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How Much Iron is Too Much?

By Dr. Alecia Nero

The days of taking Granny’s iron tonic may not be the best medicine if you have sickle cell disease and receive blood transfusions.  Low iron can cause anemia, or low red blood cell count.  However, people with sickle cell disease are anemic due to rapid breakdown of the red blood cells and usually not due to low iron.

Too much iron (often called “iron overload”) can actually be harmful to many organs in the body such as the heart and liver.  These organs can ultimately fail after enough iron damage.  As a person with sickle cell disease, it is critical to speak with your doctor before taking iron or multivitamins that may also contain iron.  Frequent blood transfusions lead to iron overload as the blood contains iron.

It does not take many transfusions in your lifetime to cause iron overload.  Therefore, knowing whether or not you should be treated with blood transfusions is also very important and should be clearly discussed.  If you already have excess iron in the body, it is important to take the medicine to remove iron as prescribed.  This is critical as iron overload is a silent disease you may not feel until long after the organs have sustained irreversible damage.  Awareness and adherence can be live-saving.

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