Blood donations used for high iron

Dear Dr. Roach: I’m a 70-year-old woman. During my annual physical, blood tests showed that my iron levels were extremely high. My doctor did additional blood tests for hemochromatosis and concluded that I didn’t have it. She suggested that I donate blood every three months to keep the iron levels down, which I have been doing for a year. Every time I donate, they comment on how high my iron levels are and ask if I’m taking iron supplements (I’m not) or eating a lot of iron-rich foods (no). I am otherwise healthy, except for aches and pains, and being tired all the time.

With hemochromatosis, iron is deposited in vital organs. Could this be happening to me? — P.C.

Hemochromatosis is a common but often unrecognized genetic condition caused by an inability to regulate iron absorption. Iron is absorbed as much as possible, all the time, even if the body doesn’t need it. You are right that the iron can affect many tissues of the body, particularly damaging the heart and liver, but also predisposing to certain infections and to diabetes. Your aches and pains also are concerning for joint symptoms, common in hereditary hemochromatosis.

I don’t have enough information to comment on how likely it is that you might have hemochromatosis. Blood tests can lead a doctor to suspect the diagnosis, and in some cases, can make the diagnosis with high certainty, such as in a person with iron overload by blood testing (a high ferritin level, and a high percentage of bound iron in the blood) combined with a positive genetic test. The diagnosis also can be made by liver biopsy.

I am concerned that the frequent blood donations may have made it harder to diagnose you, and I’d recommend a consultation with a hemochromatosis expert.