Controlling iron Overload
Too much iron can be as bad as too little
The gradual build-up of iron levels in the body over many years is a hereditary condition known as haemochromatosis. It’s one of the most common genetic disorders and affects around one in 200 people – especially those from a Celtic/European background. The faulty gene causes us to absorb twice as much iron as we need. This much extra iron is thought to increase free radical chemicals in the body, linked to ageing and many diseases. But the excess builds up gradually from childhood, so symptoms take years to appear – often in our thirties or forties, or even later in women, as we lose some iron in our periods.
In 90% of cases, the HFE gene is to blame, but other mutations are sometimes involved. You won’t develop haemochromatosis unless you get two doses of the faulty gene, one from each parent. A single dose means you’re a carrier, with a one in two chance of passing on that single dose. If your partner is a carrier too, your children have a one in four chance of getting the double dose.
These come on slowly and may seem vague at first, or resemble other medical conditions that affect us from midlife onwards. Early symptoms include feeling constantly tired, joint pains, weight loss, and irregular or absent periods. As the deposits increase in your skin, you may develop a permanent tan. In other organs, however, these deposits can produce serious complications. Your liver may develop scarring and stop working properly, which can lead to cirrhosis or, in rare cases, cancer.
You’ll notice tummy pain, nausea, jaundice (yellow eyes and skin) and itching. As your pancreas becomes affected, you may develop high blood sugar and diabetes. Joints feel stiff and painful and heart-muscle damage
may lead to heart failure with chest pain, breathlessness, ankle swelling and palpitations. Men develop erection problems, and both sexes lose their libido.
This involves removing iron from your body. It’s like giving a 500ml blood donation, weekly at first, then every two months or so. If this isn’t effective, you may be prescribed chelation therapy (tablets to make you excrete iron). Many of your symptoms will improve, but you may need treatment for diabetes, heart failure or other complications. You’ll need to avoid iron, vitamin C supplements and fortified cereals containing iron. Your doctor may also advise against drinking tea, coffee and alcohol with meals, as well as avoiding iron-rich foods (red meat, liver and kidneys) and raw shellfish.
The Haemochromatosis Society can provide support (helpline 03030 401 102; haemochromatosis.org.uk).
Dr Melanie Wynne-Jones has over 30 years’ experience as a GP
The condition is caused by the faulty HFE gene Cirrhosis of the liver Skin darkening Loss of libido Iron is used to make red blood cells in the bone marrow Irregular heartbeat or heart failure High blood sugar and/or diabetes Joint pain