What are the symptoms of hereditary hemochromatosis (HH)?

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Last updated: February 17, 2025 • View editorial policy

From the Guidelines

Hereditary hemochromatosis (HH) is characterized by a range of symptoms, including fatigue, joint pain, and weakness, which can progress to more severe manifestations such as liver dysfunction, cardiomyopathy, and skin hyperpigmentation 1, 2. Common symptoms also include abdominal pain, arthralgias, chondrocalcinosis, impotence, and decreased libido 3. In advanced cases, patients may exhibit signs of liver decompensation, such as jaundice, ascites, and hepatic encephalopathy.

Key Symptoms

  • Fatigue and weakness are common initial symptoms 1, 2
  • Joint pain and arthralgias are also frequent complaints 3
  • Skin pigmentation and greyish-brown discoloration of the skin can occur 2
  • Endocrine abnormalities such as hypogonadism, erectile dysfunction, and amenorrhea may be present 3
  • Gastrointestinal symptoms like abdominal pain, nausea, and vomiting can occur 3 ### Advanced Symptoms
  • Liver dysfunction and cirrhosis can lead to liver failure 1, 2
  • Cardiomyopathy and heart failure can occur in severe cases 3, 2
  • Diabetes and osteoporosis are also potential complications 1, 2 It is essential to consider HH in patients presenting with these symptoms, especially if they have a family history of the disease 1, 3. Prompt diagnosis and treatment can help prevent long-term complications and improve patient outcomes.

From the Research

Symptoms of Hereditary Hemochromatosis (HH)

The symptoms of hereditary hemochromatosis (HH) can vary, but common manifestations include:

  • Chronic liver damage, hypogonadotropic hypogonadism, cardiac diseases, and endocrine dysfunctions 4
  • Weakness, skin hyperpigmentation, joint pain, and amenorrhea 4
  • Cardiovascular manifestations such as dilated cardiomyopathy, conduction abnormalities, heart failure, cardiac fibrosis, myocardial infarction, and valvular heart disease 5
  • Liver cirrhosis, hepatocellular cancer, cardiomyopathy, and diabetes due to systemic iron overload and associated oxidative stress 6
  • Endocrine dysfunction, including diabetes, hypogonadism, hypopituitarism, and abnormalities of adrenal, thyroid, and parathyroid glands 7

Organ Damage and Complications

The excess iron deposition in HH can cause damage to various organs, including:

  • Liver: cirrhosis, hepatocellular cancer 6
  • Heart: cardiomyopathy, heart failure, cardiac fibrosis, myocardial infarction, and valvular heart disease 5
  • Pancreas: diabetes 6, 7
  • Joints: joint pain 4
  • Endocrine glands: hypogonadism, hypopituitarism, and abnormalities of adrenal, thyroid, and parathyroid glands 7

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.