People often feel weak and tired.
Diagnosis is with blood tests to measure iron level.
Treatment is usually with drugs that bind and remove iron from the body (chelation).
Severe complications are less likely than in people who have hemochromatosis Hemochromatosis Hemochromatosis is a hereditary disorder that causes the body to absorb too much iron, causing iron to build up in the body and damage organs. In the United States, over 1 million people have... read more 
, a genetic disorder that causes iron overload. (See also Overview of Iron Overload Overview of Iron Overload Iron is essential for life, so the body usually tightly controls iron absorption from food and recycles the iron from red blood cells. People lose small amounts of iron every day, and even a... read more .) However, some people develop complications involving the heart, the liver, and endocrine organs.
Causes of Secondary Iron Overload
Secondary iron overload typically occurs in people who have disorders that impair red blood cell production such as
Inherited disorders of hemoglobin structure or function (for example, sickle cell disease Sickle Cell Disease Sickle cell disease is an inherited genetic abnormality of hemoglobin (the oxygen-carrying protein found in red blood cells) characterized by sickle (crescent)-shaped red blood cells and chronic... read more
, thalassemia Thalassemias Thalassemias are a group of inherited disorders resulting from an imbalance in the production of one of the four chains of amino acids that make up hemoglobin (the oxygen-carrying protein found... read more , or sideroblastic anemias Overview of Anemia Anemia is a condition in which the number of red blood cells is low. Red blood cells contain hemoglobin, a protein that enables them to carry oxygen from the lungs and deliver it to all parts... read more ) Disorders that cause abnormal breakdown of red blood cells (hemolytic anemias that are present from birth such as hereditary spherocytosis or pyruvate kinase deficiency—see table More About Some Causes of Anemia More About Some Causes of Anemia
)Disorders caused by poorly formed red blood cells (myelodysplasia Myelodysplastic Syndrome (MDS) Myelodysplastic syndrome refers to a group of related disorders in which abnormal blood-forming cells develop in the bone marrow. At first, these cells interfere with the production of normal... read more )
In such disorders, the body sometimes increases the amount of iron it absorbs. However, the body cannot always use all of the iron because of the difficulty of producing new red blood cells. In such cases, iron overload can occur.
Iron also can accumulate in the body when people take in too much iron from
Iron therapy given in excessive amounts or for too long
Men and postmenopausal women do not usually need to take iron supplements. If they do take supplements, they may have excess iron in the body, although usually not enough to be dangerous.
Symptoms of Secondary Iron Overload
People with mild iron overload usually have no symptoms. Others typically feel weak and fatigued. Severe iron overload causes the same symptoms as in hemochromatosis Symptoms Hemochromatosis is a hereditary disorder that causes the body to absorb too much iron, causing iron to build up in the body and damage organs. In the United States, over 1 million people have... read more :
Bronze-colored skin
Joint pains
Diagnosis of Secondary Iron Overload
Blood tests
Secondary iron overload is diagnosed by tests that measure blood levels of
Iron
Ferritin, a protein that stores iron
Transferrin, the protein that carries iron in blood when iron is not inside red blood cells
Treatment of Secondary Iron Overload
Removal of blood or chelation
The goal of treatment is to reduce the body's iron content. For some people, treatment is to remove blood (phlebotomy). However, many people with secondary iron overload also have anemia Overview of Anemia Anemia is a condition in which the number of red blood cells is low. Red blood cells contain hemoglobin, a protein that enables them to carry oxygen from the lungs and deliver it to all parts... read more . Because phlebotomy worsens anemia, these people are given iron chelation therapy Chelation Therapy Chelation, a biologically based practice, describes a chemical reaction in which certain molecules bind to metal atoms (such as calcium, copper, iron, or lead). Chelating drugs, such as ethylenediaminetetraacetic... read more .
Iron chelation may be given by mouth using deferasirox or deferiprone or by an infusion of deferoxamine, which can be given under the skin (subcutaneous) or into a vein (intravenous). Sometimes deferasirox and deferiprone can be given together.
Iron chelation drugs given by mouth are very effective in lowering the iron level in the body. Side effects of oral iron chelation include abdominal pain, diarrhea, and rash. The treatment sometimes causes liver and kidney damage, so blood tests are done periodically to monitor the function of these organs.
Deferoxamine infusion for iron chelation is usually given overnight. Side effects include digestive upset, low blood pressure, and severe allergic reaction (anaphylaxis). Sometimes people have hearing and vision loss with long-term use.
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
Iron Disorders Institute: provides information about disorders that cause iron imbalance, including testing and tips for living with these disorders
