Excess Iron in the Body: Causes, Symptoms, Treatment and Diet

Hemochromatosis represents a systemic metabolic disorder characterized by dysfunction of the physiological pathways governing iron homeostasis within the body. This regulatory failure results in the pathological deposition of iron ions (Fe²⁺/Fe³⁺) in the parenchyma of internal organs—most notably the liver, pancreas, heart, and endocrine glands. Chronic tissue exposure to excess free radicals generated via Fenton chemistry triggers a cascade of oxidative damage, which ultimately progresses to potentially fatal multiorgan failure if left unmanaged.

Within clinical practice, two distinct forms of hemochromatosis are recognized, each exhibiting divergent etiologies. **Primary (idiopathic) hemochromatosis**, historically referred to as "bronze diabetes," represents one of the most prevalent congenital metabolic disorders characterized by an autosomal recessive inheritance pattern [3]. Its pathophysiological basis lies in the dysregulation of iron homeostasis mechanisms, resulting in uncontrolled, excessive absorption of dietary iron at the intestinal level. **Secondary (acquired) hemochromatosis**, also termed siderosis, manifests as a pathological syndrome of iron overload within tissues, precipitated by exogenous factors—most notably chronic over-supplementation or repeated blood transfusions. Conditions frequently associated with this syndrome include: **chronic viral hepatitis C** (less commonly hepatitis B), **non-alcoholic fatty liver disease (NAFLD)**, **alcoholic cirrhosis**, and **porphyria cutanea tarda**. A particularly high-risk cohort comprises patients undergoing recurrent blood transfusions, among whom "there exists a substantial risk of developing symptoms linked to iron overload" [2].

The genetically determined disorder is present from birth, yet owing to the non-specific and paucisymptomatic presentation in its early phases, pre-clinical detection of hemochromatosis poses substantial diagnostic challenges. Medical literature indicates that initial manifestations encompass systemic exhaustion of the organism (excessive daytime somnolence, accelerated fatigability during physical exertion) alongside persistent arthralgias. Biochemical blood analyses reveal elevated liver transaminase activity, potentially indicative of subclinical hepatic parenchyma damage. The full symptomatic spectrum of classical hemochromatosis typically emerges only between the fourth and sixth decades of life, when total body iron accumulation reaches 40–60 grams. Advanced-stage disease is characterized by a diagnostic triad: bronze-colored hyperpigmentation of the skin (so-called "bronze diabetes"), metabolic derangements culminating in type 2 diabetes mellitus, and cardiovascular complications (cardiomyopathy, arrhythmias). Additionally, progressive hepatic failure ensues with cirrhosis development, significantly elevating the risk of malignant transformation toward hepatocellular carcinoma (HCC) and consequently reducing life expectancy.

The cornerstone of therapeutic intervention for primary hemochromatosis consists of scheduled phlebotomy sessions performed one to two times weekly, coupled with rigorous monitoring of biochemical serum markers and complete blood count parameters. Each 500-milliliter blood withdrawal procedure facilitates the removal of approximately 250 milligrams of excess iron from the body. The clinical efficacy of this approach is critically dependent on the degree of preexisting organ damage at the commencement of treatment. In cases of secondary iron overload (hemosiderosis), pharmacological chelation agents—such as deferoxamine—are employed to enhance the mobilization and excretion of iron via urinary and gastrointestinal pathways, thereby mitigating systemic iron burden.

In a healthy organism, however, an excessive supply of iron with nutrients does not cause disturbances due to the presence of well-functioning mechanisms to regulate the economy of this micro-element. Dietary action for iron deficiency syndrome is to limit the consumption of iron-rich products, especially high bioavailability heme products. Among the foods rich in the nutrient is: meat (meat, beef, pork), pork (peat, kidneys), rice, egg yolks, seeds with a long shelf-life (grains, grains, legumes, fruits, etc.).