What to do if your iron is very high?

November 28, 2025 •

4 min read

Excess iron, known as iron overload or hemochromatosis, can be highly toxic and accumulate over many years, causing significant organ damage, particularly to the liver, heart, and pancreas. Finding out what to do if your iron is very high requires understanding the underlying cause and following a medical management plan.

Quick Summary

Excess iron in the body can lead to serious health issues, necessitating professional medical treatment. Management includes therapeutic blood removal (phlebotomy), iron-chelating medications, and dietary changes to reduce iron absorption and protect vital organs from damage.

Key Points

Consult a Doctor Immediately: Very high iron levels can be toxic, so a medical professional must diagnose the underlying cause, most commonly hemochromatosis.
Undergo Phlebotomy: The most effective treatment for hereditary hemochromatosis is therapeutic blood removal (phlebotomy) to reduce overall iron stores.
Consider Chelation Therapy: For individuals unable to undergo phlebotomy, chelation therapy uses medication to remove excess iron from the body.
Avoid Supplements: Do not take iron or high-dose vitamin C supplements, as these increase iron absorption and exacerbate the condition.
Limit Alcohol Intake: Reduce or eliminate alcohol consumption, especially if liver damage is present, to prevent further organ strain.
Modify Your Diet: Focus on a balanced diet, limiting red meat and fortified cereals while incorporating foods with calcium, tannins (like tea), and phytates to inhibit iron absorption.
Get Screened for Complications: Untreated iron overload can damage the liver, heart, and joints, making regular monitoring crucial.

A diagnosis of high iron levels, often indicated by a high ferritin blood test, should be managed by a healthcare professional. While the most common cause is hereditary hemochromatosis, other conditions like chronic liver disease, repeated blood transfusions, or certain blood disorders can also lead to iron overload. It is crucial to address this condition promptly to prevent long-term complications, which can include liver damage (cirrhosis), heart failure, diabetes, and arthritis.

Medical Treatments for High Iron Levels

Managing very high iron levels is a multi-faceted approach, primarily revolving around medical procedures designed to physically remove or chemically bind the excess iron in the body. Dietary modifications, while helpful, are supplementary to these primary treatments.

Therapeutic Phlebotomy

Phlebotomy is the most common and effective treatment for hereditary hemochromatosis. The procedure is very similar to a standard blood donation and is performed in a medical setting. By removing a pint of blood, the body is forced to use its stored iron to create new red blood cells, thus lowering overall iron levels over time.

Initial Phase: During the initial, or induction, phase, phlebotomies may be performed frequently, sometimes weekly, until iron levels (ferritin) fall into a normal range. The required frequency and amount of blood removed will depend on the individual's iron levels and overall health.

Maintenance Phase: Once iron levels have normalized, a maintenance phase begins. This involves less frequent phlebotomies, typically every 2 to 4 months, for the rest of a person's life to prevent iron from building up again.

Iron Chelation Therapy

For individuals who cannot undergo phlebotomy due to other medical conditions, such as anemia or heart problems, chelation therapy is an alternative. This treatment uses medication to bind to excess iron, which is then excreted from the body through urine or stool.

Oral Medications: Medicines like deferasirox and deferiprone can be taken orally.
Injections: Deferoxamine is a chelating agent that is administered via infusion.
Effectiveness: Chelation therapy is generally less effective than phlebotomy for removing iron but can be an essential tool for managing the condition in certain patients.

Dietary and Lifestyle Adjustments

While medical treatment is paramount, making strategic dietary and lifestyle changes can help manage iron levels and reduce the risk of complications. It is important to discuss any changes with a doctor, as excessive dietary restrictions may cause nutritional deficiencies.

Foods and Habits to Avoid

Iron Supplements: Do not take iron supplements or multivitamins containing iron, as this will increase iron levels further.
Vitamin C Supplements: High-dose vitamin C supplements enhance iron absorption. While natural vitamin C from foods is generally not restricted, supplements should be avoided.
Excessive Alcohol: Alcohol consumption can increase the risk of liver damage in individuals with high iron. If liver disease is present, alcohol should be avoided completely.
Raw Fish and Shellfish: People with hemochromatosis are at higher risk for bacterial infections from certain bacteria found in raw shellfish.
Fortified Foods: Check labels and avoid foods, such as some breakfast cereals, that are fortified with iron.

