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Iron Overload and Hemochromatosis: Treatment

photo of doctor and patientHemochromatosis can be treated simply and successfully. The treatment, called phlebotomy (pronounced “fle-bot-o-me”), removes blood to lower the amount of iron in the body. The treatment is similar to giving blood and is the best way to treat the disease.

If phlebotomy treatment is started before too much iron has built up in the body, it can stop many of the serious problems of hemochromatosis.

  • If you have no organ damage and get proper care, you can expect to live a normal life.
  • If you already have organ damage, treatment can stop additional damage, but it cannot reverse damage that has already started.
  • Even if you have developed serious problems, treatment can lessen many symptoms and improve your quality of life.

Important things to know about phlebotomy treatment for hemochromatosis:

  • Drink plenty of water, milk, or fruit juices both before and after the treatment.
  • Avoid vigorous physical activity for 24 hours after your phlebotomy treatment.
  • Be sure to keep your phlebotomy appointments as directed by your doctor.


Treatment Process

The phlebotomy treatment consists of two phases: an “iron reduction” phase and the long-term maintenance phase.

Iron Reduction Phase
In the iron reduction phase, a health care professional removes about one pint of whole blood, usually once or twice a week.

This phase usually lasts until all of the extra iron stored in your body has been removed. It can take three months to one year, but the time varies from person to person. Age, gender, the cause of the iron overload, and severity of symptoms all affect how long this phase takes. During this phase, your doctor checks your hemoglobin and serum ferritin levels.

Long-term Maintenance Phase
Once the extra iron has been taken out, your doctor will set up a long-term maintenance program to make sure you keep a normal amount of iron in your body.

How often a person needs phlebotomy during this phase varies based on the severity of the symptoms. During this phase, your doctor continues to check your hemoglobin and your serum ferritin levels.

Note
Hemoglobin is a protein that is a found in red blood cells; about 75% of the body’s iron is bound to hemoglobin which is involved in oxygen transport from the lungs to the rest of the body.


Regular phlebotomy treatment keeps the amount of iron in your body at a normal level. A normal amount of iron is between 25 and 50 ng/mL (nanograms per milliliter).

  • Men usually need to have 3 to 4 pints of blood taken out each year (about once every 3 months) to maintain this level.
  • Women may need to have 1 to 2 pints of blood taken out each year (about once every 6 months) to maintain this level.
  • Some people, especially older people, may not need to have any more treatments, but they should still have their serum ferritin level checked at least once a year.

If you have hemochromatosis, you should have your serum ferritin level checked at least once a year. Doing so can help keep your iron level within the normal range and avoid the serious problems caused by too much iron.


Donating Blood

Many patients and their doctors ask if it is safe for people with hemochromatosis to give blood. The U.S. Food and Drug Administration (FDA) has stated that blood from hemochromatosis patients can be used for people needing blood if the facility where the blood is donated meets the following rules:

  1. The blood collection center cannot charge a fee for collecting the blood.
  2. The blood center must apply to the FDA to be exempt from the existing rules.

For a list of organizations approved to accept blood from patients with hemochromatosis, visit Variances for Collection of Blood and Blood Products from Patients with Hemochromatosis.

For answers to other questions about blood donation from patients with hemochromatosis, try the following patient resource:

Key Point
Most people with hemochromatosis should be checked at least once a year to be sure that their iron level is within the normal range. If the iron level is too high, phlebotomy treatments are needed to keep extra iron from building up in the body.

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*Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.

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Hemochromatosis: What Every Clinician and Health Care Professional Needs to Know
Hemochromatosis: What Every Clinician and
Health Care Professional Needs to Know

Cover of Iron Overload and Hemocromatosis Brochure:  Information for Patients and Their Families
Iron overload and Hemochromatosis
Information for Patients and Family

 
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Thank you for visiting the CDC-NCBDDD Web site. Click here to contact the National Center on Birth Defects and Developmental Disabilities

We are not able to answer personal medical questions. Please see your health care provider concerning appropriate care, treatment, or other medical advice.
 

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Date last reviewed: 11/01/2007
Content source: Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disabilities
  
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