Hemochromatosis Arthropathy
Hemochromatosis hurts.
Nearly all individuals with high iron will experience some degree of joint, muscle, or body pain at some point if their levels aren’t well controlled.
In fact, this was my first clue when I first suspected I might have iron overload. I began to have knee pain without any injuries or overuse. Both of my knees progressively became painful, stiff, and sore. What’s more, I was only in my 30’s when these symptoms began to occur…
I’m not alone, as generally speaking one of the most prominent hemochromatosis symptoms is pain.
These painful symptoms of hemochromatosis range from mild to severe and can occur daily or periodically. Going beyond general body aches and pains, chronic iron overload may progress and damage the joints leading to arthritis.
You Are Not Alone, Either
Let’s call it the Iron Twist… How has hemochromatosis changed your life and your joints?
Countless individuals have told us their stories of battling hemochromatosis symptoms – telling a tale and humanizing an all too-common problem.
Excess iron can cause a myriad of arthritic symptoms, including complications that may cause significant joint damage or even destruction.
Unfortunately, it’s exceedingly common for someone with undiagnosed hemochromatosis to struggle for years without any help.
On the other hand, with properly identified excess iron, a lot can be done to improve your chances of having healthy joints with less pain and discomfort.
Is there anything you can do to help improve your quality of life?
Absolutely!
This article details the condition of hemochromatosis as it relates to arthritis, as well as ideas for steps you can take right now to take charge of your health with iron overload.
So let’s get started!
In This Article:
Why Does Hemochromatosis Cause Joint Pain?
Hemochromatosis is a genetic and metabolic disorder that causes the body to absorb too much iron from food. This excess iron can build up in the organs, especially the liver, spleen, and pancreas. It can also damage the joints, potentially leading to a type of arthritis called hemochromatosis arthropathy.
Hemochromatosis arthropathy is a type of osteoarthritis that is caused by the buildup of iron in the joints. The iron can damage the cartilage, which cushions the ends of the bones in the joints. This may lead to pain, stiffness, and swelling in the joints.
Hemochromatosis arthropathy can affect any joint in the body, but it is most common in the fingers, hands, wrists, hips, and knees. The symptoms of hemochromatosis arthropathy will likely vary from person to person. Some people may have mild symptoms, while others may have more severe symptoms.
There is no cure for hemochromatosis arthropathy, but there are treatments that can help to relieve the symptoms. Your doctor may recommend treatments such as pain relievers, anti-inflammatory medications, and physical therapy. In some cases, surgery may be necessary to replace a damaged joint.
Many of our readers have told us about their joint replacement surgeries, and I myself had my right hip replaced at age 48!
Of course, not all cases of arthritis are due to hemochromatosis and not all cases of arthropathy lead to severe joint deterioration, but if you do have iron overload, it is especially important to see your doctor regularly to monitor your iron levels and to check for any signs of joint damage.
Early diagnosis and treatment of hemochromatosis arthropathy can help to prevent further joint damage and improve your quality of life.
How Common are Hemochromatosis Arthritis Symptoms?
Studies show that around 44% of people with hemochromatosis report arthritis symptoms. However, this number can vary depending on the study and the population being studied. Some research has found that up to 70% of people with hemochromatosis may experience joint pain or arthritis-related issues.
That is a high percentage of people showing signs of arthritic pain, but it is important to understand that this discomfort does not always progress to arthropathy and permanent damage of the joint.
According to Arthritis Australia:
However not all people with haemochromatosis will experience these complications. For example, only one in four people will have joint damage.
Yet, the mere presence of hemochromatosis does increase the risk of developing arthritis, particularly the type called hemochromatosis arthropathy.
This one-in-four frequency of significant arthritis due to iron overload was also demonstrated in the following study:
An arthropathy consistent with that commonly attributed to HH was found to occur in 24% of patients with definite/probable HH. The association observed between this arthropathy, homozygosity for C282Y, and serum ferritin concentrations at the time of diagnosis suggests that iron load is likely to be a major determinant of arthropathy in HH and to be more important than occupational factors.
