Iron Overload and Hemochromatosis : Treatment and Self-Care

by CDC

(Page 3 of 5)

Hemochromatosis can be treated simply and successfully. The treatment, called phlebotomy (pronounced "fle-bot-o-me"), removes blood to lower the amount of iron in the body. The treatment is similar to giving blood and is the best way to treat the disease.

If phlebotomy treatment is started before too much iron has built up in the body, it can stop many of the serious problems of hemochromatosis.

• If you have no organ damage and get proper care, you can expect to live a normal life.
• If you already have organ damage, treatment can stop additional damage, but it cannot reverse damage that has already started.
• Even if you have developed serious problems, treatment can lessen many symptoms and improve your quality of life.

Important things to know about phlebotomy treatment for hemochromatosis:

• Drink plenty of water, milk, or fruit juices both before and after the treatment.
• Avoid vigorous physical activity for 24 hours after your phlebotomy treatment.
• Be sure to keep your phlebotomy appointments as directed by your doctor.

Treatment Process

The phlebotomy treatment consists of two phases: an "iron reduction" phase and the long-term maintenance phase.

Iron Reduction Phase

In the iron reduction phase, a health care professional removes about one pint of whole blood, usually once or twice a week.

This phase usually lasts until all of the extra iron stored in your body has been removed. It can take three months to one year, but the time varies from person to person. Age, gender, the cause of the iron overload, and severity of symptoms all affect how long this phase takes. During this phase, your doctor checks your hemoglobin and serum ferritin levels.

Long-term Maintenance Phase

Once the extra iron has been taken out, your doctor will set up a long-term maintenance program to make sure you keep a normal amount of iron in your body.

How often a person needs phlebotomy during this phase varies based on the severity of the symptoms. During this phase, your doctor continues to check your hemoglobin and your serum ferritin levels.

Note

Hemoglobin is a protein that is a found in red blood cells; about 75% of the body's iron is bound to hemoglobin which is involved in oxygen transport from the lungs to the rest of the body.

Regular phlebotomy treatment keeps the amount of iron in your body at a normal level. A normal amount of iron is between 25 and 50 ng/mL (nanograms per milliliter).

• Men usually need to have 3 to 4 pints of blood taken out each year (about once every 3 months) to maintain this level.
• Women may need to have 1 to 2 pints of blood taken out each year (about once every 6 months) to maintain this level.
• Some people, especially older people, may not need to have any more treatments, but they should still have their serum ferritin level checked at least once a year.

If you have hemochromatosis, you should have your serum ferritin level checked at least once a year. Doing so can help keep your iron level within the normal range and avoid the serious problems caused by too much iron.

Donating Blood

Many patients and their doctors ask if it is safe for people with hemochromatosis to give blood. The U.S. Food and Drug Administration (FDA) has stated that blood from hemochromatosis patients can be used for people needing blood if the facility where the blood is donated meets the following rules:

1. The blood collection center cannot charge a fee for collecting the blood.

2. The blood center must apply to the FDA to be exempt from the existing rules.

Key Point

Most people with hemochromatosis should be checked at least once a year to be sure that their iron level is within the normal range. If the iron level is too high, phlebotomy treatments are needed to keep extra iron from building up in the body.

Self-Care Tips

There is much you can do to make sure your life is as normal and healthy as possible.

Check-ups: Have the amount of iron in your blood checked regularly.

Phlebotomy: Make sure to get phlebotomies when you need them.

Iron pills: Don't take iron pills, supplements, or multivitamin supplements that have iron in them. Eating foods that contain iron is fine.

Vitamin C: Vitamin C increases the amount of iron your body absorbs. Avoid taking pills with more than 500 mg of vitamin C per day. Eating foods with vitamin C (such as oranges) is fine.

Food: Don't eat raw fish or raw shellfish. Cooking destroys germs harmful to people with hemochromatosis. People with hemochromatosis are at greater risk for bacteremia, a bacterial infection of the blood stream.

Alcohol: If you choose to drink alcohol, drink very little. Women should have no more than one drink a day. Men should have no more than two drinks a day. However, if you have liver damage, do not drink any alcohol.

Exercise: You can exercise as much as you want. The CDC and the American College of Sports Medicine offers the following physical activity recommendations:

Adults should engage in moderate-intensity physical activities (indicated by some increase in breathing or heart rate) for at least 30 minutes on most preferably all days of the week.

Key Point

Phlebotomy is the best treatment for hemochromatosis. Hemochromatosis cannot be treated by changing your diet alone.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.