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How is hemochromatosis treated?

Hemochromatosis (HE-mo-kro-ma-TO-sis) is a disease in which too much of iron builds up in your body (iron overload).

– Iron is a mineral found in many foods.
– Too much iron is toxic to your body.
– It can poison your organs and cause organ failure.
– In hemochromatosis, iron can build up in most of your body’s organs.
– It builds especially in the liver, heart, and pancreas.
– Too much iron in the heart can cause irregular heartbeats called arrhythmias (ah-RITH-me-ahs) and heart failure.
– Too much iron in the pancreas can lead to diabetes.
– If hemochromatosis isn’t treated, it may even cause death.

Too much iron in the liver can cause:
– an enlarged liver,
– liver failure,
– liver cancer,
– cirrhosis (sir-RO-sis): scarring of the liver, which causes the organ to not work well.

Signs and Symptoms of Hemochromatosis:
– Joint pain
– Fatigue
– Lack of energy
– Abdominal pain
– Loss of sex drive
– Heart problems
– Arthritis
– Amenorrhea
– Early menopause
– Loss of sex drive
– Impotence
– Shortness of breath
– Liver disease, including an enlarged liver, cirrhosis, cancer, and liver failure.
– Damage to the pancreas, possibly causing diabetes
– Chronic (ongoing) abdominal pain

The goals of treating hemochromatosis include:
– Reducing the amount of iron in your body to normal levels.
– Preventing or delaying organ damage from iron overload.
– Treating complications of the disease.
– Maintaining a normal amount of iron in your body for the rest of your life.
– The most effective treatment for hemochromatosis is to reduce iron in the body by phlebotomy (withdrawal of blood from the arm veins).
– One unit of blood, which contains 250 mg of iron, usually is withdrawn every one to two weeks.
– Serum ferritin and transferrin saturation are checked every two to three months.
– Once ferritin levels are below 50 ng/ml and transferrin saturations are below 50%, the frequency of phlebotomies is reduced to every two to three months.
– When hemochromatosis is diagnosed early and is treated effectively, damage to the liver, heart, testicles, pancreas and joints can be prevented completely.
– In patients with established cirrhosis, effective treatment can improve the function of the heart, skin color, and diabetes.
– The cirrhosis is irreversible and the risk of developing liver cancer remains.

The benefits of therapeutic phlebotomy in hemochromatosis are as follows:
– It prevents the development of liver cirrhosis and liver cancer upon early detection.
– It improves liver function partially in patients who have already developed advanced cirrhosis.
– It improves and completely resolves symptoms of weakness, liver pain, joint pain, and fatigue.
– It improves function of the heart in patients with mild and early heart disease.

What are dietary recommendations in hemochromatosis?
– A normal balanced diet is recommended.
– Iron containing foods are not totally avoided.
– Alcohol should be avoided.
– Alcohol consumption increases the risk of developing cirrhosis and liver cancer.
– Ingestion of high doses of vitamin C in patients with iron overload may lead to fatal abnormal heart rhythms.
– It is reasonable to avoid vitamin C supplementation until patients are adequately treated.
– Raw seafood should be avoided.
– Patients with hemochromatosis are at risk of acquiring bacterial infections that flourish in iron rich environment.

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