Hemochromatosis is a condition where your body stores too much iron. Over time, this excess iron builds up in organs like your liver, heart, and pancreas — and can cause serious damage. It is one of the most common genetic conditions in Canada, particularly among people of Northern European descent. The good news is that when caught early, hemochromatosis is very treatable.

What Is Hemochromatosis?

Your body needs iron to make haemoglobin, the protein in red blood cells that carries oxygen. Iron also gives your muscles and tissues the energy they need to function. However, your body has no natural way to get rid of excess iron. When too much iron builds up, it gets stored in your organs and slowly damages them.

Hemochromatosis is sometimes called “bronze diabetes.” This nickname comes from two of its well-known effects: skin that turns a bronze or grey colour, and diabetes caused by iron damage to the pancreas. For more background on how iron affects the body, visit Health Canada’s nutrition and wellness resources.

Types of Hemochromatosis

There are two main types of hemochromatosis. Understanding which type you have helps guide treatment.

Hereditary (Genetic) Hemochromatosis

This is the most common form. It is passed down through families and is caused by a change in a gene called HFE. Hemochromatosis follows an autosomal recessive pattern. This means a child must inherit the changed gene from both parents to develop the condition. It is especially common in people with ancestors from Northern Europe.

Secondary (Acquired) Hemochromatosis

This type is not inherited. Instead, it develops as a result of another condition or lifestyle factor. Common causes include:

  • Repeated blood transfusions

  • Certain blood disorders, such as thalassemia

  • Chronic liver disease

  • Long-term heavy alcohol use

  • Taking too many iron supplements

  • A diet extremely high in iron (rare)

Who Is at Risk for Hemochromatosis?

Hemochromatosis can affect anyone. However, some people face a higher risk than others.

Men are more likely to develop symptoms than women. Women naturally lose iron through menstruation and pregnancy. As a result, iron builds up more slowly in women. After menopause, however, a woman’s risk increases significantly.

You may be at higher risk if you have:

  • A parent, sibling, or child diagnosed with hemochromatosis

  • Unexplained liver disease or abnormal liver test results

  • Type 2 diabetes with an enlarged liver or heart problems

  • Early-onset joint pain, heart disease, or sexual dysfunction with no clear cause

  • Skin that has turned darker without explanation

  • Low sex hormone levels

  • Routine blood tests showing high iron levels

If any of these apply to you, speak with your family doctor. Early testing can make a real difference in your long-term health.

Symptoms of Hemochromatosis

Symptoms of hemochromatosis usually appear between the ages of 40 and 60. This is because iron builds up slowly over many years. In addition, the symptoms are often vague, which makes the condition easy to miss or confuse with other health issues.

Common symptoms include:

  • Fatigue and weakness

  • Joint pain, especially in the hands, hips, knees, and ankles

  • Unexplained weight loss

  • Abdominal pain

  • Loss of sex drive or impotence

  • Increased urination

  • Skin that takes on a bronze or grey colour

Without treatment, iron continues to build up. When iron levels become dangerously high, serious complications can develop. These include diabetes, arthritis, liver cirrhosis, heart failure, and liver cancer. Learn more about iron overload complications at the Mayo Clinic’s hemochromatosis overview.

How Is Hemochromatosis Diagnosed?

Diagnosing hemochromatosis often starts with a conversation. Your doctor will ask about your symptoms, your diet, your family health history, and any previous blood transfusions. A physical exam will also be done.

Blood Tests

The most important first step is a blood test. Key tests include:

  • Transferrin saturation: This measures how much iron is bound to a blood protein called transferrin. A high result can signal iron overload.

  • Serum ferritin: This measures the amount of stored iron in your body.

  • Serum iron (sideremia): This checks the level of iron circulating in your blood.

Additional blood tests may check for complications such as diabetes or liver disease. A complete blood count (CBC) may also be ordered to rule out blood disorders like thalassemia.

Genetic Testing

Genetic testing can identify changes in the HFE gene linked to hereditary hemochromatosis. If you are diagnosed, your doctor will likely recommend that close family members — including parents, siblings, and children — also get tested. This is an important step, since the condition runs in families.

Imaging and Liver Biopsy

In some cases, your doctor may order a CT scan or MRI to check how iron has affected your organs. A liver biopsy may also be done. This involves taking a small sample of liver tissue to check for cirrhosis or other liver damage. Your doctor may also test your alpha-fetoprotein level. This is a blood marker that can indicate liver cancer.

Screening for Hemochromatosis in Canada

Routine screening of the general population for hemochromatosis is not currently recommended in Canada. However, screening is strongly encouraged for people at higher risk. This includes anyone with a first-degree relative — a parent, sibling, or child — who has been diagnosed with hemochromatosis.

