A hereditary condition called hemochromatosis is characterized by excessive bodily iron buildup and absorption. The disorder interferes with the body’s natural iron metabolism, causing an overabundance of iron to accumulate in a number of organs and tissues, especially the liver, heart, and pancreas. If left untreated, this excess iron can damage and malfunction these organs over time, resulting in significant health issues.
The majority of the time, hemochromatosis is a hereditary illness, meaning that it is handed down from parents to their offspring through genetic abnormalities. Hereditary hemochromatosis (HH), the most prevalent manifestation of the disease, is typically brought on by mutations in the HFE gene. The HFE gene controls how much iron is absorbed in the intestines; when it is altered, this process is disrupted, leading to an excessive iron buildup.
Hemochromatosis symptoms vary based on the extent of iron overload and the organs that are impacted. People may not have any observable symptoms in the early stages. However, symptoms such as exhaustion, joint pain, stomach pain, weakness, and unexplained weight loss might emerge when iron levels rise. Over time, too much iron can lead to more severe issues like diabetes, heart issues, liver cirrhosis, and an even higher risk of some malignancies.
Blood tests that assess ferritin, transferrin saturation, and iron levels are frequently used to identify hemochromatosis. To find certain mutations linked to the illness, genetic testing might also be carried out.
In order to avoid problems, hemochromatosis must be diagnosed and treated early. If you believe you have hemochromatosis or your family has a history of the disease.
Causes of Hemochromatosis
- Hereditary hemochromatosis (associated with HFE):
- Mutations in the HFE gene: The HFE gene generally controls how well iron is absorbed in the intestines. Excessive iron accumulation results from disruptions in the HFE gene, specifically the C282Y and H63D variants.
- Hemochromatosis in children:
- Mutations in the HJV (hemojuvelin) gene make it difficult for the body to control iron levels, leading to iron overload at a young age.
- Hemochromatosis Associated with Transferrin Receptor 2
- Mutations of the transferrin receptor 2 genes increase the absorption and storage of iron by altering the signaling pathways involved in iron metabolism.
- Hemochromatosis Caused by Ferroportin:
- Mutations in the Ferroportin gene: Ferroportin is in charge of removing iron from cells. Impaired iron transport and excessive iron accumulation are the results of mutations in the ferroportin gene.
- a surplus of iron in Africa
- The precise genetic origin of this kind of hemochromatosis, which is primarily seen in sub-Saharan Africa, is still not entirely understood.
Effects for Hemochromatosis
1. Problems with the liver
- Hepatic Iron Overload: Excessive liver iron deposition can result in hepatic iron overload, which can cause inflammation, scarring, and ultimately liver cirrhosis.
- Cirrhosis of the liver can develop as a result of a protracted iron overload in the liver, which can also cause fibrosis, scarring, and deteriorated liver function. Due to this, there is a higher chance of liver cancer and liver failure.
2. Heart and Vascular System
- Cardiomyopathy is a disorder marked by faulty heart structure and function that can be brought on by iron buildup in the heart muscles.
- Hemochromatosis can impair electrical signaling in the heart, which can cause arrhythmias or irregular heartbeats.
3. Dysfunction of the pancreas
- Diabetes Mellitus: An excess of iron in the pancreas can hinder the release and manufacture of insulin, which results in the onset of diabetes mellitus.
4. Bones and Joints:
- Joint Pain and Arthritis: Iron buildup in the joints can result in discomfort, stiffness, and eventually symptoms resembling arthritis.
- Osteoporosis: Hemochromatosis can cause osteoporosis, which increases the risk of bone fractures by causing bone loss.
5. Hormone system
- Hypothyroidism: Iron buildup in the thyroid gland can interfere with its normal operation and cause an underactive thyroid, often known as hypothyroidism.
- Hypogonadism: Hemochromatosis can impact how sex hormones are produced and regulated, which can result in lower libido, infertility, and other related problems.
6. Skin Colour and Pigmentation
- Bronze or Greyish Skin: Hemochromatosis occasionally results in changes in skin pigmentation that give rise to a bronze or greyish coloring.
