Doctors can treat hereditary hemochromatosis safely and effectively by removing blood from your body (phlebotomy) on a regular basis, just as if you were donating blood. (Some blood collection centers in the United States have obtained FDA permission to collect this blood and use it for transfusion.) The goal is to reduce your iron levels to normal. The amount of blood drawn depends on your age, your overall health and the severity of iron overload. It may take several years to reduce the iron in your body to normal levels.
- Initial treatment schedule. Initially, you may have a pint (470 milliliters) of blood taken once or twice a week — usually in a hospital or your doctor's office. This process shouldn't be too uncomfortable. While you recline in a chair, a needle is inserted into a vein in your arm. The blood flows from the needle into a tube that's attached to a blood bag. Depending on the condition of your veins and the consistency of your blood, the time needed to remove a pint of blood can range from 10 to 30 minutes.
- Maintenance treatment schedule. Once your iron levels have returned to normal, blood draws can be less frequent, typically every three to four months. Some people may maintain normal iron levels without any blood draws, and some may need to have blood drawn monthly. The schedule depends on how rapidly iron accumulates in your body.
Treating hereditary hemochromatosis can help alleviate symptoms of tiredness, abdominal pain and skin darkening. It can help prevent serious complications such as liver disease, heart disease and diabetes. If you already have one of these conditions, phlebotomy may slow the progression of the disease, and in some cases even reverse it.
If you have hemochromatosis but no complications of cirrhosis or diabetes, you have the same life expectancy as a healthy person of your same age.
Phlebotomy will not reverse cirrhosis or improve joint pain.
If you have cirrhosis, your doctor may recommend periodic screening for liver cancer. This usually involves an abdominal ultrasound and a blood test.
Chelation for those who can't undergo blood removal
If you can't undergo phlebotomy, because you have anemia, for example, or heart complications, your doctor may recommend a medication to remove excess iron. The medication can be injected into your body, or it can be taken as a pill. The medication causes your body to expel iron through your urine or stool in a process that's sometimes called chelation.
Feb. 18, 2015
- AskMayoExpert. Hereditary hemochromatosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Bacon BR, et al. Diagnosis and management of hemochromatosis: 2011 Practice Guideline by the American Association for the Study of Liver Diseases. Hepatology. 2011;54:328.
- What is hemochromatosis? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hemo/. Accessed Nov. 7, 2012.
- Eng KG, et al. Natural history and management of HFE-Hemochromatosis. Seminars in Liver Disease. 2011;31:293.
- Hemochromatosis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/hemochromatosis/index.htm. Accessed Nov. 12, 2012.
- Poterucha JJ (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 29, 2012.
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