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Hemochromatosis Treatment Needs Time to Lessen Fatigue

Dear Dr. Roach: My 50-year-old, active son-in-law became very fatigued a year and half ago. He initially was diagnosed with low testosterone and given further testing. Finally, about six months from the onset of his symptoms, he was diagnosed with hemochromatosis, with iron levels in the 600s. Consequently, one and a half pints of blood have been withdrawn weekly for about two months. Levels are now in the 500s. His organs all have been tested for damage, but only two benign tumors have been found, in his kidneys. Despite treatment, the fatigue has continued. Is there anything else he should be doing? — M.F.

Answer: Hemochromatosis is a disease of iron metabolism. In hereditary hemochromatosis, the body absorbs as much iron as it can, even if it doesn’t need it, and the iron builds up in various tissues in the body. The organ systems most commonly affected are the bone marrow, heart and liver; however, many other organs will be affected if the disease is not treated. Low testosterone is common in hemochromatosis, and it might have been a clue in such a young man.

Men tend to be affected at a younger age than women, as women are protected to a certain extent by menstruation, but young women certainly can have asymptomatic or even symptomatic disease.

Fatigue in hemochromatosis can have several causes, but the most worrisome is iron overload in the heart, which can cause heart failure. He probably should have an echocardiogram if his doctors have not already done one. Fatigue is common and does not need to be heart-related. In my experience, fatigue often gets better with treatment of the iron overload, which can take a year or more to successfully return to normal.

Dear Dr. Roach: I’m a 42-year-old woman in good health. I am beginning a new job soon, and I feel it’s a good idea to build up my immunity before I work in this new environment. I chose an over-the-counter support supplement, but I am coming down with a cold!

I have found that I regularly react in this way to vitamins and supplements. Is this common? — D.F.

Answer: Having a strong immune system is always a good idea. However, supplements, even those that say they are good for the immune system, have no proof that they prevent colds or shorten their duration. A healthy diet, exercise and good sleep are much better for your immune system than a supplement.

Some readers insist that these products are effective for them, but the science so far has not proven it. Also, any drug, herb, vitamin or other supplement always has the potential for side effects. I would advise you to save your money.

Dr. Roach Writes: In February, a writer asked why there is a stigma against hearing aids, and why some people do not want to wear them. I received many letters noting the cost of the units, which for many is prohibitive. My answer, that glasses are not necessarily a sign of growing old but hearing aids almost always are, wasn’t to explain why people don’t get hearing aids, but rather why I think some people don’t WANT to get them or even to wear the ones they have. However, the cost issue may be the real reason for many or even most people.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.