7. Increased Chance of Specific Cancers:
- Though the precise processes are unclear, hemochromatosis has been linked to a higher chance of developing liver cancer (hepatocellular carcinoma) and perhaps other malignancies as well.
Symptoms of Hemochromatosis
- Hemochromatosis is frequently accompanied by symptoms of chronic fatigue, weakness, or an absence of vitality.
- Joint Stiffness and Pain: Hemochromatosis may result in joint pain, especially in the hands, wrists, knees, and ankles. A tight, bloated, and restricted range of motion in the joints is possible.
- As a result of an enlarged liver or other consequences associated with the disease, certain hemochromatosis patients may have abdominal pain, usually in the upper right quadrant.
- Loss of Libido and Sexual Dysfunction: Hemochromatosis may have an impact on a person’s sexual health and result in diminished sex desire, erectile dysfunction in men, and irregular menstruation periods in women.
- Unexpected Weight Loss: Unexpected weight loss can sometimes happen even when there are no dietary or exercise modifications.
- Changes in Skin Pigmentation: Hemochromatosis can change the color of the skin, especially on the face, hands, and lower limbs, resulting in a bronze or greyish discoloration.
- Fullness in the abdominal region: Hemochromatosis-related liver enlargement can be characterized by a feeling of fullness or pain in the abdominal area, frequently following small meals.
- Heart Issues: Iron buildup in the heart can cause cardiac issues like arrhythmias—irregular heartbeats—heart palpitations, and even cause you to feel breathless.
- Hemochromatosis can impair the body’s capacity to control blood sugar levels, which can result in symptoms like excessive thirst and frequent urination as well as a higher risk of developing diabetes.
- Memory and Cognitive Issues: Some hemochromatosis sufferers may have changes in their cognitive abilities, such as memory issues, trouble concentrating, and mood swings.
Natural remedies for Hemochromatosis
1. Dietary adjustments
- Limit Iron Intake: Steer clear of or consume less iron-rich meals such as red meat, organ meats, and foods with added iron.
- Avoid taking vitamin C with food: Avoid taking vitamin C-rich foods or supplements at mealtimes because vitamin C increases the absorption of iron.
2. Herbal supplements
- Turmeric: Due to its anti-inflammatory characteristics, turmeric may help lessen joint inflammation and pain brought on by hemochromatosis.
- Milk Thistle: Milk thistle is well-known for protecting the liver and may help people with hemochromatosis maintain healthy liver function.
3. Foods High in Antioxidants:
- To assist fight the oxidative stress brought on by iron overload, eat foods high in antioxidants, such as fruits and vegetables.
4. Green tea
- Individuals with hemochromatosis may benefit from some of the antioxidant-rich chemicals found in green tea.
5. Exercising and other physical activities:
- The risk of hemochromatosis-related problems can be decreased with regular exercise, which can also aid with overall health improvement and weight management.
6. Phlebotomy:
- Therapeutic phlebotomy is a common hemochromatosis treatment, despite not being a natural remedy per se. Donating blood frequently can help the body absorb less iron than usual.
Treatment options for Hemochromatosis
1. Clinical phlebotomy
- The cornerstone of hemochromatosis treatment is phlebotomy. To reduce iron levels, regular blood removal from the body is required.
- Phlebotomy treatments may be repeated often at first, typically once or twice per week, until iron levels return to normal.
- Phlebotomy is used less regularly to maintain iron levels once they are within the desired range, typically every two to four months. This helps to avoid iron overload from happening again.
2. Medication to Reduce Iron:
- Iron-chelating drugs may be used to assist eliminate extra iron from the body in situations where phlebotomy is not possible or not enough.
- Chelating substances that bind to iron and facilitate its removal through urine or feces include deferoxamine, deferasirox, and deferiprone.
- When phlebotomy alone cannot control iron levels effectively or in people who cannot undergo phlebotomy owing to other medical issues, iron-chelating medicines are frequently employed.
3. Dietary adjustments
- To assist stop future iron accumulation, it’s vital to keep your intake of iron-rich foods, like red meat and foods fortified with iron, in check.
