“Excessive iron in your body can lead to Hemochromatosis”, says Dr RP Singh Malhotra of Healthy Human Clinic New Delhi

Symptoms don’t appear until a person reaches the age 40 or older, because extra iron builds up slowly throughout the person’s life. Symptoms appear after a certain amount of extra iron builds up”, says Dr. RP Singh Malhotra, Director, Liver Transplant & Gastro Sciences, Healthy Human Clinic, New Delhi.

In an interview with The Indian.News Editor, Jayashankar Menon, Dr Malhotra speaks in details about Hemochromatosis and its impact on the health in addition to the remedial measures and precautions to be taken to get into the trap of Hemochromatosis. Excerpts:

Dr. R P Singh Malhotra, Director, Liver Transplant & Gastro Sciences, Healthy Human Clinic, New Delhi.

TIN: What exactly is Hemochromatosis?

RPSM: Hemochromatosis happens when too much iron builds up in your body. Of course, the body needs iron to make hemoglobin, the part of blood that carries oxygen to all of your cells. But when there is too much iron, it can damage the liver and heart and lead to other diseases, such as diabetes and arthritis.

TIN: Is there any pragmatic treatment available? If ignored, what are the consequences?

RPSM: Hemochromatosis can be treated to prevent serious problems. But without treatment, hemochromatosis will continue storing iron in the body. When iron levels are dangerously high, organ and tissue damage can happen.

TIN: What are the most common type of Hemochromatosis?

RPSM: The most common type of Hemochromatosis runs in families. This is called hereditary or primary Hemochromatosis. But people sometimes get it from having a lot of blood transfusions, certain blood problems, liver disease, or alcoholism. This is called acquired or secondary Hemochromatosis.

TNI: Do Hemochromatosis affect both the genders?

RPSM: Men are more likely than women to have too much iron built up. Women get rid of extra iron through blood from their menstrual cycles and during pregnancy.

TIN: What are the general symptoms of Hemochromatosis?

RPSM: Symptoms often don’t appear until a person is age 40 or older. This is because extra iron builds up slowly throughout the person’s life. And symptoms appear after a certain amount of extra iron builds up. The early symptoms are somewhat vague or subtle. So this disease is sometimes mistaken for another condition. Early symptoms include tiredness, weakness, pain in the joints, weight loss and urinating more often.

TIN: How is Hemochromatosis diagnosed?

RPSM: Your doctor will do a physical exam and ask about your medical history. If the doctor suspects Hemochromatosis, you will have blood tests to see if you have too much iron in your body. Most of the time Hemochromatosis is caused by a gene that runs in families. It is an autosomal recessive disorder that can be passed to a child from the parents. Hemochromatosis can be found early with a blood test. If you have this disease, you may want to have your children tested to see if they have it. Other family members may also want to be tested. Talking to a genetic counsellor will help you decide whether genetic testing is a good idea for you and your family.

TIN: How is Hemochromatosis treated?

RPSM: Treatment for Hemochromatosis includes Phlebotomy and Chelation therapy. While Phlebotomy is the most common treatment, it is like donating blood and is done on a regular schedule, whereas, Chelation Theraphy, also known as Chelating agents, is a medicine that helps the patient’s body to get rid of excess iron. This method of treatment is given to those patients who can’t have Phlebotomy. The treatment can safely and quickly remove excess iron from the blood, besides limiting the progression and possible complications of the disorder. What is more, the treatment might as well prevent organ damage such as in the liver or heart.

TIN: Is the treatment a short term affair?

RPSM: Most patients need treatment for the rest of their lives. Nevertheless, some patients might not need further treatment, if their iron levels return to normal and the Hemochromatosis is clearly caused by another disease or by a treatment for another disease such as blood transfusions.

TIN: How can we prevent Hemochromatosis?

RPSM: Having Hemochromatosis in your family doesn’t mean that you will automatically get it. If you find out that you have inherited a gene that causes Hemochromatosis that means you are more likely to get Hemochromatosis. Your doctor or a genetic counsellor can help you understand the results of a gene test. You might watch for symptoms so that if you do get Hemochromatosis, you can get treatment as early as possible. Early treatment can reverse most symptoms and prevent future problems.

TIN: How can patients take care of themselves at home?

RPSM: There are a slew of steps for the patients to make sure they are not getting too much iron in food or drinks. Limit, or if possible, the patients should give up consumption of alcohol. If the patients tend to consumer alcohol, they absorb more iron from food and raise the risk of liver cirrhosis (damage). Patients are advised not to take extra vitamin C supplements (more than 200 mg per day), as extra vitamin C can increase the amount of iron the patient absorbs from food. Furthermore, the patients can eat food that naturally contain vitamin C. Also, the patients should not take nutritional supplements or vitamins that contain iron. If the patients are getting Phlebotomy, they should consult their doctors, if the could change food they eat. If the patients need to lower the amount of iron in their diet, they can eat less red meat and iron fortified food such as cereals. About consuming bevrages like tea and coffee, tea, more than coffee can cause the body to absorb less iron from the food the patient eats. Consuming these beverages does not replace usual treatment. Care needs to be taken in not using iron cookware as food cooked in ironware can absorb some of the iron. Last, but not the least, do not eat uncooked seafood as it can contain bacteria that is harmful to patients who are already afflicted with Hemochromatosis.