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

Question

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.

Kindly guide.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. Your elevated iron saturation and serum ferritin levels suggest the possibility of iron overload or hereditary hemochromatosis (HH). The test you mentioned, followed by the hematologist's decision to halt phlebotomy, could imply the detection of a homozygous variant. Research indicates that most individuals identified with homozygous HH through population screening studies tend to be asymptomatic, often leading to normal lifespans even without undergoing phlebotomy. However, due to your elevated ferritin levels, I recommend discussing weekly phlebotomy with your hematologist. To further assess your condition, I'd appreciate additional information: do you have any history of liver disease or abnormal liver enzymes? Have you initiated Relpax (Eletriptan) for headaches? Are there any instances of reduced vision, dizziness, vertigo, or diabetes? Lastly, is there a family history of a similar disorder?

I hope this helps.

Thank you.