About Iron Overload (IO)
Iron overload can occur in people of any age, any ethnicity, or gender; iron overload is a condition of excess (too much) iron in the body. Excess iron in vital organs, even in mild cases of iron overload, increases the risk for liver disease (cirrhosis, cancer), heart failure, diabetes mellitus, osteoarthritis, osteoporosis, metabolic syndrome, hypothyroidism, hypogonadism, numerous symptoms and in some cases premature death. Iron mismanagement resulting in overload can accelerate such neurodegenerative diseases as Alzheimer’s, early-onset Parkinson’s, Huntington’s, epilepsy, and multiple sclerosis.
Iron overload can be inherited (genetic) or acquired by receiving numerous blood transfusions, getting iron shots or injections, or consuming high levels of supplemental iron. Some of the genetic disorders that result in iron overload include are hereditary hemochromatosis (all types), African iron overload, sickle cell disease, thalassemia, X-linked sideroblastic anemia, enzyme deficiencies (pyruvate kinase; glucose-6-phosphate dehydrogenase) and very rare protein transport disorders aceruloplasminemia and atransferrinemia. None of these conditions should be confused with polycythemia vera (PV), which is not an iron disorder, but a condition where the bone marrow produces too many blood cells (red, white and platelet). People with PV have abnormally high hemoglobin and are at risk for a stroke and progressing to acute myelogenous leukemia (AML). Part of the therapy for PV is phlebotomy.
Symptoms, signs and diseases resulting from too much iron (iron overload):
- chronic fatigue
- joint pain
- abdominal pain
- liver disease (cirrhosis, liver cancer)
- diabetes mellitus
- irregular heart rhythm
- heart attack or heart failure
- skin color changes (bronze, ashen-gray green)
- loss of period
- loss of interest in sex
- hair loss
- enlarged liver or spleen
- adrenal function problems
- early onset neurodegenerative disease
- elevated blood sugar
- elevated liver enzymes
- elevated iron (serum iron, serum ferritin)
The treatment for iron overload is iron reduction therapy. A person’s hemoglobin is key in the physician’s decision of iron reduction therapy. If the patient’s hemoglobin level is sufficient to tolerate blood removal (phlebotomy), the doctor can provide either an order for therapeutic phlebotomies or can recommend that a patient routinely donate blood. When a patient’s hemoglobin is too low for phlebotomy, iron reduction will likely require iron-chelation, which is the removal of iron using specific drugs. In some situations the physician may use a combination of these two therapies.
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