Too much iron can cause the body to store too much of this mineral. It is usually caused by a condition called hereditary hemochromatosis, a genetic condition in which a person’s body absorbs too much iron from food and drink.
The body cannot excrete excess iron, so it stores it in certain organs, especially the liver, heart, and pancreas, which can lead to organ damage. Damage to the pancreas can cause diabetes. Excess iron can, without treatment, also turn the skin a bronze color.
With treatment, people with this condition usually recover without problems. Treatments may include drawing blood to lower the body’s iron levels and making dietary changes to reduce intake of this micronutrient.
What is hemochromatosis?
People with iron overload disorders absorb more iron than usual from food or supplements. The body can’t excrete the extra amount fast enough, so it continues to build up. It normally stores it in the tissues of the organs, mainly in the liver, as well as in the heart and pancreas.
There are several types of iron overload disorder. Hereditary hemochromatosis is a primary condition that has a genetic component. People can also have secondary hemochromatosis, which develops as a result of another disease or condition.
Over time, untreated hemochromatosis increases the risk of arthritis, cancer, liver problems, diabetes, and heart failure. The body has no easy way to get rid of extra iron, so the most effective way to get rid of the excess is through blood loss.
Therefore, menstruating women are less likely to experience iron overload. Also, those who donate blood frequently have a lower risk.
There are several types of iron overload disorder, each with different causes.
Hereditary hemochromatosis, also known as primary or classic hemochromatosis, is one of the most common genetic conditions. However, not all people experience symptoms.
This condition mainly affects white people. Hereditary hemochromatosis occurs due to a mutation in a gene called HFE. This gene controls how much iron the body absorbs. Two possible mutations in the HFE gene are C282Y and H63D.
Most people with hereditary hemochromatosis have inherited two copies of C282Y, one from the mother and one from the father. It is not certain that a person who inherits a single defective gene will develop iron overload syndrome, but they will be a carrier and will probably absorb more iron than normal.
Some people inherit a C282Y mutation and an H63D mutation. A small proportion of these people will develop symptoms of hemochromatosis.
According to experts, secondary hemochromatosis can be the result of some types of anemia, such as thalassemia, or chronic liver disease, such as chronic hepatitis C infection or alcohol-related liver disease.
Blood transfusions, taking iron pills by mouth, or receiving long-term iron injections or kidney dialysis can also cause secondary hemochromatosis.
Red meats are not the only foods to worry about. Some nutritious foods can improve absorption and promote iron overload. These include:
- Citrus: Vitamin C is one of the most powerful enhancers of non-heme iron absorption. An intake of 100 milligrams (equivalent to two glasses of orange juice) can increase iron absorption fourfold. Besides citrus fruits, other rich sources of vitamin C are tomatoes and red bell peppers.
- Alcohol – Non-heme iron absorption is increased by about 10% when alcohol is added to a meal. Wine and hard liquor seem to have the same effect.
- Sugar: Sugar and sugar-rich foods can increase non-heme iron absorption by up to 300%.
Beta-carotene found in brightly colored foods like carrots, sweet potatoes, beets, and red and yellow bell peppers is also thought to promote iron absorption. Still, their nutritional benefits outweigh potential risks, and beta-carotene-rich foods are not excluded from the hemochromatosis diet.
Signs and symptoms of iron overload disorder are usually mild, and in most cases, people with excess iron have no symptoms.
The signs usually don’t appear until middle age or, in women, after menopause. Today, people with hemochromatosis are less likely to develop symptoms because the diagnosis is often made earlier than it was a few years ago.
If the condition progresses, the main symptoms are:
- Tiredness or fatigue
- Soft spot
- Abdominal pain
- High blood sugar levels
- Hyperpigmentation, or the skin turns a bronze color
- Loss of libido or sexual desire
- Reduction in the size of the testicles
- Reduced or absent menstruation
Over time, arthritis, liver disease or cirrhosis (permanent scarring) of the liver, enlarged liver, diabetes, hypothyroidism, heart disease, or pancreatitis may develop.
How to avoid?
There are some recommendations that can help control excess iron in the blood:
- Get yearly blood tests to check your iron levels.
- Avoid multivitamins, vitamin C and iron supplements
- Avoid alcohol, which can cause additional liver damage
- Taking care to avoid infections, for example by getting regular vaccinations and following good hygiene practices
- Keep track of iron levels to monitor changes
- Following all doctor’s instructions and keeping all appointments
- Contact a doctor if symptoms worsen or change
- Have a good, balanced and varied diet
- Regular physical exercise
If a person receives early diagnosis and treatment, they will have a normal life expectancy. However, regular blood tests should be done and treatment will usually continue for life. There are several treatments for iron overload disorders.
Phlebotomy, or venesection, is a common treatment to remove iron-rich blood from the body. Typically, this will need to be done weekly until levels return to normal. When iron levels build up again, the person will need to repeat the treatment.
How much blood your doctor takes, and how often, depends on your age and gender, general health, and the severity of your iron overload.
Doctors may remove a pint of blood once or twice a week in the early stages of treatment. After this, they may draw blood every 2 to 4 months. Phlebotomy cannot reverse cirrhosis, but it can improve symptoms such as nausea, abdominal pain, and fatigue.
Iron chelation therapy involves taking oral or injected medications to remove excess iron from the body. Medications may include a drug that binds to excess iron before it is excreted from the body.
Although doctors don’t usually recommend it as a first-line treatment for hemochromatosis, it may be right for some people.
changes in diet
Dietary changes to limit iron intake may help reduce symptoms. Some of these changes may be:
- Avoid supplements that contain iron
- Avoid supplements that contain vitamin C, as this vitamin increases iron absorption
- Reduce iron-rich and iron-fortified foods
- Avoid raw fish and shellfish
- Limit alcohol intake, as this can damage the liver
There are certain dangers and side effects of having an excess of this mineral.
There is no doubt that iron overload can lead to cancer in both animals and humans. It appears that regular blood donation or blood loss can reduce this risk.
Observational studies suggest that a high intake of heme iron may increase the risk of colon cancer . Human clinical trials have shown that heme iron from supplements or red meat can increase the formation of cancer-causing N-nitroso compounds in the digestive tract.
The association of red meat and cancer is a hotly debated topic. Although there are some plausible mechanisms that explain this link, most of the evidence is based on observational studies.
Both iron overload and iron deficiency seem to make people more susceptible to infections. There are two reasons for this:
- The immune system uses iron to kill harmful bacteria, so a certain amount of iron is needed to fight infection.
- High levels of free iron stimulate the growth of bacteria and viruses, so too much iron can have the opposite effect and increase the risk of infections.
Several studies indicate that iron supplementation may increase the frequency and severity of infections. People with hereditary hemochromatosis are also more susceptible to infections.