The earlier hemochromatosis is found and treated, the better. Early treatment can prevent life-threatening complications like liver failure and heart disease. Furthermore, if you have unexplained abnormal iron levels on routine bloodwork, ask your doctor whether further testing makes sense for you.

Treatment Options for Hemochromatosis

The main treatment for hemochromatosis is called phlebotomy, which simply means removing blood. By taking blood out of your body regularly, your iron levels drop. This is safe, effective, and widely available across Canada.

Phlebotomy (Blood Removal)

Most doctors recommend starting phlebotomy even before symptoms appear, once hemochromatosis is confirmed. Depending on your iron levels, you may need between 40 and 80 sessions to bring your iron down to a safe range. Treatment usually begins with one or two sessions per week. Each session removes about 450 to 500 mL of blood — similar to a regular blood donation. Once iron levels stabilise, maintenance phlebotomy — typically four to six times per year — keeps levels in a healthy range.

Dietary and Lifestyle Changes

While diet alone cannot treat hemochromatosis, some changes can help slow iron build-up. Your doctor may advise you to:

  • Avoid iron supplements unless specifically prescribed

  • Limit vitamin C supplements, since vitamin C increases iron absorption

  • Reduce or eliminate alcohol, which adds stress to the liver

  • Limit red meat and shellfish if your iron levels are very high

Always speak with your doctor or a registered dietitian before making major changes to your diet. For more guidance on managing iron in your diet, Healthline’s guide to dietary iron offers helpful background information.

When to See a Doctor

You should talk to your family doctor if you notice unexplained fatigue, joint pain, skin colour changes, or loss of sex drive — especially if these symptoms have been going on for a while. These symptoms can have many causes, but it is always worth ruling out hemochromatosis.

If you do not have a family doctor, a walk-in clinic can order the initial blood tests. Most provincial health plans in Canada cover testing for hemochromatosis when it is medically indicated. If you have a close family member with this condition, bring it up at your next appointment — genetic testing and early screening could protect your long-term health.

Please speak with a qualified healthcare provider before making any decisions about your health. This article is for general information only and does not replace professional medical advice.

Frequently Asked Questions About Hemochromatosis

What is hemochromatosis and what causes it?

Hemochromatosis is a condition in which the body absorbs and stores too much iron. The most common cause is a genetic change in the HFE gene, which is inherited from both parents. It can also develop as a result of repeated blood transfusions, certain blood disorders, or chronic liver disease.

What are the early warning signs of hemochromatosis?

Early signs of hemochromatosis can include persistent fatigue, joint pain in the hands and knees, and abdominal discomfort. Because these symptoms are vague and develop slowly, hemochromatosis is often not diagnosed until middle age. If you notice unexplained skin darkening or loss of sex drive alongside these symptoms, see your doctor.

Is hemochromatosis common in Canada?

Yes, hereditary hemochromatosis is one of the most common genetic conditions in Canada, particularly among Canadians of Northern European descent. Estimates suggest that roughly 1 in 200 to 1 in 300 people of Northern European ancestry carry the gene mutations associated with the condition. Many people are undiagnosed because symptoms develop slowly and are easy to overlook.

Can hemochromatosis be cured?

Hemochromatosis cannot be cured, but it can be very effectively managed with regular phlebotomy (blood removal). When treatment begins early, most people with hemochromatosis live a normal, healthy life. However, any organ damage that has already occurred — such as cirrhosis — may not fully reverse with treatment.

Should family members be tested if someone has hemochromatosis?

Yes, absolutely. Since hereditary hemochromatosis is a genetic condition, first-degree relatives — parents, siblings, and children — have a higher chance of carrying the same gene changes. Genetic testing and iron blood tests are recommended for these family members, even if they have no symptoms. Early detection leads to much better outcomes.

What foods should you avoid with hemochromatosis?

People with hemochromatosis are generally advised to limit red meat, alcohol, and high-dose vitamin C supplements, all of which can increase iron absorption or add strain to the liver. Iron supplements should be avoided unless prescribed by a doctor. A registered dietitian can help you build a meal plan that supports your treatment without unnecessary restriction.

Key Takeaways

  • Hemochromatosis causes the body to store too much iron, which can damage the liver, heart, and other organs.

  • The hereditary form is one of the most common genetic conditions in Canada, especially among those with Northern European ancestry.

  • Symptoms often do not appear until age 40 to 60, which makes early screening important for those at risk.

  • Men are at higher risk than pre-menopausal women, who naturally lose iron through menstruation.

  • The most effective treatment is regular phlebotomy — a simple blood removal procedure covered by most provincial health plans.

  • If a close family member has hemochromatosis, ask your family doctor or walk-in clinic about genetic testing.

  • When caught and treated early, hemochromatosis allows for a normal, healthy life.