Iron surplus: The most important questions and answers

Iron is a well-known trace element and stands for energy and vitality. However, iron excess is not nearly as well known as iron deficiency. However, the long-term effects of an excess can cause serious damage to your body. Therefore, in this article we want to inform you in detail about an excessively high iron content in the blood.

In the following we would like to answer important questions about iron excess. First, we'll go over basic things like how iron works and iron-rich foods. Then you will learn everything you need to know about the causes and symptoms of high iron levels and how to treat it. If you suspect that you are suffering from such an excess, you can find detailed information on this topic here.

the essentials in brief

• Iron is a trace element with central functions in the body. It is mainly responsible for oxygen transport and cellular respiration.
• Iron is mainly found in meat and seafood. But plant foods such as whole grain products and legumes can also provide you with the trace element.
• An excess of iron can have dangerous consequences for the body and damage organs in the long term. However, this excess is usually triggered by genetic causes.

Definition: what is iron?

Iron is an important trace element for the body. It is responsible for the transport of oxygen in the body and is therefore important for the provision of energy in the cells. This makes an adequate supply of iron vital. (1.15)

Meat sources of iron include pork, offal, and black pudding. But plant foods also contain the trace element. (Image source: unsplash / Jez Timms)

Since iron can only be ingested through food, you should ensure you eat a balanced diet. Meat is generally considered a good source of iron. Vegetarians and vegans in particular should therefore take care of their diet and specifically use plant-based sources of iron. These include whole grain products, legumes and seeds. (1.17)

Background: What you should know about high iron levels in the blood

In the following we will answer some essential questions about iron and iron excess. You will learn details about the functions of iron and iron-containing foods. Then we provide you with important information about an excess of iron, such as its causes and consequences.

What is the role of iron in the body?

As already mentioned, iron is a trace element that is responsible for central functions in the body. (15) Hair, skin, nails, and muscles can also be affected by iron. The central task of iron is the formation of red blood cells, which is essential for so-called cell respiration. (1.14)

Iron is central to cellular respiration.

When you breathe in oxygen through your lungs, it is bound to hemoglobin, the red blood pigment, by the iron in the red blood cells. This then carries the oxygen through the whole body so that it can serve as an energy supplier.

Therefore, iron deficiency can be harmful in the long term. However, a permanently high iron content can also have harmful consequences. Both phenomena can significantly disturb your organism and trigger deficiency symptoms or stress on the metabolism. (4)

What is the daily requirement of iron?

In order for the iron to be able to carry out its important functions, you must ensure that you have a sufficient supply of the trace element. This can be ensured through diet or through dietary supplements. To be on the safe side, you should consult a doctor before taking such preparations. The table below shows the daily iron requirements for men and women in specific age groups.

Old	Daily requirement men / women
15 to under 19 years	12/15 milligrams per day
19 to under 51 years	10/15 milligrams per day
51 to under 65 years	10/10 milligrams per day
65 years and older	10/10 milligrams per day (5)

As you can see, your iron requirement depends on your age and gender. Pregnant women need an intake of 30 milligrams per day. Infants from 4 to 12 months need 8 mg per day. Teenage girls and women generally need more iron than men because they lose blood through menstruation. (5.6)

Which foods contain iron?

Iron is mainly found in meat, offal and seafood. (12) Plant sources of iron include whole grains, green vegetables, and legumes. (2) You should also get enough vitamin C as it can increase iron absorption. (13)

food	Iron content in milligrams per 100 grams
beef	2.1
Chicken	0.7
pork liver	18
oatmeal	4.2
pumpkin seeds	11.2
tofu	5.4
Dried Lentils	8 (8)

Nuts and seeds such as pumpkin seeds, almonds and dried fruit are also vegetable sources of iron. Vegetarians and vegans should therefore ensure a balanced diet. Eggs and dairy products also contain small amounts of iron. (8th)

What are the causes of too high an iron content?

Now that you are well informed about the trace element iron, let's take a closer look at the topic of iron excess. There are basically two forms of excess iron. You can distinguish between primary iron excess, which is congenital, and the secondary form, acquired iron excess.

The primary iron excess results from a mutation of the HFE gene. As a result, iron absorption in the intestine is no longer inhibited and too much iron is absorbed through the intestine. As a result, the amount of iron in the whole body increases. Excess iron cannot be broken down here.

An excess of iron from iron tablets is comparatively rare. Genetic causes are often responsible for the excess.

A common cause of secondary excess iron is an acquired or congenital dysfunction in the formation of blood. Patients then usually receive blood transfusions, which can trigger the excess. Again, too much iron is absorbed through the intestines. (16.18)

What are the consequences of too high an iron content?

Excess iron can have serious or even life-threatening effects if it is present long-term. When the iron stores in the body are full, the excess iron is transported away. It is then usually deposited in the heart, liver and pancreas. Joints can also be affected.

These deposits can cause damage in the body that can limit organ functions. In the worst case, organ failure can threaten. Possible damage is discussed in more detail in the next section. (4,16,18)

Did you know that certain foods can inhibit iron absorption? Examples include coffee and black tea. To ensure good iron absorption, you should consume these foods a few hours before or after a main meal.

What are the symptoms of too high an iron content?

