We can provide a venesection service for patients with a diagnosis of haemochromatosis. This service is usually covered by private health insurance.
What is Hemochromatosis?
Hemochromatosis is an iron disorder in which the body simply loads too much iron. This action is genetic and the excess iron, if left untreated, can damage joints, organs, and eventually be fatal. Haemochromatosis is especially prevalent among the Irish and other Celtic people. It is very often asymptomatic but can cause general fatigue and achy joints.
At Dooradoyle Medical Centre we offer screening for this condition with a blood test ( serum ferritin). If this is raised we offer further testing for iron overload ( fasting iron profile) and if indicated will then test for specific genetic abormalites which if present will then confirm the diagnosis.
There are several types of hemochromatosis. Type 1, also called Classic Hemochromatosis (HHC), is a leading cause of iron overload disease. People with HHC (too much iron) absorb extra amounts of iron from the daily diet. The human body cannot rid itself of extra iron. Over time, these excesses build up in major organs such as the heart, liver, pancreas, joints, and pituitary. If the extra iron is not removed, these organs can become diseased. Untreated hemochromatosis can be fatal.
Iron is an essential nutrient found in many foods. Iron carries oxygen (in hemoglobin) to all parts of the body. Normally, humans absorb about 8-10% of the iron in foods that they eat. People with hemochromatosis (too much iron) can absorb four times more iron than normal.
Undiagnosed and untreated hemochromatosis (too much iron) increases the risk for diseases and conditions such as:
- Diabetes mellitus
- Irregular heart beat or heart attack
- Arthritis (osteoarthritis, osteoporosis)
- Cirrhosis of the liver or liver cancer
- Gall bladder disease
- Depression
- Impotence
- Infertility
- Hypothyroidism
- Hypogonadism
- Some cancers
What is the treatment?
Treatment is most effective when begun early as it can successfully prevent or stop organ damage. If damage has already occurred, treatment should halt any further damage and in most cases bring about improvement. The only method of removing excess iron from the body is by removal of blood. This is by giving a blood donation and is called venesection or phlebotomy therapy. Every unit of blood removed contains 250mg of iron. The body then uses some of the excess stored tissue iron to make new blood cells which are removed in subsequent phlebotomy.
The length of treatment depends on the amount of excess iron in the body at the time of diagnosis, which is measured by the ferritin and transferrin saturation. Treatment may mean weekly phlebotomy for one to two years or until the iron levels have been reduced to a safe level. During the treatment the serum ferritin levels are monitored, the results of these tests give a measure of the remaining iron stores. Once the initial treatment is completed and the iron levels are back to normal then they are monitored every 3 months. As they start to rise again phlebotomy is recommended.
Treatment for Haemochromatosis is ongoing for life and may require blood to be removed once or twice yearly depending on how quickly the iron is reaccumulating. This is called maintenance therapy. Venesection treatment will allow iron tissue to be mobilized and iron stores will return to normal. However, it will not cure any clinical condition such as diabetes already present at the time treatment is started. This emphasises the importance of early diagnosis!
