From the Guidelines
Increased iron levels with low UIBC typically indicate iron overload, which may be due to conditions like hemochromatosis, multiple blood transfusions, or excessive iron supplementation, and prompt evaluation and treatment are necessary to prevent organ damage. This combination suggests that your blood has high iron levels and reduced capacity to bind additional iron, as most binding sites are already occupied. You should consult with a healthcare provider promptly for proper evaluation, which will likely include additional tests such as ferritin, transferrin saturation, and possibly genetic testing for hereditary hemochromatosis, as recommended by the EASL clinical practice guidelines on haemochromatosis 1.
Key Considerations
- Treatment depends on the underlying cause but often involves therapeutic phlebotomy (blood removal) to reduce iron levels, typically 500ml every 1-2 weeks until iron levels normalize, then maintenance sessions several times per year.
- Dietary modifications to reduce iron intake may be recommended, including limiting red meat, vitamin C with meals, and alcohol, as excessive alcohol consumption can accelerate fibrosis and increase the risk of cirrhosis, HCC, and liver-related mortality in patients with haemochromatosis 1.
- Early treatment is important as untreated iron overload can damage organs including the liver, heart, and pancreas, potentially leading to cirrhosis, heart failure, diabetes, and other complications.
Monitoring and Management
- Serum ferritin levels and transferrin saturation should be monitored to assess iron overload, as recommended by the NCCN clinical practice guidelines in oncology 1.
- Iron chelation therapy may be considered in patients with iron overload, particularly those with transfusional iron overload, as it has been shown to improve cardiac iron content and reduce morbidity in patients with MDS 1.
- The choice of iron chelator depends on the individual patient's needs and circumstances, and should be guided by clinical guidelines and expert opinion, with deferoxamine and deferasirox being two commonly used options 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Increased Iron and UIBC Low
- Increased iron levels can lead to iron overload, which can cause serious clinical implications 2.
- UIBC (Unsaturated Iron Binding Capacity) is a measure of the amount of iron that can be bound by transferrin, a protein that transports iron in the blood. A low UIBC indicates that the transferrin is already saturated with iron, and there is little capacity to bind more iron.
- Iron chelation therapy is a treatment option for iron overload, which involves using medications to bind to excess iron and remove it from the body 3, 4.
- Deferasirox is an oral iron chelator that has been shown to be effective in reducing iron overload in patients with transfusional iron overload 4, 5.
- Iron chelation therapy has been proposed for use in patients with non-transfusion-dependent thalassemia syndromes, including thalassemia intermedia, to prevent iron overload and related organ damage 6.
Treatment Options
- Phlebotomy is a treatment option for iron overload, which involves removing blood from the body to reduce iron levels 2.
- Iron chelation therapy can be used in combination with phlebotomy to remove excess iron from the body 2.
- Deferasirox has been shown to be well-tolerated and effective in reducing iron overload in patients with transfusional iron overload 4, 5.
Monitoring and Management
- Regular monitoring of iron levels and UIBC is important to manage iron overload and prevent related organ damage 3, 5.
- Iron chelation therapy should be tailored to the individual patient's needs, taking into account the severity of iron overload and the presence of any underlying medical conditions 5, 6.