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Too Much or Too Little Iron


Too much or too little iron in the system can be fatal. Death is often due to heart or liver failure.

Risk Factors* for too much or too little iron
*A risk factor is any behavior, condition or environmental factor known to increase the possibility of a disease outcome.  

Risk factors for too much iron include but may not be limited to:

  • Taking excessive amounts of supplemental iron; or receiving iron shots or iron infusions
  • Having received (or are receiving) frequent blood transfusions
  • Consuming excessive amounts of red meat or foods that enhance iron absorption (supplemental vitamin C, alcohol, sugar)
  • Having risk factors for metabolic syndrome that heighten the risk of type 2 diabetes and cardiovascular diseases
  • Using tobacco products on a regular basis or being exposed to tobacco smoke (lung)
  • Being exposed to iron-containing asbestos (lung)
  • Working or long-term computing in subways (lung)
  • Working in iron smelters or coal mines (lung)
  • Living in highly polluted areas—usually large metro-urban cities (lung)
  • Having an inherited iron loading condition such as hemochromatosis

Risk factors for too little iron include but may not be limited to:

  • Age and gender: women, children and the elderly are most at risk
  • Ethnicity: non-whites are at increased risk
  • Consuming foods or substances that impair iron absorption: fiber, tannin in coffee or tea, dairy products, eggs, or chocolate
  • Being a super blood donor (especially people with hemochromatosis who are overbled)
  • Having inherited conditions that impair absorption: celiac’s, crohn’s—colitis
  • An inadequate intake of iron (not enough meat or being strictly vegetarian)
  • Excessive aerobic exercise, marathon runner
  • Taking aspirin, antacids or calcium supplements
  • Being exposed to toxins (chemicals) such as lead,
  • Abusing drugs: pain meds, alcohol
  • Diseases  of the digestive tract; infection; diseases of the endocrine system or bone marrow
  • Surgery, gastro banding or short bowel syndrome
  • Having an eating disorder (bulimia)
  • Having an inherited anemia such as thalassemia or sickle cell disease

Complicated Iron (many of these are rare): when you have too much and too little at the same time

  • Anemia in these patients is due to having a particular disease of blood cell production or blood cell management such as thalassemia, sickle cell disease, sideroblastic anemia, enzyme deficiencies, bone marrow problems, iron-transport protein  problems.  Iron overload is often caused by a combination of the disease itself and the treatment, which is often blood transfusion or iron infusion.

When a person is receiving blood transfusions on a regular basis, iron can build up to toxic levels requiring iron chelation therapy. See our pamphlet on Transfusional Iron Overload.

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