Like other essential minerals with multiple functions, iron is only beneficial within a certain range. While low levels cause iron-deficiency anemia, high levels also threaten health in various ways, some of which are serious.

My friend Martha has iron overload—a condition in which the body stores excess amounts of iron. Consequently, she donates blood regularly, which is the main treatment.

“As I get nearer the time to donate, I have increasing fatigue and pain in my joints,” she said.

These symptoms stem from the effects of iron accumulation in the organs and tissues, such as the heart and joints.

“I’ve also noticed mental difficulties and emotional effects, including impatience, irritability, and crying easily,” she said.

These symptoms are due to iron accumulation in the brain.

Once Martha donates blood, her iron levels drop and she feels immediate relief. Since her doctor recommends monthly blood donations, she goes through a constant cycle of worsening symptoms followed by improvement.

Martha is one of an estimated 16 million people in the United States who have some degree of iron overload. The most common cause is an inherited condition called hemochromatosis, which causes the absorption of more iron than normal, leading to its accumulation and deposits in various organs. If untreated, it hinders organ functions and causes damage.

Iron overload may result from chronic or acute conditions, and in either case, the effects can be toxic.

Iron Overload Overview

Below is an overview of what happens in iron overload and interventions to manage it.

Symptoms

The symptoms may not manifest for many years, but they usually begin to appear after age 40, the National Institutes of Health (NIH) notes. These include:

• Fatigue or weakness


• Erectile dysfunction or decreased interest in sex


• Joint pain, especially in the hands and knees


• Abdominal pain near the liver


• Skin discoloration, appearing bronze, gray, or metallic

Complications

Without treatment, iron can accumulate in the liver and cause cirrhosis, which happens when scar tissue replaces healthy tissue. Scar tissue impedes blood flow, causing the liver to malfunction and increasing the risk of liver cancer. Cirrhosis eventually leads to liver failure, which means the liver stops working.

Iron may also build up in the endocrine glands, increasing the risk of diabetes and hypothyroidism. In the heart, such buildup can lead to heart failure, in which the heart muscle can no longer pump blood effectively.

Treatments

Early treatment is very important, as it leads to a positive prognosis, but people with inadequate or delayed treatment have lower survival rates.

Phlebotomy—the removal of blood through a vein—is the main treatment for iron overload. It is usually done in blood banks by donating blood regularly. Doctors may order it done once or twice per week for several months upon diagnosis, then reduce the frequency to once every one to three months—eventually decreasing it to once or twice per year. Although phlebotomy can prevent complications of hemochromatosis, it may not be able to restore health after complications such as cirrhosis or diabetes develop.

Before Martha was diagnosed with iron overload, she had a long-standing habit of donating blood. She always noticed that after donating, she felt better physically. It turns out that this altruistic habit was helping manage her condition for a number of years before her symptoms became troublesome enough to seek medical attention.

Some people with hemochromatosis can’t receive phlebotomy treatment. In such cases, treatment can involve chelating agents—medications that bind to iron and cause it to be eliminated in the urine. However, chelating agents don’t work as effectively as phlebotomy.

Diet

According to the NIH, someone with hemochromatosis should eat a healthy, well-balanced diet. It states that there is no need to reduce iron intake, as such dietary changes would have a relatively small effect compared with the much larger effect of phlebotomy.

Dr. Daniel Landau, a hematologist and contributor to The Mesothelioma Center at Asbestos.com, said that he agrees with this advice. Most patients with hemochromatosis don’t need to completely avoid iron, he said. Iron-rich foods such as steak and leafy vegetables are acceptable when consumed in moderation.

For those at risk of iron overload, doctors recommend avoiding undercooked or raw shellfish, which can cause a serious infection if liver disease is present. They also advise refraining from taking supplements that contain iron and vitamin C, which increases the absorption of iron.

“Folks with hemochromatosis should do their best to avoid drinking,” Landau said. “Since we don’t technically know how much is safe, we generally preach avoidance. ”

Naturopathic physician Eric Lewis, who specializes in hemochromatosis, has a somewhat different opinion.

