Dysmetabolic Iron Overload

IRON USA 2000 “…fatty liver disease is going to be the next big health issue.” Herbert Bonkovsky, MD Chair Iron Disorders Institute Scientific and Medical Advisory Board


Iron Deficiency anemia

Anemia of Chronic Disease

Iron Overload 

Iron Avidity

Dysmetabolic Iron Overload

Dysmetabolic Iron Overload Syndrome (DIOS) is characterized by an elevated serum ferritin accompanied by a transferrin-iron saturation percentage (TS%) within normal range (25-35%); some research investigators note that the TS% can be slightly elevated.  Most at risk for DIOS are adult males or postmenopausal females. People with DIOS are generally overweight with abdominal fat most prominent; fat on the nape of the neck might be present.  Other presentations may include type II diabetes mellitus, elevated lipids including triglycerides, elevated blood pressure, elevated uric acid, elevated insulin, elevated urine levels of hepcidin, and they will likely also have an elevated liver enzyme gamma glutamyl transferase (GGT), possibly due to a fatty liver.


DIOS is similar to NAFLD (non-alcoholic fatty liver disease) in some ways. Individuals with these conditions often report little to no consumption of alcoholic beverages.  Alcohol increases the absorption of iron and accelerates oxidation (of fats) leading to liver deterioration when alcohol is consumed in excess. Both DIOS and NAFLD can lead to severe liver disease including non-alcoholic steatohepatitis (NASH), cirrhosis,  liver cancer, and liver failure.

Individuals with DIOS may be helped by blood donation, but diet, and exercise are key to iron and inflammation reduction. See past issue of our newsletter nanograms DIOS below. 

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