If you suffer from a high iron content in the blood, this becomes clear through various symptoms. These usually only appear after decades in adulthood. However, it can also be rare that no symptoms are noticeable. (16)

Early Symptoms

Symptoms in the early stages of iron excess are non-specific and do not clearly indicate the excess. Examples of these symptoms include:

• fatigue
• weakness
• joint problems
• susceptibility to infection
• hair loss
• discoloration of the skin

Intense tiredness or a general feeling of weakness often occur. Joint problems, often in the fingers, are also possible consequences of excess iron. In addition to susceptibility to infections, hair loss and premature graying of the hair can occur. The most noticeable symptom is a bronze discoloration of the skin. (9.16)

late damage

Long-term effects of excess iron can have serious effects on your health as they affect different organs. Long-term excess can result in permanent illnesses.

• Liver: Excess iron can cause the liver to enlarge. This can lead to cirrhosis of the liver. If it lasts longer, a tumor can develop.
• Pancreas: The function of the pancreas can be severely disturbed. This can lead to diabetes mellitus, also known as sugar disease.
• Heart: If a lot of iron builds up in the heart, this can lead to heart failure. Cardiac arrhythmias can also be triggered.
• Pituitary gland: If damage occurs here, this can herald an early onset of menopause in women. In men, excess iron can result in a testosterone deficiency.

In particular, the liver, pancreas and heart are affected by the excess. However, the iron can also be deposited in the pituitary gland and cause damage there. This can lead to various secondary diseases such as diabetes mellitus or even tumors. (10.16)

What should be considered if the iron content is too high during pregnancy?

Iron supplements are often recommended during pregnancy to prevent anemia. Pregnant women have a higher iron requirement than other women. Frequent blood tests during pregnancy can detect an excess or deficiency of iron at an early stage.

During pregnancy, the daily requirement for iron increases. Iron excess and iron deficiency should be avoided in pregnant women. (Image source: unsplash / Suhyeon Choi)

The iron requirement can also be fully met through a wholesome and balanced diet. You should therefore consult a doctor before taking iron tablets. Overdosing on iron tablets can often lead to gastrointestinal problems such as diarrhea and nausea. (11)

How are high iron levels and alcohol consumption related?

Excessive alcohol consumption can disrupt iron metabolism in your body. In people with an excess of iron in particular, frequent alcohol consumption can increase the excess and its consequences. This is particularly harmful to the liver.

Moderate alcohol consumption in healthy people usually cannot cause an excess of iron.

In addition, increased levels of iron in the organ are found in about a third of patients with liver damage caused by heavy alcohol consumption. This again shows a connection between alcohol consumption and iron content in the body. (7)

How does an iron deficiency manifest itself?

Iron deficiency is generally better known than iron excess. The symptoms of the two phenomena can be similar in the early stages, making self-diagnosis more complicated. A blood test with an analysis of the iron balance can definitively determine whether your iron level in the body is too high or too low.

Especially during pregnancy, women should pay attention to an adequate iron intake, as their iron requirements increase. Anemia can be harmful to both mother and child. However, as mentioned above, you should not take iron tablets without a doctor's recommendation. (1.11)

Iron levels too high: 3 effective approaches to treatment and prevention

A blood test and measurement of iron levels can usually determine whether there is a problem with your iron balance. To get more certainty, a genetic test can be performed. This determines whether there is a genetic abnormality that affects iron processing. (16) If you suffer from iron excess, various therapies can be used to treat it.

bloodletting

In bloodletting therapy, blood is drained every one to two weeks. This can be a quantity of up to 500 milliliters. This will remove the blood with the excess iron from your body. This therapy can be carried out for more than a year, and the intervals between treatments are usually increased.

Advantages

• Simply
• No side effects

Disadvantages

Hard for patients

Regular implementation

Not possible with anemia

The advantages of bloodletting therapy are that it is easy to carry out. Also, there are usually no side effects. However, bloodletting can be stressful for patients and it must be performed regularly. This therapy is also not possible in the case of anemia. (3)

erythrocyte apheresis

Blood is also drained during erythrocyte apheresis. With this method, however, the blood is mechanically filtered and the red blood cells are removed. This is how the iron can be removed from the blood. Then the blood is pumped back into the body.

Advantages

• More effective than bloodletting
• Few treatments needed

Disadvantages

Not possible everywhere

This method is more effective than bloodletting. In addition, fewer treatments are required for a good effect. However, erythrocyte apheresis cannot be performed everywhere. (9.16)

adjust diet

If you have an excess of iron, you are advised not to eat foods that contain a lot of iron. So you should avoid offal or black pudding here. You should also reduce your vitamin C intake at main meals, as vitamin C facilitates iron absorption in the body.

Adjusting your diet alone is not enough.

A completely iron-reduced diet is hardly possible and difficult to maintain. Therefore, if the iron content is too high, you should only adjust your diet to accompany one of the treatments mentioned above. However, you cannot avert an excess of iron in an advanced stage with an adapted diet alone.

Advantages

• No medical intervention
• Can be done at any time

Disadvantages

Not sufficient

Only accompanying

One of the advantages of an adapted diet is that no medical intervention is necessary. You can also change your diet at any time. However, diet alone is not enough to treat excess iron. (2.16)

Conclusion

Since iron is a vital trace element, an undiscovered excess can cause serious damage to the body decades later. Organs such as the liver or the heart can be permanently impaired in their functioning. Therefore, a timely diagnosis is of great importance. This can be determined by a blood test.

Too high an iron content cannot usually be triggered by an overdose of iron tablets. As a rule, an excess occurs due to genetic causes and its consequences usually only become apparent after many years. However, the treatment options for iron excess are rather simple to carry out. If in doubt, we advise you to consult a doctor.

Individual proofs(18)

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