It’s also important to keep in mind that arthritis can also be caused by other factors, such as age, injury, or other medical conditions. Therefore, not everyone with hemochromatosis will necessarily develop arthritis.
However, for our purposes the research indicates that half to three quarters of individuals with hemochromatosis have arthritis symptoms and one quarter may develop the more significant arthropathy.
What Joints are Most Affected by Hemochromatosis?
Here are the top 5 most commonly affected joints by arthritis in hemochromatosis:
The Top 5 Most Commonly Affected Joints by Arthritis in Hemochromatosis
According to clinical research and observation, this list is in relative order of frequency of occurrence:
1. Metacarpophalangeal (MCP) joints
These are the joints at the base of your fingers, where they meet your hand. The second and third MCP joints are most commonly affected.
2. Proximal interphalangeal (PIP) joints
These are the middle joints of your fingers.
3. Wrists
4. Knees
5. Hips
Other joints that can be affected include the elbows, ankles, and feet.
It’s important to note that the pattern of joint involvement in hemochromatosis arthritis can sometimes mimic other types of arthritis, such as rheumatoid arthritis or osteoarthritis. However, there are some key differences that can help doctors distinguish between these conditions.
For example, hemochromatosis arthritis often affects the MCP and PIP joints while sparing the distal interphalangeal (DIP) joints (the joints closest to your fingertips).
Additionally, X-rays of affected joints in hemochromatosis may show characteristic changes, such as hook-like bone growths on the metacarpal heads.
Hemochromatosis Arthritis Treatments: Can They Help?
Given the available iron-reducing treatments such as phlebotomy or chelating medications, and complementary nutritional approaches to lower iron such as diet and supplementation, it begs the following questions:
- If a person has arthritis and hemochromatosis, and if they reduce their iron levels, do their arthritis symptoms improve?
- In other words, will I feel better after phlebotomy?
Unfortunately, while reducing iron levels is crucial for managing hemochromatosis and preventing further damage, it doesn’t always lead to significant improvement in existing arthritis symptoms. Here’s why:
- Irreversible joint damage: Hemochromatosis can cause permanent damage to the cartilage and bone within the joints. Even when iron levels are normalized, this damage may persist, leading to ongoing pain and stiffness.
- Other factors involved: Arthritis in hemochromatosis can be influenced by other factors beyond iron overload, such as genetic predisposition, inflammation, and wear and tear on the joints. Reducing iron levels may not address these underlying causes.
However, reducing iron levels can still be beneficial for people with hemochromatosis and arthritis:
- Preventing further damage: Lowering iron levels can help slow down the progression of joint damage and prevent further deterioration.
- Reducing inflammation: High iron levels can contribute to inflammation in the body. Reducing iron may help lessen overall inflammation, potentially easing some arthritis symptoms.
- Improving overall health: Managing hemochromatosis through iron reduction can improve overall health and well-being, which may indirectly have a positive impact on arthritis symptoms.
In my case, I noticed a remarkable improvement in my original knee pain once I identified my high iron levels and began phlebotomy. And over the years, we’ve been very grateful to hear many success stories of individuals who showed marked improvements in their joint pain because they lowered their iron levels.
So there is much to be hopeful about!
At the same time, it’s important to have realistic expectations. While reducing iron levels is essential for managing hemochromatosis, it may not completely eliminate arthritis symptoms. However, it can still play a role in slowing down disease progression and potentially improving overall well-being.
If you have hemochromatosis and arthritis, it’s crucial to work closely with your doctor to develop a comprehensive management plan. This may include:
- Regular monitoring of iron levels and adherence to treatment for hemochromatosis.
- Management of arthritis symptoms through pain relievers, anti-inflammatory medications, physical therapy, and other supportive measures.
- Lifestyle modifications such as maintaining a healthy weight, staying active, and protecting your joints.
Remember, every individual’s experience with hemochromatosis and arthritis is unique. What works for one person may not work for another. It’s important to have open communication with your healthcare providers to find the best approach for managing your specific condition.
Hemochromatosis and Other Forms of Arthritis
Hemochromatosis may also be correlated with other types of arthritis – namely rheumatoid arthritis as well as pseudogout.
