Hemochromatosis is treated by removing excess iron from the body to bring iron levels back down to normal.
Phlebotomy
The most common treatment method for hemochromatosis is iron reduction through phlebotomy, which is regular blood removal or donation. Phlebotomy is generally divided into two stages, initial treatment and maintenance treatment for hemochromatosis.
For initial hemochromatosis treatment, blood is taken once or twice a week for several months to a year, depending on the severity of iron overload and age of the individual. The goal of phlebotomy is to bring blood ferritin down to normal levels (50-150ng/mL). The rate of serum ferritin reduction is about 30ng/mL for every 500mL of blood removed. However, if serum ferritin is falling at a much higher rate after phlebotomy, it can involve other confounding reasons such as inflammation, alcohol or medication consumption.
Once the iron level has returned to normal, maintenance hemochromatosis treatment can follow. Blood removal occurs approximately every two to four months for life, depending on the type of diet and rate of iron absorption of the individual. This helps to maintain iron at normal iron levels and prevent further iron accumulation in the body. Hereditary hemochromatosis treatment is effective when hemochromatosis is detected and treated early, with prognosis of normal life expectancy after treatment.
Treating hemochromatosis with phlebotomy helps to prevent serious complications such as liver disease, heart disease, arthritis and diabetes. It can also help to improve or resolve symptoms of abdominal pain, weakness and fatigue. However, hemochromatosis treatment is less effective when detected at later stages after organ damage has already occurred, since phlebotomy cannot reverse the organ damage such as cirrhosis, joint pain etc. The life expectancy may be shortened in these individuals with hemochromatosis due to complications and higher risks of developing liver cancer.
Chelation
Another hemochromatosis treatment method is removal of excess iron through chelation. This hemochromatosis treatment option is for individuals who cannot undergo blood removal due to conditions such as anemia or heart complications. Chelation is a process that involves binding excess iron with medication, which helps to expel iron through urine or stool.
