Treatment for hemochromatosis can:

• Safely and rapidly remove excess iron from the blood.
• Limit the progression and possible complications of the disorder.
• Prevent organ damage.

Doctors treat hemochromatosis by removing the extra iron in the body. Phlebotomy is most often the first choice, because it's safer and quicker than injecting medicine ( chelation therapy). ³

• Phlebotomy is a procedure that removes blood from the body in a process similar to donating blood. Phlebotomy is the preferred method of treating most forms of hemochromatosis. Most people with hemochromatosis need regular phlebotomy throughout their lives. Doctors will monitor the serum ferritin levels to make sure treatment is lowering iron stores.
• Chelating agents are medicines that help your body get rid of excess iron. The chelating agents deferoxamine and deferasirox bind to iron in your blood. The chelating agent and iron leave your body through urine or stool. Doctors can use deferoxamine or deferasirox treatment if you cannot have phlebotomy.

Treatment for hemochromatosis can reverse most symptoms and prevent complications. If treatment begins before liver damage ( cirrhosis) develops, a person with hemochromatosis may have a normal life span.

Initial treatment

Many doctors advise regular phlebotomy for people who are diagnosed with hemochromatosis, even if they do not yet show symptoms. Depending on the amount of iron in your blood, it may take 30 or more phlebotomies to bring your iron levels down to the desired level. Treatment usually begins with phlebotomy once or twice a week until iron levels are in a target range. Most people are free of early-stage symptoms soon after phlebotomy begins. Weekly treatment continues until:

• Ferritin iron levels are less than 50 nanograms (ng) per milliliter.
• Transferrin saturation levels are less than 50%.
• Hemoglobin concentration levels off. The ideal levels are not the same for men and women.

After levels are stable, you'll have fewer phlebotomy treatments, first monthly and then about every 3 months. The goal is keeping serum ferritin levels normal (about 50ng per milliliter). ¹ The mild iron deficiency that regular phlebotomy causes will protect the body from excess iron buildup in the future.

Phlebotomy is not possible for all people. In these cases, doctors use medicines known as chelating agents (deferoxamine or deferasirox) to remove excess iron. Deferoxamine is slowly injected under the skin (subcutaneously) daily. You can use a portable pump to inject the medicine. This is something you can do at home. Deferasirox is taken by mouth.

Chelating agents remove excess iron from your body through urine or stool. It's a slower process than phlebotomy, taking twice as long. It also means you'll need more treatments to lower iron stores back to normal.

Hemochromatosis caused by blood transfusions or vitamin overdoses often does not need further chelating treatment after you've reached normal iron levels. The cause of the condition must be found and stopped before treatment begins.

Ongoing treatment