To learn more about this potential association, click on the box below to expand its content.
Hemochromatosis and Other Forms of Arthritis: Rheumatoid Arthritis and Pseudogout
There is a link between rheumatoid arthritis (RA) and hemochromatosis, although it is not a direct causal relationship.
Rheumatoid arthritis is an autoimmune disease that causes the body’s immune system to attack the joints. This can lead to inflammation, pain, and swelling in the joints.
While hemochromatosis and rheumatoid arthritis are two distinct conditions, they can sometimes occur together. Studies have shown that people with rheumatoid arthritis are more likely to have hemochromatosis than people without rheumatoid arthritis. This may be because both conditions share some common risk factors, such as genetic predisposition and inflammation.
It is important to note that not everyone with rheumatoid arthritis will develop hemochromatosis, and vice versa. However, if you have either of these conditions, it is important to be aware of the potential link and to talk to your doctor about any concerns you may have.
Here are some key points to remember about the link between rheumatoid arthritis and hemochromatosis:
- Hemochromatosis is a genetic disorder that causes the body to absorb too much iron.
- Rheumatoid arthritis is an autoimmune disease that causes the body’s immune system to attack the joints.
- People with rheumatoid arthritis are more likely to have hemochromatosis than people without rheumatoid arthritis.
- Both conditions share some common risk factors, such as genetic predisposition and inflammation.
There is also a link between pseudogout and hemochromatosis.
Pseudogout, also known as Calcium Pyrophosphate Deposition Disease (CPPD), is a type of arthritis that is caused by the buildup of calcium pyrophosphate crystals in the joints. These crystals can trigger inflammation and pain in the joints, similar to gout.
Studies have shown that people with hemochromatosis are more likely to develop pseudogout than people without hemochromatosis. This may be because the excess iron in the body can interfere with the way the joints process calcium pyrophosphate, leading to the formation of crystals.
Just like rheumatoid arthritis, it is important to note that not everyone with hemochromatosis will develop pseudogout, and vice versa.
Here are some key points to remember about the link between pseudogout and hemochromatosis:
- Pseudogout is a type of arthritis caused by the buildup of calcium pyrophosphate crystals in the joints.
- People with hemochromatosis are more likely to develop pseudogout than people without hemochromatosis.
- The excess iron in the body may interfere with the way the joints process calcium pyrophosphate, leading to the formation of crystals.
Hemochromatosis and Joint Replacement Surgery
Individuals with significant joint destruction may get to the point where their doctor recommends arthroplasty – a procedure that involves replacing a damaged or diseased joint with an artificial joint, known as a prosthesis.
To learn more about how hemochromatosis arthropathy and joint replacement surgery may be associated, click on the box below to expand its content.
Hemochromatosis Arthropathy and Joint Replacement Surgery
People with both arthritis and hemochromatosis may require joint replacement surgery more often than those with arthritis alone. This is because hemochromatosis can cause more severe and rapid joint degeneration due to the iron overload in the joints.
Here are some factors that influence the likelihood of joint replacement surgery in people with both arthritis and hemochromatosis:
- Severity of arthritis: The severity of arthritis plays a significant role in determining the need for joint replacement surgery. People with severe arthritis that significantly impacts their daily life and doesn’t respond to conservative treatments may be candidates for surgery.
- Joint damage: The extent of joint damage caused by hemochromatosis and arthritis can also influence the decision for joint replacement surgery. If the damage is severe and irreversible, surgery may be necessary to relieve pain and improve joint function.
- Age and overall health: Age and overall health are also important factors to consider. Younger individuals in good health may be more likely to undergo joint replacement surgery, while older individuals or those with other health conditions may have a higher risk of complications.
- Response to conservative treatments: If conservative treatments such as pain relievers, anti-inflammatory medications, physical therapy, and lifestyle modifications fail to provide adequate relief, joint replacement surgery may be considered.
It’s important to note that the decision to undergo joint replacement surgery is made on a case-by-case basis after careful evaluation by an orthopedic surgeon. The surgeon will consider all relevant factors, including the severity of arthritis, joint damage, age, overall health, and response to conservative treatments, to determine if joint replacement surgery is the best option for the individual.
