How Is Hemochromatosis Treated?

Treatments for hemochromatosis include therapeutic phlebotomy, iron chelation (ke-LAY-shun) therapy, changes in diet, and other treatments for complications.

Goals of Treatment

The goals of treating hemochromatosis are to reduce the amount of iron in your body to normal levels, prevent or delay organ damage from iron overload, treat complications of the disease, and maintain normal iron levels over the long term (for life).

Therapeutic Phlebotomy (Periodic Blood Removal)

This type of treatment is used to remove iron from your body in a process very much like donating blood. Therapeutic phlebotomy generally begins soon after diagnosis. Blood removal can be done in blood donation centers, hospital donation centers, or a doctor's office.

Therapeutic phlebotomy is usually advised for people with very high serum ferritin levels and people who have signs and symptoms of hemochromatosis. In the first stage of treatment, about 1 pint of blood is removed once or twice a week. After iron levels return to normal, you may continue phlebotomy treatments but may need them much less often, typically every 3 months. As long as treatment continues, which is often for the rest of your life, the doctor will order lab tests often to check iron levels.

Iron Chelation Therapy

Iron chelation therapy uses medicine to remove excess iron from your body. It is a good option for people who cannot undergo repeated blood removal.

Injected iron chelation therapy can be done in the doctor's office. Oral iron chelation therapy can be taken at home. The medicines used for chelation therapy include:

• Deferoxamine mesylate (Desferal®). This medicine is injected either in a muscle, under the skin, or through a vein.
• Exjade® (Deferasirox). This is an oral medicine that binds with the extra iron and then leaves the body in the feces.
• Experimental medicines. Deferiprone (Ferriprox®) is an oral medicine that binds with the extra iron and then leaves the body in the urine or feces.

Changes in Diet

Your doctor may advise you to change your diet if you have hemochromatosis. You may be advised to:

• Avoid taking iron (including iron pills, injections of iron, or multivitamins that contain iron).
• Limit your intake of vitamin C. Vitamin C increases the amount of iron the body absorbs. You should take no more than 500 mg per day from nonfood sources such as pills.
• Avoid uncooked fish and shellfish. Some fish and shellfish contain bacteria that could cause infection in people with hemochromatosis.
• Limit alcohol intake. Drinking alcohol increases the risk for liver disease and can make liver disease worse.

Treatment for Complications

Your doctor may provide other treatment as needed for complications such as liver disease, heart problems, or diabetes.