the amount of iron the body has stored. Serum ferritin levels help diagnose and follow the patient during treatment.
Both tests are needed to diagnose hemochromatosis. Sometimes they need to be repeated for better accuracy, because other diseases and conditions can raise ferritin levels.
These two blood tests are not usually performed routinely unless an individual has a parent, child, or sibling with hemochromatosis.
People with the following signs and symptoms may also have this test:
- Elevated liver enzymes
- Erectile dysfunction, or male impotence
- Extreme tiredness
- Heart disease
- Joint disease
In people who consume excessive amounts of alcohol, those who have had many blood transfusions, or who have had hepatitis C, blood tests may suggest iron overload. Additional tests can help to confirm a diagnosis of hereditary hemochromatosis. Genetic testing can determine whether the patient carries the HFE gene. A liver biopsy can determine iron levels in the liver and reveal any scarring, cirrhosis, or other damage.
Venesection, or phlebotomy, is a regular treatment to remove iron-rich blood from the body. It is like donating blood, but the aim is to reduce iron levels to normal. However, while phlebotomy cannot reverse the symptoms of cirrhosis, it can improve symptoms such as nausea, abdominal pain, and fatigue. It may improve heart function and joint pain.
How much blood is taken and how often depends on the patient’s age, overall health, and the severity of the iron overload. Normally, this happens weekly until levels return to normal. Patients can repeat the treatment as needed.
Medications can include a drug that binds the excess iron before being excreted from the body.
The patient should have regular blood tests, and treatment normally continues for life.
Life expectancy is normal if hemochromatosis is diagnosed and treated early, before too much additional iron accumulates.
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- 23 Aug 2018
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