Hemochromatosis Joint Pain Relief: Which Nutrients May Provide Support?
The cornerstone of hemochromatosis treatment remains the medical intervention phlebotomy (venesection) to reduce iron overload, and no natural remedies have been definitively proven to cure or significantly reverse the joint damage caused by hemochromatosis arthropathy.
However, some natural approaches may help manage the symptoms of joint pain and inflammation, and may be used in conjunction with standard medical care, but should not replace it.
Always discuss any complementary therapies with your doctor first.
Natural Approaches That May Provide Support to Joint Pain
Here are some natural approaches that may offer some symptom relief, but it’s crucial to understand they are not a substitute for medical treatment:
Dietary Modifications
- Limit iron intake: This is essential for managing hemochromatosis itself. Avoid iron-rich foods and supplements unless specifically recommended by your doctor for a different reason.
- Anti-inflammatory diet: Focus on whole foods, fruits, vegetables, and omega-3 fatty acids (found in fish oil, etc.). These may help reduce overall inflammation, which can contribute to joint pain. Limit processed foods, red meat, and sugary drinks, as these can promote inflammation.
- Hydration: Staying well-hydrated is important for overall health and can help maintain joint lubrication.
Supplements (discuss with your doctor first)
- Curcumin: This compound from turmeric has anti-inflammatory properties and may help reduce pain.
- Ginger: Another natural anti-inflammatory that may offer some pain relief.
- Omega-3 fatty acids: As mentioned above, these may help reduce inflammation. Fish oil is a common source.
- Glucosamine and chondroitin: These are often used for osteoarthritis, but their effectiveness is debated. Some people find them helpful for joint pain, but studies have shown mixed results.
Lifestyle changes
- Regular exercise: Gentle exercise, like swimming, walking, or yoga, can help maintain joint mobility and reduce stiffness. Avoid high-impact activities that could further damage the joints. Consider working with a physical therapist to develop a safe and effective exercise plan.
- Weight management: Maintaining a healthy weight can reduce stress on the joints.
- Heat and cold therapy: Applying heat (e.g., warm baths, heating pads) can help relax muscles and reduce stiffness. Applying cold (e.g., ice packs) can help reduce inflammation and pain.
- Stress management: Stress can exacerbate pain. Techniques like meditation, deep breathing, or yoga can help manage stress.
- Acupuncture: Some people find acupuncture helpful for pain management.
The best approach for managing hemochromatosis arthropathy is a combination of medical treatment to address the underlying iron overload and strategies to manage pain and improve joint function. Discuss all your options with your doctor to create a personalized treatment plan.
At the end of the day, if you are suffering with joint discomfort, pain, and inflammation or if your iron overload has progressed to the point where you are experiencing arthritis symptoms or outright hemochromatosis arthropathy, know that we are here to help support you in any way we can!
Top Six Ways to Take Charge of Your Health with Iron Overload
Hemochromatosis can be scary, lonely, and intimidating.
As naturopathic doctors and a family personally impacted by hereditary hemochromatosis, we want to empower people with iron overload to take charge and learn how to live healthier lives with hemochromatosis.
How We Can Help
Here are six things you can do right now to take charge of your health with iron overload:
- If you haven’t already, be sure to sign up for our newsletter that contains great info on a wide range of subjects related to iron overload.
- To learn more about hemochromatosis, be sure to check out our Hemochromatosis Learning Center on our website, with links to a wide range of topics such as symptoms, treatments, genetics, as well as diet and nutritional information relating to iron overload.
- My book Holistic Help for Hemochromatosis is a complete guide to the use of diet and supplements in healing from iron overload. Available as a paperback and also as an instant-download e-book.
- My wife’s cookbook Cooking for Hemochromatosis is a comprehensive guidebook to help you plan, shop, and cook to reduce iron in your diet. Much more than just a cookbook, it will teach you how to decide what to eat, plan meals, and enjoy food again when facing iron overload.
- We have created a line of nutritional supplements designed to help support the health of an individual with high iron.