Foods and Habits to Incorporate

Calcium-Rich Foods: Calcium can inhibit iron absorption. Incorporate dairy products like milk and cheese, and leafy greens.
Tea and Coffee: Tannins and polyphenols in tea and coffee can reduce iron absorption when consumed with meals.
Plant-Based Protein: Lean white meats, fish, eggs, and plant-based protein sources are preferable to red meat, which contains more easily absorbed heme iron.
Whole Grains: These contain phytates, which can inhibit iron absorption.

Comparison of Treatment Methods


Feature	Therapeutic Phlebotomy	Iron Chelation Therapy
Mechanism	Removes iron-rich blood directly from the body.	Uses medication to bind to and excrete excess iron.
Primary Use	First-line treatment for most cases of hereditary hemochromatosis.	For patients who cannot tolerate phlebotomy (e.g., due to anemia or fragile veins).
Administration	Performed in a medical setting, similar to blood donation.	Oral tablets or subcutaneous/intravenous infusions.
Frequency (Initial)	Weekly or bi-weekly, depending on iron levels.	Daily, depending on the specific medication.
Frequency (Maintenance)	Every 2-4 months or as needed based on monitoring.	Ongoing, as prescribed by a doctor.
Effectiveness	Highly effective for reducing total body iron stores.	Less effective than phlebotomy, but vital for specific patient groups.
Potential Side Effects	Fatigue, lightheadedness, bruising, anemia if over-treated.	Gastrointestinal issues, skin reactions, potential organ toxicity (requires monitoring).

Conclusion

Managing very high iron levels is a critical and long-term process that requires a close partnership with your healthcare provider. The most effective treatment, therapeutic phlebotomy, works to normalize iron stores by regularly removing blood. When phlebotomy isn't an option, chelation therapy provides a viable alternative. Supplementing medical treatment with mindful dietary choices—particularly avoiding iron and vitamin C supplements, excessive alcohol, and limiting red meat—can further support the management of iron overload. Early diagnosis and consistent treatment are key to preventing serious complications and maintaining long-term health.

Get Medical Advice for High Iron Levels

This information is for educational purposes and should not be taken as medical advice. If you suspect your iron levels are high, consult a healthcare professional for accurate diagnosis and a personalized treatment plan.

Note: While some information suggests blood donation is an option during the maintenance phase, eligibility is subject to individual donor criteria and approval from a physician and blood service.

Key Takeaway: Early medical intervention for high iron levels, primarily through phlebotomy or chelation, is essential to prevent severe organ damage.

Frequently Asked Questions

Symptoms of iron overload can develop slowly and may include fatigue, joint pain (especially in the knees and hands), abdominal pain, weakness, and a darkening or bronze tint to the skin.

No, while dietary modifications are important for managing iron absorption, they are not sufficient to treat very high iron levels. Medical treatments like phlebotomy or chelation therapy are necessary to reduce significant iron overload.

The primary treatment for hemochromatosis and high iron is therapeutic phlebotomy, a procedure that removes blood from the body, similar to donating blood.

Once you reach the maintenance phase of treatment and with your doctor's approval, it may be possible to donate blood. Eligibility depends on specific blood service criteria, and regular medical monitoring is still required.

You should avoid iron-fortified cereals, raw shellfish, and excessive amounts of red meat and organ meats. It is also important to limit alcohol consumption and avoid high-dose vitamin C supplements.

The duration of treatment varies depending on the severity of the iron overload. The initial phase with frequent phlebotomies can last for a year or more, while the maintenance phase is ongoing.

Ferritin is a protein that stores iron in the body, so a ferritin blood test measures your body's stored iron reserves. High ferritin levels often indicate high overall iron levels or inflammation, though further tests are needed for confirmation.