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Q. Should anything be done to pull out the excess iron level in blood?

Answered by
Dr. Santosh Badaku Desai
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 31, 2016 and last reviewed on: Feb 22, 2021

Hello doctor,

I am a 61 year old male. For many years, I was treated for hemochromatosis. Then, about 12 years ago, I had a genetic test. The results prompted the hematologist to abruptly stop the recurring phlebotomies. I do not recall the test result and apparently, it cannot be located. But, I remember it was something about the homozygotic versus heterozygotic situation. My current iron level is high at 216 mcg/dL, IBC is normal at 259 and iron saturation is high at 83%. The ferritin is also high at 1042 mg/dL. All blood count factors are in the normal range. Should anything be done to pull out some of the iron? Currently, I am taking Losartan, Hydrochlorothiazide and Relpax.

#

Hi,

Welcome to icliniq.com.

I understand your concern.

  • Your iron saturation and serum ferritin is high and these are suggestive of iron overload or hereditary hemochromatosis (HH).
  • You talked about a test that was done and then the hematologist stopped the phlebotomy. I think, probably he must have found a homozygous variant.
  • Studies have shown that the majority of the patients who are found to have homozygous HH during a population screening studies are likely to be asymptomatic. They usually have a normal lifespan even if they do not undergo phlebotomy.
  • However, since your ferritin levels are high, I would suggest that you go for a weekly phlebotomy after talking to your hematologist.
  • I would also like to know a few details, so that we can confirm if you are symptomatic or asymptomatic.
  1. Do you have any history of liver disease or deranged liver enzyme? Also, please let me know whether you started on Relpax (Eletriptan) for a headache?
  2. Do you have any history of decreased vision, dizziness or vertigo and diabetes?
  3. Is there any history of a similar disease in the family?

Revert back with the details to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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