Iron overload

Also known as haemochromatosis

Iron overload is a condition that occurs when too much iron builds up in the body. If undetected, high levels of iron are toxic to the body organs such as the liver, pancreas and heart.

Iron is a mineral found in some foods that our bodies need to work well. The body needs iron for our red blood cells to carry oxygen around our bodies and for proteins in our muscles. Iron is also needed for many other roles including our immune system.

Iron overload affects approximately 1 in 200 New Zealanders and is more common in New Zealanders of Celtic, Anglo and Northern European descent.

Types of haemochromatosis

Primary haemochromatosis is the most common form and is a genetic disorder passed down through families resulting in problems controlling iron absorption from your intestine and iron levels in the blood and body tissues. The abnormal gene is very common with one in 12 of us being a carrier.

Secondary (acquired) haemochromatosis occurs due to other conditions (such as thalassemia, or some anaemias), or as a result of multiple blood transfusions or long-term alcoholism.

Symptoms

While haemochromatosis can occur in all age groups, it tends to be detected in men between the ages of 30–50 years and doesn't tend to produce symptoms in women till over 60 years of age. The symptoms can include:

  • lack of energy
  • fatigue
  • weakness
  • joint pain
  • generalized darkening of skin colour (often referred to as bronzing)
  • reduced sex drive
  • weight loss.

Diagnosis

If someone in your family has iron overload or you think you may have symptoms, see your doctor for a blood test. The main test is an iron saturation test and/or a raised serum ferritin level. To confirm a diagnosis, you will be asked to have a blood test to see if you carry the haemochromatosis genes.

Sometimes other tests are needed such as:

  • blood sugar (glucose) level
  • liver function tests
  • echocardiogram (ECHO) to examine the heart's function
  • electrocardiogram (ECG) to look at the electrical activity of the heart
  • liver or abdominal ultrasound.

Screening

If your brother or sister has haemochromatosis, see your doctor to discuss whether genetic testing is possible. You have a 25% risk of having the disease and 50% risk of being a carrier (able to pass the gene on to your own children).

Treatment

The key goal of treatment for haemochromatosis is to remove excess iron from the body and treat any organ damage. The simple way to do this is by giving blood regularly. This is also known as venesection.

To start with, this may need to be done once a week, until the iron levels and iron stores in the body are back to normal. This procedure can then be done less often, depending on how much iron is in your diet (what you eat) and how your body responds.

A useful record book is available from the NZ support organisation to help you track your haemoglobin and iron levels. 

If haemochromatosis goes undetected, iron builds up in organs and body tissues and, over time, this can lead to:

Self care

If you have haemochromatosis, you may be advised that diet has not proven effect to reduce your iron stores, but you can try the following suggestions:

  • Reduce the iron in your diet by NOT eating foods fortified with iron (such as some cereals).
  • Cut back red meat.
  • Limit alcohol to reduce further stress on your liver.
  • Do not take iron pills, multivitamins or supplements containing iron.
  • Do not use iron cookware.
  • Avoid raw seafood (cooked is fine).

Learn more

Haemochromatosis Leukaemia and Blood Cancer NZ
Haemochromatosis  NHS Choices
Haemochromatosis  National Institute Diabetes & Digestive Disorders, USA
Haemochromatosis  Medline Plus

Credits: Editorial team. Last reviewed: 04 Sep 2015