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Iron Overload (IO)

Iron Overload (IO): Causes, Symptoms, Complications, and Treatment

What is Iron Overload (IO)?

Iron Overload (IO), also known as hemochromatosis, is a condition in which the body accumulates excessive iron. Since the body has no natural way to excrete excess iron, it builds up in organs over time, potentially causing serious damage168.

Causes

• Genetic (Primary) Hemochromatosis:
  Most often caused by mutations in the HFE gene (especially C282Y and H63D), leading to increased intestinal absorption of iron67.
• Secondary (Acquired) Iron Overload:
  • Frequent blood transfusions (transfusional iron overload), common in conditions like thalassemia or sickle cell disease8.
  • Excessive iron supplementation (iatrogenic).
  • Certain red cell disorders.

Symptoms

Symptoms often develop gradually and may not appear until significant organ damage occurs. Common symptoms include367:

• Fatigue and weakness
• Joint pain
• Weight loss
• Abdominal pain (especially right upper quadrant)
• Skin darkening (“bronze diabetes”)
• Erectile dysfunction or irregular periods
• Mood changes, depression, or “brain fog”

Complications

If untreated, iron overload can lead to serious organ damage, including368:

• Liver: Cirrhosis, liver failure, and increased risk of liver cancer (hepatocellular carcinoma)
• Heart: Irregular heart rhythms, heart failure
• Pancreas: Diabetes mellitus
• Joints: Arthritis
• Hormone glands: Hypogonadism, hypothyroidism, fertility problems

Diagnosis

• Blood tests: Elevated serum ferritin and transferrin saturation
• Genetic testing: To confirm hereditary hemochromatosis
• Liver function tests: To assess liver damage
• Imaging or biopsy: In advanced cases to evaluate organ involvement

Treatment

• Phlebotomy (Venesection):
  The mainstay of treatment for most forms of iron overload. Regular removal of blood (similar to blood donation) helps lower iron stores. Initially, this may be done weekly, then less frequently for maintenance25678.
• Chelation Therapy:
  Medicines that bind and remove iron from the body, used when phlebotomy is not possible (e.g., in patients receiving regular transfusions)468.
• Lifestyle modifications:
  • Avoid iron and vitamin C supplements
  • Limit alcohol intake (alcohol accelerates liver damage)
  • Avoid foods with added iron (e.g., some breakfast cereals)6
• Treat complications:
  Managing diabetes, hormone deficiencies, or heart failure as needed.

Prognosis

Early diagnosis and treatment can prevent most complications and allow a normal life expectancy. If diagnosis is delayed and organ damage is advanced, prognosis worsens, especially with liver cirrhosis or heart failure26.

Summary Table

Aspect	Details
Causes	Genetic (HFE mutation), frequent transfusions, excessive supplementation, red cell disorders
Symptoms	Fatigue, joint pain, weight loss, abdominal pain, skin darkening, hormonal changes
Complications	Liver cirrhosis/cancer, heart failure, diabetes, arthritis, hormone problems
Diagnosis	Blood tests (ferritin, transferrin saturation), genetic testing, organ assessment
Treatment	Phlebotomy, chelation therapy, lifestyle changes, manage complications
Prognosis	Good if treated early; poor if advanced organ damage

Consult with Our Team of Experts Now!
At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about Iron Overload or would like more information on our services, consult with our experts today!

Consult with Our Team of Experts Now!

References:
1 Cleveland Clinic
2 StatPearls (NCBI)
3 MSD Manuals
4 StatPearls (NCBI)
5 Mayo Clinic
6 NHS
7 Apollo Hospitals
8 UCLH

In summary:
Iron overload is a potentially serious but treatable condition. Early recognition and regular treatment (usually by phlebotomy) can prevent life-threatening complications. If you have symptoms or a family history of hemochromatosis, consult your healthcare provider for testing and management.