What is iron overload? 

As with anything, too much of a good thing can be, well, not so good. This is especially the case for iron – a key mineral that plays a part in many vital functions in the body.   

Iron is important for making red blood cells which help to transport oxygen around the body. And our tissues need oxygen to make energy. Too little iron can lead to iron deficiency anaemia. But too much iron can lead to iron overload and also cause problems.  

In this article, we cover:  

• What is iron overload? 
• What are the symptoms of iron overload? 
• What causes iron overload? 
• How is iron overload diagnosed? 
• How is iron overload treated? 
• When should I see a GP?  
   

What is iron overload?
 

Iron overload, or haemochromatosis, is when the body stores too much iron. Excess iron is deposited into organs throughout the body, particularly the liver, heart, and joints, leading to unpleasant symptoms. 
 

What are the symptoms of iron overload?
 

Early symptoms of iron overload tend to be vague and may be confused with other medical conditions.  

Early symptoms of iron overload include:  

• Feeling tired all the time 
• Low mood or anxiety 
• Weight loss 
• Joint pain 
• Erectile dysfunction 
• Irregular periods 

As the condition progresses, it may lead to other problems, often related to the organ that’s affected.  

Late symptoms of iron overload include:  

• Loss of libido 
• Darker skin 
• Tummy pain 
• Feeling thirsty all the time 
• Jaundice (yellowing of the skin and the whites of the eyes) 
• Chest pain and shortness of breath  
• Irregular heartbeat 
   

What causes iron overload?
 

You may be wondering what causes a build-up of iron, and it’s not always a case of eating too much. 

Causes of iron overload may be primary (due to a genetic cause) or secondary (which may be due to many different reasons.  

Primary iron overload is usually caused by:  

• Hereditary haemochromatosis — this is an inherited condition caused by a faulty gene, leading to excess iron absorption. It’s the most common genetic condition in the UK, with over 380,000 people diagnosed. It’s thought that many more people have the condition unknowingly.  

Secondary causes of iron overload include:  

• Excess iron intake — iron supplements and an iron-rich diet can lead to iron overload in some individuals.  
• Multiple blood transfusions — this is usually people with blood disorders, like sickle cell anaemia.  
• Chronic liver disease 
• Iron loading anaemias — for example, thalassaemia.
   

How is iron overload diagnosed?
 

Iron overload is diagnosed with a blood test, but you may need further tests to work out the underlying cause.  

Blood tests 

Usually, an iron profile is performed in the first instance. You can check your iron levels at home with our Iron Blood Test. This test gives more information about your iron levels and how it’s stored and transported. Our Liver Function Blood Test may also be useful to see if high levels of iron are affecting your liver function.  

Other tests 

If iron overload is confirmed, you may require other tests such as:  

• Genetic testing — to see if you have the gene that predisposes you to genetic haemochromatosis.  
• MRI scan — in severe cases, your doctor may request an MRI scan to assess levels of iron in the liver and heart.  
• Liver biopsy — this involves using a needle to remove a sample of the liver to analyse in the laboratory. It can be used to check if the liver has been damaged by the build-up of iron. 
   

How is iron overload treated?
 

There are several treatment options for iron overload.  

Treatment for iron overload includes:

• Venesection — this involves taking blood (and iron) from the body, similar to a blood donation.  
• Chelation — this is a less popular option and is usually reserved for people who cannot undergo venesection. It involves taking medications to help to get rid of excess iron. These medications can cause side effects.  

Lifestyle changes can also help you maintain normal levels of iron.  

Lifestyle changes to help manage iron overload include:  

• Cutting back on iron-rich foods like red meat and iron-fortified cereals   
• Reducing iron supplementation 
• Reducing vitamin C intake (as vitamin C increases iron absorption)   
   

When should I see a GP about iron overload?
 

It’s best to see your GP if you have persistent symptoms that could be due to iron overload. Remember that many of these symptoms can be caused by other conditions.  

If you’ve taken a blood test with us and you’re found to have iron overload, we’ll advise you on any next steps.  
 

Where can I learn more about iron?  
 

Iron can be a complicated mineral to understand. Want to find out more?   
  
Take a look at our other iron blogs:  

Are you iron deficient?   

What’s the difference between ferritin and iron?