Treatment of Hemochromatosis

In most cases, doctors treat hemochromatosis with phlebotomy, or drawing about a pint of blood at a time, on a regular schedule. This is the most direct and safe way to lower body stores of iron NIH external link.

Treatment of hemochromatosis can improve symptoms and prevent complications.

Phlebotomy
Phlebotomy removes extra iron from your blood. Phlebotomy is simple, inexpensive, and safe.

How much blood is drawn and how often depends on your iron levels. Doctors usually start by having a pint of blood drawn once or twice a week for several months. Doctors will order regular blood tests to check iron and ferritin NIH external link levels.

Phlebotomy is usually done in blood banks just like routine blood donation NIH external link. In some cases, blood drawn from people with hemochromatosis may be donated and used in people who need blood transfusions NIH external link.

After phlebotomy has removed extra iron and blood levels of iron and ferritin return to normal, doctors will reduce phlebotomies to once every 1 to 3 months and eventually to 2 to 3 times a year. Doctors will continue to order regular blood tests to check iron and ferritin levels.
People who receive blood transfusions to treat certain types of anemia and develop secondary hemochromatosis cannot have phlebotomy to lower their iron levels. To treat secondary hemochromatosis in these people, doctors prescribe medicines, called chelating agents, that bind to iron and allow it to pass from the body in urine. Chelating agents may be pills taken by mouth or intravenous (IV) medicines, and they do not remove iron as effectively as phlebotomy.

Doctors treat neonatal hemochromatosis in newborns with exchange transfusions—removing blood and replacing it with donor blood—and IV immunoglobulin—a solution of antibodies from healthy people. These treatments do not always work to reverse severe liver damage, and a liver transplant may be needed. Often the newborn’s mother or father can serve as a living liver donor. Only a small part of the adult donor liver is needed for transplantation into a newborn.
Phlebotomy can prevent the complications of hemochromatosis. For people who already have complications such as cirrhosis, liver failure, or liver cancer NIH external link when they are diagnosed with hemochromatosis, phlebotomy may not be able to restore health.

Doctors can treat many complications of cirrhosis with medicines, minor medical procedures, and surgery. People with liver failure or liver cancer usually need a liver transplant to restore health.