- Reduced iron absorption can be caused by avoiding vitamin C supplements or eating foods high in the vitamin during meals.
4. Observation and Action:
- In order to evaluate the efficacy of treatment and modify the treatment plan as necessary, regular monitoring of iron levels, liver function, and other pertinent parameters is essential.
- Healthcare professionals may also keep an eye out for any hemochromatosis-related concerns, such as changes in liver function or the emergence of linked diseases like diabetes or cardiac issues.
Lifestyle changes with living with Hemochromatosis
1. Dietary modifications
- Limit Iron-Rich Foods: Limit or cut back on the intake of foods high in iron, such as red meat, organ meats (liver, kidney), shellfish, and meals containing iron.
- Watch Your Vitamin C Intake: When eating, stay away from foods or supplements high in vitamin C because this vitamin helps the body absorb iron.
2. Hydration:
- Drink a lot of water all day long to stay appropriately hydrated. Proper organ function and support for general health are provided by enough hydration.
3. Moderation or avoidance of alcohol:
- Limit your alcohol intake or don’t drink at all. In people with hemochromatosis, excessive alcohol consumption can exacerbate liver damage and raise the risk of consequences.
4. Exercise Frequently:
- Exercise as tolerated and engage in frequent physical activity. Exercise boosts cardiovascular health, improves general health, and can help you control your weight.
5. Monitoring and Conformity
- Maintain scheduled follow-up checkups and medical monitoring to check your iron levels, liver function, and other pertinent factors.
- Follow the directions provided by the healthcare professional for therapeutic phlebotomy or iron-chelating drugs, and take prescription medications as indicated.
6. Managing Stress:
- Use stress-relieving strategies, such as mindfulness meditation, deep breathing exercises, or relaxing hobbies and activities.
- Chronic stress may increase hemochromatosis-related symptoms or consequences as well as have a detrimental impact on one’s general health.
7. Adequate Support:
- To address any emotional or psychological difficulties caused by living with hemochromatosis, seek assistance from medical personnel, support groups, or counseling services.
- People who can help and understand you should hear about your worries and experiences.
Preventions of Hemochromatosis
1. Family screening and genetic testing:
- If you fear you may be at risk for hemochromatosis or if your family has a history of the disease, you should think about getting genetic testing to look for any potential hemochromatosis-related gene mutations. Early detection and prompt action can both benefit from this.
2. Regular medical examinations
- Make appointments with your doctor for routine checkups to evaluate your overall health and determine your iron levels. If you have a history of hemochromatosis in your family or are exhibiting symptoms of iron excess, you should take particular note of this.
3. Clinical phlebotomy
- Therapeutic phlebotomy is a crucial prophylactic strategy after a hemochromatosis diagnosis. Regular blood donations aid in removing extra iron from the body and shield against difficulties brought on by iron overload. Follow the phlebotomy schedule that has been given by your doctor.
4. Dietary adjustments
- Adopt a balanced diet and refrain from consuming too much iron-rich food. Limit your consumption of red meat, organic meats, and meals high in iron.
- If a doctor hasn’t recommended them, stay away from iron supplements.
5. Taking Vitamin C:
- Take care while ingesting foods or supplements high in vitamin C because this vitamin helps the body absorb iron. To lessen iron absorption, avoid eating foods high in vitamin C right before or right after meals.
6. Moderation or avoidance of alcohol:
- Limit your alcohol intake or don’t drink at all. In people with hemochromatosis, excessive alcohol consumption can exacerbate liver damage and raise the risk of consequences.
7. Tests for hepatitis C:
- Get tested for hepatitis C since it can hasten the development of liver damage in people with hemochromatosis.
8. Weight Management with Regular Exercise:
- Maintain a healthy weight while engaging in regular physical activity. Exercise promotes general health and can help prevent or treat hemochromatosis-related problems.
9. Awareness of Medication:
- All medical professionals should be informed of your hemochromatosis diagnosis in order to avoid giving you iron supplements or iron-containing drugs unless your doctor deems them to be required.
*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.
Author Information
Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician and Rajeshwar Rao, Pharm D.