“While I agree that an individual with iron overload should focus primarily on eating a healthy, well-balanced diet, decreasing foods high in iron content may make sense,” he told The Epoch Times in an email.

A portion of the iron contained in animal foods is called heme iron, which is more easily absorbed, Lewis said. As a result, a person may wish to consider reducing or limiting heme iron intake to lower their total iron levels.

On the other hand, Lewis said that balance is essential, and the extent of dietary restrictions should depend on the severity of the hemochromatosis.

“It is rarely necessary to avoid a specific food entirely,“ he said. ”In the effort to reduce dietary iron, extreme avoidance of a food could inadvertently create a different nutrient deficiency.”

Supplements

Lewis highlights three supplements that show potential for removing iron from the body’s cells:

• Turmeric: This spice contains curcumin—the compound that gives it a yellow color—which has been shown in a mouse study to decrease cellular iron and reduce iron in the bloodstream. Curcumin also lowers inflammation, which may contribute to the fatigue and pain associated with hemochromatosis.


• Milk thistle: This herb acts as a liver protector, anti-inflammatory agent, blood sugar regulator, and antioxidant—properties that may benefit people with hemochromatosis. A clinical trial also suggested that it reduces iron absorption from food.


• Tea: Green tea is rich in polyphenol antioxidants that bind to iron and inhibit its absorption during meals. A study found that these iron-chelating properties may help treat iron overload. A clinical trial also showed that drinking black tea with meals reduces the frequency of phlebotomy needed to manage hemochromatosis. For those who struggle to drink enough green tea, supplements are an option.

Iron Toxicity and Overdose

People with hemochromatosis aren’t the only ones with excess iron. Accidental ingestion of toxic amounts can happen in children who take adult vitamins. Since iron poisoning is especially dangerous in this age group, adult supplements should be kept out of reach.

In addition to hemochromatosis, other causes of iron overload in adults include frequent blood transfusions, excessive alcohol intake, and some liver diseases.

Because iron is an ingredient in many over-the-counter vitamins, people who take several dietary supplements can ingest high amounts.

Joseph Lopez, founder of Pure IV Utah, told The Epoch Times how toxicity from supplements can easily happen. He recalls having a client who was taking a multivitamin, separate iron pills, and fortified protein powder—getting nearly 100 milligrams daily when most people only need 8 to 18 milligrams.

The following side effects can occur.

Gastrointestinal

These symptoms are common with high doses of iron supplements and include nausea, vomiting, diarrhea, and abdominal pain.

Cardiovascular

Extra iron contributes to oxidative reactions, causes damage in the walls of blood vessels, and disrupts the energy machinery inside heart muscle cells, Renee Young, a naturopathic physician and founder of Young Naturopathic Center for Wellness, said in an email to The Epoch Times.

Additionally, large population surveys show that men with the highest iron levels face roughly twice the risk of a heart attack compared with those in the middle range, she said.

“This does not mean that every supplement triggers a crisis, yet it reminds us that iron belongs in a narrow healthy window and that more is never automatically better,” Young said.

Brain

Young characterizes iron in the brain as a tightrope act. Neurons need trace amounts for mitochondrial energy, yet once unbound iron crosses the blood-brain barrier, it triggers reactive oxygen radicals that oxidize or damage delicate tissues. Imaging and cerebrospinal fluid studies show that people who accumulate iron in the hippocampus and cortex areas of the brain lose memory faster. The iron surplus appears to amplify the buildup of amyloid plaque and tau tangles. These substances impair brain functions such as memory and language and are associated with Alzheimer’s disease.

The aim is balance rather than elimination, she said. Too little iron impairs oxygen delivery and neurotransmitter synthesis, while too much drives oxidative stress that accelerates cognitive decline.

Young stressed that “keeping serum iron near the midpoint of the reference range, checking levels before starting supplements, and retesting every three to six months helps maintain a neurologically safe window.”

“Once excess iron embeds itself in neural tissue, removing it becomes far more challenging,” she said.