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High blood iron: when should you worry?

High blood iron: when should you worry? We often talk about problems related to low iron values, but even high blood iron can cause some disorders. Let’s find out the causes and symptoms of high iron and what to do in cases of iron overload

What are the causes of high iron and the mechanisms leading to iron overload?

High iron or iron overload occurs when iron values are higher than normal. Iron overload is usually a condition that occurs when the mechanisms for regulating the metabolism of this essential mineral do not work well. In such cases, there is a surplus of iron in the body that causes damage to cells of different severity, depending on the amount of excess iron. 

In normal health conditions, iron circulates throughout the body bound to a protein: transferrin. In conditions of overload, however, transferrin can no longer bind all the iron circulating in the body. Consequently, “free” or “unbound” iron (NTBI) begins to circulate in the body: Non-Transferrin Bound Iron) which can promote oxidative stress on cells and thus also damage tissues. 

High iron in the blood may be due to:

  1. Hereditary hemochromatosis or primitive overload. 
    This is a metabolic disease with a genetic basis that can generate an excessive accumulation of iron caused by increased iron absorption in the intestine. The symptoms of high blood iron are apathy, asthenia, abdominal pain, hepatomegaly (increased liver volume) and abnormal liver enzymes. In the more advanced stages, when the overload is more severe, cirrhosis of the liver, diabetes mellitus (hemochromatosis is also known as bronzine diabetes due to of the bronze colour of the urine and skin), loss of libido and, in women, amenorrhoea (absence of menstrual cycle) can occur. Hereditary hemochromatosis is a rare genetic disease that especially affects, with obvious clinical symptoms, males aged between 40 and 60 years. 
  1. Secondary iron overload 
    Haemosiderosis (also known as secondary haemochromatosis or secondary overload) can be caused by repeated blood transfusions. Blood transfusions also contain iron, an element used by the body to produce the haemoglobin present in red blood cells. Some types of hereditary anaemia, which have severe haemoglobin deficiencies (e.g., homozygous beta-thalassemia) require continuous blood transfusions that can lead to secondary iron overload.

    Secondary iron overload can also develop independently of blood transfusions. This is the case with anaemia with reduced red blood cell production. In these cases, the symptoms are similar to those of hereditary haemochromatosis and may be aggravated by the damage caused by the anaemia. 

The clinical picture related to an iron overload is more or less serious depending on the amount of free iron in the body and the duration of the overload. The organs most affected in cases of serious and prolonged high blood iron conditions are: the liver, heart and pancreas. In cases of high iron , the doctor will make the diagnosis by carrying out an accurate medical history of the patient.

Can high blood iron be caused by excessive dietary intake?

If you are following an iron-rich diet or taking iron-rich dietary supplements, it is unlikely that there will be a surplus of this nutrient. Our body, in normal health conditions, is able to regulate the intestinal absorption of iron in order to prevent overloading. If blood tests show high iron values, the doctor will investigate the causes and assess the most suitable therapy to bring the iron values back to normal. 

What are the remedies for high blood iron?

If laboratory tests indicate high blood iron values, the doctor will proceed with identifying the cause of the iron overload. High iron in the body is often related to hereditary haemochromatosis or secondary overload following blood transfusions. In these cases, the doctor will assess the severity of the overload and proceed with prescribing chelation therapy to reduce the amount of free iron.

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