Therapy of hemochromatosis

The aim of the therapy is to empty the overfilled iron stores in human tissue. This will ensure that no further potential damage occurs. This is done most effectively, safely and cheaply by regular bloodletting. The frequency of the phlebotomies and the amount of blood removed at each one depend on the patient’s tolerance of the therapy, wellbeing and clinical situation. Usually at the beginning of the therapy 450-500ml of blood are taken once or twice a week, which accounts for circa 250mg of iron. Patients with very high ferritin values can have phlebotomies five days a week. Patients should take care to drink plenty of water before and after phlebotomies, and after the therapy should not engage in cardiovascular or strength training. On the whole, phlebotomies are tolerated well. When ferritin values of 50-100µg/l are reached the interval between phlebotomies can be lengthened. At this stage therapy is adapted individually and phlebotomies are carried out only one to six times per year. The ideal value is around 100µg/. Bloodletting therapy must be carried out over the course of the patient’s life. If the ferritin does not increase without phlebotomies there is a possibility of internal blood loss (intestine), and further checks are recommended. In very rare cases, such as severe anaemia or advanced heart disease, phlebotomies are not ideal and a drug therapy can be used. The medical treatment works through a substance that binds iron. However, this form of therapy is less effective, has more side effects and is more expensive than bloodletting.

A special diet poor in iron is not necessary for hemochromatosis patients. However, red meat, offal, dietary supplements containing vitamin C and red wine should not be consumed in excess. Multivitamins containing vitamin C and iron should not be taken.