Hemochromatosis and Alcohol: What Is the Connection 

Something’s felt a little off lately. Maybe we’ve recently lost weight without trying; we feel exhausted all the time; we have this awful joint pain, or our skin tone has been looking a little strange. The first step is to start running down the list of possibilities. After we rule out the scary stuff (thanks, Google!), we might finally get to something realistic: maybe we’ve been drinking too much. “Hmm,” we might think. “Maybe if I stop drinking for a bit, I’ll feel better.”

Could this really be the case? The symptoms described above are indicative of hemochromatosis, a disease wherein our body has too much iron. Extra iron in our body leads to toxic reactions that can damage our organs, and drinking alcohol in excess leaves us vulnerable to developing hemochromatosis. Keep reading to learn about the causes of hemochromatosis, the science behind it, and how we can manage the risk factors.

What Is Hemochromatosis?

Hemochromatosis occurs when the body has too much iron and it builds up, causing toxic reactions. Our body needs iron to maintain many life-sustaining functions, such as DNA synthesis and transportation of oxygen throughout the body. We don’t make iron ourselves, so we get all of our iron from the food we eat.

When we eat foods rich in iron (such as nuts, legumes, tofu, red meat, shellfish, or spinach), the iron is absorbed by the cells that line our small intestines. Excess iron is stored mainly in our liver, but if we have too much iron in our system, it can become toxic. 

Also referred to as iron overload, hemochromatosis occurs when the digestive system absorbs too much iron from the food we eat. When there is excess iron in the body, a toxic reaction occurs and results in the release of reactive oxygen species, which causes damage to cells. The areas most affected by excessive iron are the places where it’s stored in our body, such as the heart, liver, pancreas, and endocrine glands. 

How does our body go from absorbing just enough iron to overdoing it? Let’s take a look at the two mechanisms that could be responsible.

What Causes Hemochromatosis?

There are two types of hemochromatosis. One is an inherited genetic mutation known as primary hemochromatosis and the other (secondary hemochromatosis) is a result of medical treatments or conditions. Hemochromatosis is most common in men of European descent. Women tend to have lower levels of iron due to losing more iron naturally from menstruation, and typically they do not develop hemochromatosis until after menopause. 

There are four types of primary hemochromatosis and each type shows up differently depending on the gene that is mutated. Type one hemochromatosis is the most common — in fact, it’s one of the most common genetic mutations in the United States. The main symptoms show up in our 40s or 50s and include liver disease. Although different genes are mutated, all hereditary forms of hemochromatosis have similar pathology and result in similar symptoms. 

Secondary (acquired) hemochromatosis comes from other diseases or conditions that increase iron levels. Circumstances that lead to excessive iron include multiple blood transfusions, anemia treatments, kidney dialysis, or excessive iron supplementation. Conditions or diseases that can cause secondary hemochromatosis include hepatitis C, diseases of the red blood cells, or chronic liver diseases.

But where does alcohol come into play? With all this talk of liver disease, it’s natural to look to alcohol as a potential cause. The answer, however, is a little more complicated.

Does Alcohol Cause Hemochromatosis?

Alcohol intake increases iron stores in the liver. Alcohol also stops or prevents the breakdown of iron in the liver, which leads to an abundance of it in the body. Though light to moderate drinking may increase iron, the increase isn’t substantial enough to cause hemochromatosis on its own. However, heavy drinkers and those with alcohol use disorder (AUD) are at a greater risk for developing iron overload. 

In those with primary hemochromatosis, alcohol can make symptoms worse, since both alcohol and excessive iron can lead to liver damage. In heavy drinkers, there is more intestinal iron absorption. AUD or heavy alcohol use will not cause hemochromatosis, but they can increase our risk for developing it and exacerbate existing disease.

We know how we can get hemochromatosis, but what does it look like if we have iron overload?

Symptoms of Hemochromatosis

There are several symptoms associated with hemochromatosis. Let’s go through some of the most common symptoms associated with hemochromatosis.

• Unusual fatigue or weakness
• Unexplained weight loss 
• Bronze or grayish skin
• Pain in muscles, joints, or stomach 
• Memory fog, problems focusing
• Impotence or loss of sex drive
• Mood changes
• Digestion problems
• Shortness of breath

If you notice a pattern of these symptoms, speak with your doctor. These symptoms on their own are cause for concern, but together they can indicate a more dangerous condition such as hemochromatosis.

Dangers of Hemochromatosis

Untreated iron overload can be dangerous to our overall health. Aside from the uncomfortable or harmful symptoms, hemochromatosis can lead to other diseases or the following complications: 

• Liver disease. Excess iron is stored in the liver. Since too much iron can lead to toxic reactions that cause cell death, hemochromatosis can cause liver damage. The damage to the liver can include cirrhosis (scarring of the liver), enlarged liver, liver cancer, or liver failure. Signs of liver disease or failure include jaundice, itchy skin, dark urine, pale stool, easy bruising, or swelling of the belly, legs, and ankles. 
• Heart problems. Too much iron can cause issues with the heart. Our heart’s ventricles may become dilated and unable to circulate the amount of blood our body needs. This can lead to a condition called congestive heart failure. Iron overload also can cause abnormal heart rhythms and palpitations that lead to dizziness or fainting. 
• Diabetes. Some excess iron is stored in the pancreas. Iron toxicity can damage the pancreas, reducing its ability to produce enough insulin.  
• Reproductive system problems. Extra iron can damage male and female reproductive organs and cause sexual problems such as decreased libido. In males, hemochromatosis can cause erectile dysfunction, and in females, it can disrupt the menstrual cycle or even lead to premature menopause. 
• Arthritis. Sometimes our joints can be damaged by iron overload, leading to pain and stiffness in the affected joints.

Hemochromatosis can lead to health conditions ranging from uncomfortable to serious. Luckily, it’s a manageable condition, and there are many ways to prevent hemochromatosis from getting worse.

How Is Hemochromatosis Treated? 

Unfortunately, there is no cure for hemochromatosis, but with medication and lifestyle changes, it can be managed. If hemochromatosis is diagnosed early enough, most serious health consequences can be avoided. The following are treatments or changes we can make to our daily habits to treat hemochromatosis. 

• Phlebotomy. Phlebotomy is the removal of blood. This process works because as we lose blood, our body uses iron to replace the blood cells that were lost. Phlebotomy needs to be repeated every few months to help use the excess iron.  
• Chelation therapy. Heavy metal poisoning occurs when the soft tissues of the body absorb toxic amounts of metal. In this weekly therapy, substances known as chelators bind to heavy metals and transport them out of the body.
• Dietary changes. If we have hemochromatosis, we should avoid foods that are rich in iron, such as raw fish or shellfish, breakfast cereals, iron supplements or vitamins with iron, or foods high in vitamin C.
• Avoid alcohol. Drinking alcohol if we have hemochromatosis is not advised because alcohol can increase the amount of iron in our body. If we drink alcohol, it should be in moderation and with plenty of recovery time.

If we detect hemochromatosis early enough, we can prevent the disease from harming our organs. However, once it develops, it requires maintenance and lifestyle changes. Fortunately, most people with hemochromatosis have normal lifespans.

Key Takeaways

Alcohol intake is responsible for many serious and chronic illnesses, and it can exacerbate many more. If we’re managing a chronic illness such as hemochromatosis, we can make adjustments to our lifestyle to maximize our well-being, such as quitting or cutting back on alcohol. A healthy, full, rich life awaits when we put our well-being first — and we deserve it!