- We have also created the only online video course in the world designed for patients with hemochromatosis. 25 videos to help you understand your condition are packed into 5 modules and 1 bonus module.
Diet and Nutritional Supplements for Hemochromatosis
The great news is that many other recommendations may be helpful in addition to the medical treatments.
This is where the doctors at Hemochromatosis Help can support you. Our passion and expertise is the marriage of integrating medical science with our in-depth knowledge of how diet and natural remedies can be safely and effectively used in high-iron individuals.
Diet and supplementation strategies may enhance your health and wellness as a complement to your medical care.
In fact, clinical research has shown many potential health benefits of natural and holistic remedies for iron overload.
Hum, Ryan Malcolm, and Pauline Ho. “Hereditary Haemochromatosis Presenting to Rheumatology Clinic as Inflammatory Arthritis.” BMJ Case Rep 15, no. 1 (2022): e246236. https://doi.org/10.1136/bcr-2021-246236.
Photo reference link: https://pmc.ncbi.nlm.nih.gov/articles/PMC8768489/figure/F1/
- Photographs of the hands and wrists with mild swelling of the metacarpophalangeals and wrist joints bilaterally as well as Heberden’s and Bouchard’s nodes bilaterally.
CDC, Hereditary Hemochromatosis: https://www.cdc.gov/hereditary-hemochromatosis/about/index.html
NHS, UK: Complications – – – Haemochromatosis – NHS
Arthritis Australia: https://arthritisaustralia.com.au/types-of-arthritis/haemochromatosis-and-haemochromatotic-arthritis/
Carroll GJ, Breidahl WH, Bulsara MK, Olynyk JK. Hereditary hemochromatosis is characterized by a clinically definable arthropathy that correlates with iron load. Arthritis Rheum. 2011 Jan;63(1):286-94. doi: 10.1002/art.30094. PMID: 20954257.
Chit Su HM, Putchakayala K. A Mystery of Joint Pain: Is It Rheumatoid Arthritis (RA) or Hereditary Hemochromatosis (HH)? Cureus. 2022 Dec 28;14(12):e33037. doi: 10.7759/cureus.33037. PMID: 36721599; PMCID: PMC9881094.
McCurdie I, Perry JD. Haemochromatosis and exercise related joint pains. BMJ. 1999 Feb 13;318(7181):449-51. doi: 10.1136/bmj.318.7181.449. PMID: 9974464; PMCID: PMC1114910.
Cleveland Clinic, Pseudogout: https://my.clevelandclinic.org/health/diseases/pseudogout-chondrocalcinosis-cppd
Mayo Clinic, Pseudogout: https://www.mayoclinic.org/diseases-conditions/pseudogout/symptoms-causes/syc-20376983
Medline Plus, Calcium pyrophosphate arthritis: https://medlineplus.gov/ency/article/000421.htm
John’s Hopkins Medicine, Arthroplasty: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/arthroplasty
Ferreira AV, Duarte TL, Marques S, Costa P, Neves SC, Dos Santos T, Granja PL, Porto G. Iron triggers the early stages of cartilage degeneration in vitro: The role of articular chondrocytes. Osteoarthr Cartil Open. 2021 Feb 20;3(2):100145. doi: 10.1016/j.ocarto.2021.100145. PMID: 36474980; PMCID: PMC9718170.
Palmer WC, Vishnu P, Sanchez W, Aqel B, Riegert-Johnson D, Seaman LAK, Bowman AW, Rivera CE. Diagnosis and Management of Genetic Iron Overload Disorders. J Gen Intern Med. 2018 Dec;33(12):2230-2236. doi: 10.1007/s11606-018-4669-2. Epub 2018 Sep 17. PMID: 30225768; PMCID: PMC6258594.
Milman NT. Managing Genetic Hemochromatosis: An Overview of Dietary Measures, Which May Reduce Intestinal Iron Absorption in Persons With Iron Overload. Gastroenterology Res. 2021 Apr;14(2):66-80. doi: 10.14740/gr1366. Epub 2021 Apr 21. PMID: 34007348; PMCID: PMC8110241.
