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Iron Toxicity

ByLarry E. Johnson, MD, PhD, University of Arkansas for Medical Sciences
Reviewed/Revised May 2025
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Iron (Fe) is a component of hemoglobin, myoglobin, and many enzymes in the body. Heme iron is contained mainly in animal products. It is absorbed much better than the nonheme iron in plants and grains. Nonheme iron accounts for > 85% of iron in the average diet. Absorption of nonheme iron is increased when it is consumed with animal protein and vitamin C.

Iron may accumulate in the body because of

  • Iron therapy given in excessive amounts or for too long

  • Repeated blood transfusions

  • Alcohol-related liver disease

  • Overdose of iron

Iron overload can also result from an inherited iron overload disease (hemochromatosis), a potentially fatal but easily treatable genetic disorder in which too much iron is absorbed. Hemochromatosis affects > 1 million Americans.

An overdose of iron is toxic, causing vomiting, diarrhea, and damage to the intestine and other organs.

Diagnosis of iron toxicity is based on clinical presentation and confirmed with serum iron, transferrin saturation, and ferritin (>600 mcg/L) concentration.

Treatment of iron toxicity often involves deferoxamine, which binds with iron and is excreted in urine. Hemochromatosis is treated with phlebotomy.of iron toxicity often involves deferoxamine, which binds with iron and is excreted in urine. Hemochromatosis is treated with phlebotomy.

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