Excess iron in the body damages the organs and increases the patient's risk of liver disease, diabetes, osteoarthritis, heart disease, osteoporosis, hormonal disorders and premature death, according to the Iron Disorders Institute. Iron overload is caused by repeated blood transfusion, iron injections or supplements, or by genetic disorders such as hereditary hemochromatosis. Symptoms include fatigue, joint pain, abdominal pain, hair loss, depression and signs of organ disease. Removing excess iron reduces the damage to the body.
Therapeutic Phlebotomy
Therapeutic phlebotomy--removal of blood for medical reasons--reduces iron levels by reducing blood volume, according to the Iron Disorders Institutes. The process is the same as that of donating blood except that a physician's order is required. Many blood banks perform the procedure, as do some physician offices. Depending on the patient's iron level, the procedure may be done weekly or less often until the serum iron level reaches normal. Thereafter, phlebotomy may be required only a few times per year. Phlebotomy is not appropriate for anemic patients with iron overload because the procedure aggravates the anemia.
Chelation
Some iron overload patients take medication, a therapy called iron chelation, to reduce the level of iron in the blood, according to the Merck Manuals Online Medical Library. Patients who are anemic--having a hemoglobin less than 10 g/dL--or who must have transfusions for another condition, cannot tolerate phlebotomy; therefore, the health care provider may order the drugs deferasirox or deferoxamine to remove the iron. Deferoxamine, administered by slow subcutaneous infusion overnight for five to seven nights per week, causes low blood pressure and gastrointestinal disorders. Over a long period of time, it can cause vision or hearing loss. Patient noncompliance is an issue because of the time commitment for drug administration. Deferasirox, given once a day by mouth, also reduces iron levels but causes side effects in only 10 percent of patients, including diarrhea, rash, abdominal pain and nausea, and requires minimal time commitment.
Self-Care
Iron overload cannot be managed at home but self-care strategies can help to avoid further organ damage. Patients with iron overload may eat iron-rich foods but should not take iron supplements, notes the U.S. Centers for Disease Control and Prevention. Vitamin C increases iron absorption, so taking more than 500 mg per day is contraindicated. Patients with liver damage should abstain from drinking alcohol. If no liver damage is present, women should have no more than one alcoholic drink per day and men should have no more than two per day. Iron overload patients have a higher risk of bacterial infections, so should avoid eating raw fish or shellfish.
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