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Iron overload happens when your body stores too much iron in organs and tissues. This guide explains what causes it (including HFE gene variants), how it s diagnosed with ferritin and transferrin saturation (TSAT), symptoms, treatment options like therapeutic phlebotomy, and practical diet tips. Already seeing high ferritin or TSAT? You can order follow-up labs today.
Last reviewed: September 2025
Ferritin, TSAT, iron panel, CBC, and more.
What is Hemochromatosis?
Hemochromatosis (also spelled haemochromatosis) refers to disorders of iron regulation that lead to excess iron storage. Over time, iron can accumulate in the liver, pancreas, heart, joints, skin, and endocrine tissues. Primary (hereditary) hemochromatosis is often associated with HFE gene variants (e.g., C282Y, H63D).
Related reading: High Ferritin · Transferrin Saturation (TSAT) · HFE Genetic Test
Key Lab Markers (Ferritin, TSAT)
- Ferritin reflects stored iron; it can also rise with inflammation, infection, or liver conditions.
- Transferrin Saturation (TSAT) is the % of iron bound to transferrin; persistent TSAT above common clinical cut-points (often ~45%) may prompt evaluation.
- Iron panel (serum iron, TIBC/UIBC), plus CBC and liver enzymes provide context.
Tip: Ferritin alone doesn t diagnose overload pair it with TSAT and clinical context.
Ready to follow up? Order an iron panel →
Symptoms & Complications
Early signs may be subtle: fatigue, joint pain (especially in the hands), abdominal discomfort, reduced libido. Long-term iron excess can contribute to liver issues, skin bronzing, diabetes, heart rhythm changes, and hormone imbalance.
See Symptoms of Hemochromatosis for a deeper dive.
Diagnosis Pathway
- Screen with ferritin and TSAT.
- If elevated and consistent, consider HFE genetic testing with a clinician s guidance.
- Use history, exam, and other labs/imaging as appropriate.
- Plan monitoring cadence to track progression or response to therapy.
Treatment (Phlebotomy) & Monitoring
Therapeutic phlebotomy removes iron by drawing blood at set intervals. Treatment frequency and targets are individualized. Monitoring trends with ferritin, TSAT, and CBC helps assess progress and guides adjustments.
Tracking treatment? View monitoring labs →
Diet: What Helps, What to Limit
- Understand heme (animal) vs non-heme (plant) iron.
- Vitamin C can enhance iron absorption; timing relative to iron-rich meals may matter.
- Tea/coffee polyphenols can reduce iron absorption when consumed with meals.
Practical guide: Hemochromatosis Diet
Secondary Hemochromatosis
Not all iron overload is genetic. Repeated transfusions and certain blood or liver conditions can raise iron stores. Workup and management differ from hereditary cases and should be tailored to the underlying cause.
Read more: Secondary Hemochromatosis
FAQs
Is high ferritin always iron overload?
Not necessarily. Ferritin is an acute-phase reactant and can rise with inflammation or liver conditions. Pair with TSAT and clinical evaluation.
Do I need genetic testing?
It s often considered when labs suggest overload or there s family history. Discuss with a licensed clinician.
How often should I repeat labs?
Cadence depends on your stage and plan (screening, active treatment, maintenance). Your clinician can advise.
What should I change in my diet?
Diet complements (not replaces) medical care. See the diet guide and follow personalized clinical advice.
Educational content only. Not medical advice. Testing decisions and interpretation should be guided by a licensed clinician.