Iron overload (mate rino), occurs when too much iron builds up in your body. It is also known as haemochromatosis or high iron levels.
Key points about iron overload
- Iron is needed so red blood cells can carry oxygen around your body and for your immune system function.
- Iron is a mineral found in some foods, such as red meat. Iron can build up in some people’s bodies, causing iron overload (haemochromatosis).
- Haemochromatosis affects about 1 in 200 New Zealanders and is more common in people of Celtic, Anglo and Northern European descent.
- High levels of iron are toxic to organs such as your liver, pancreas and heart.
- Treatment involves giving blood regularly to remove excess iron from your body.
What causes haemochromatosis?
Primary haemochromatosis is the most common form. It is a genetic disorder passed down through families. It results in problems controlling iron absorption from your intestine and iron levels in your blood and body tissues. The abnormal gene is very common, with one in 12 people being a carrier.
Secondary (acquired) haemochromatosis is caused by other conditions (such as thalassemia or some anaemias), or as a result of multiple blood transfusions or long-term alcoholism.
What are the symptoms of haemochromatosis?
While haemochromatosis can occur in people of all age groups, it tends to be detected in men between the ages of 30–50 years and doesn't usually cause symptoms in women until they are over the age of 60. The symptoms can include:
- lack of energy
- joint pain
- unexplained stomach pain
- darkening of skin colour (often referred to as bronzing)
- reduced sex drive
- early menopause
- decrease in size of testicles
- weight loss.
How is haemochromatosis diagnosed?
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 see how much iron is stored in your body. To confirm a diagnosis, you need a blood test to see if you carry the haemochromatosis genes.
Sometimes other tests are needed such as:
- blood glucose level
- liver function tests
- echocardiogram (ECHO) to check your heart function
- electrocardiogram (ECG) to check the electrical activity of your heart
- liver or abdominal ultrasound.
Screening for haemochromatosis
If your brother or sister has haemochromatosis, talk to your doctor about 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). Other close family/whānau members may be screened as well.
What is the treatment for haemochromatosis?
The key goal of treatment for haemochromatosis is to remove excess iron from your body and treat any organ damage. The simple way to do this is by giving blood regularly. This is also known as venesection or phlebotomy.
To start with, this may need to be done once a week, until the iron levels and iron stores in your body are back to normal. This procedure can then be done less often, depending on how much iron is in your food and how your body responds to it. Once your iron levels are back to normal, they will be tested regularly and you may need to have more blood removed from time to time.
If haemochromatosis goes undetected, iron builds up in organs and body tissues and, over time, this can lead to:
- liver cirrhosis
- heart disease
- liver cancer in those with haemochromatosis and cirrhosis.
What is the outlook for someone with haemochromatosis?
If you have the inherited form of haemochromatosis it is a lifelong condition that cannot be cured. But early diagnosis and treatment can avoid symptoms and complications. If complications such as diabetes or liver scarring have already developed, they can’t be cured by removing blood. So, it is important to consult a doctor early if you think you may have haemochromatosis or if somebody in your family/whānau has it.
Self-care for haemochromatosis
If you have haemochromatosis, you may be advised that diet has not been effective 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).
- Reduce red meat.
- Limit or stop drinking 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).
It also helps to:
- keep active
- get support to stop smoking
- maintain a healthy weight.
|Dr Sharon Leitch is a general practitioner and Senior Lecturer in the Department of General Practice and Rural Health at the University of Otago. Her area of research is patient safety in primary care and safe medicine use.|