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How HFE Variants Affect Iron Levels and What You Can Do

Iron is a vital mineral your body needs to make hemoglobin for oxygen transport, produce cellular energy, and support immune function. The HFE gene helps control how much iron your gut absorbs from food by influencing hepcidin, the hormone that tells your body when to absorb more or less iron. Certain changes in the HFE gene can reduce its ability to regulate iron, which may cause the body to absorb too much iron over time. Excess iron can accumulate in organs like the liver, heart, and pancreas and increase risk for liver disease, heart problems, diabetes, and joint pain.

How to think about your HFE genotype

Your genotype for the common HFE variant rs1800562 affects how strongly your HFE protein works:

2 effect alleles (AA) — higher risk of iron overload

If you have the AA genotype, you carry two copies of the effect allele. This is associated with significantly reduced HFE function and a higher risk of iron overload. Your body may absorb more iron than it needs, and without a natural way to remove the excess, iron can build up in organs over years.

Practical considerations:

  • Have baseline and ongoing blood tests: serum ferritin, transferrin saturation, and liver function tests.
  • Avoid routine iron supplementation unless prescribed after testing shows deficiency.
  • Limit high-iron foods such as red meat and organ meats; choose lean or plant-based proteins instead.
  • Avoid consuming vitamin C supplements or large portions of vitamin C–rich foods at the same time as high-iron meals because vitamin C increases iron absorption.
  • Use dietary strategies to lower absorption: drink tea or coffee with meals, include dairy or calcium-containing foods with iron-rich meals, and avoid fortified foods high in iron.
  • Discuss therapeutic phlebotomy (regular blood removal) or specialist referral if iron levels are high.
1 effect allele (GA) — moderate increased risk

If you have the GA genotype, you carry one copy of the effect allele. This can cause a partial reduction in HFE function and a modest tendency to absorb more iron than people without the variant. Many people with one copy never develop clinically significant iron overload, but monitoring and mindful habits are still valuable.

Practical considerations:

  • Check serum ferritin and transferrin saturation periodically, especially if you have symptoms like fatigue, joint pain, or abnormal liver tests.
  • Avoid unnecessary iron supplements and high-dose vitamin C with iron-rich meals.
  • Consider moderating intake of red meat and organ meats; favor plant proteins and lean animal proteins.
  • Use foods and drinks that reduce iron absorption—tea, coffee, and dairy—with meals when appropriate.
  • If tests show rising iron stores, work with your healthcare provider on treatment options and frequency of monitoring.
0 effect alleles (GG) — typical iron regulation

If you have the GG genotype, you carry two copies of the non-effect allele and are not genetically predisposed to increased iron absorption from HFE rs1800562. Your HFE protein should regulate iron normally, allowing absorption to adjust based on daily needs.

Practical considerations:

  • Maintain a balanced diet with appropriate iron sources for your age, sex, and life stage.
  • Only take iron supplements if a healthcare provider documents iron deficiency.
  • Routine iron testing is not necessary without clinical signs or risk factors, though it may be appropriate in certain situations (pregnancy, chronic blood loss, or symptoms suggesting anemia).

Dietary guidance to manage iron absorption

  • Limit heme iron sources: Reduce portions of red meat and avoid organ meats if you are at increased risk of iron overload.
  • Choose nonheme iron sources: Plant proteins such as legumes, tofu, whole grains, nuts, seeds, and leafy greens contain iron that is less readily absorbed.
  • Pair meals strategically: Consuming calcium-rich foods or dairy with iron-containing meals can lower absorption.
  • Avoid pairing high-dose vitamin C supplements with iron-heavy meals because vitamin C enhances iron uptake. Moderate amounts of vitamin C from whole fruits are fine, but avoid taking a vitamin C pill at the same time as an iron-rich meal.
  • Use beverages that reduce absorption: Tea and coffee contain polyphenols that decrease iron absorption when consumed with meals.
  • Check labels: Limit intake of iron-fortified cereals or beverages if you are trying to lower total iron intake.

Supplements and medications — what to consider

  • Avoid iron supplements unless testing shows iron deficiency anemia and a clinician recommends supplementation.
  • If you carry risk alleles, inform any healthcare provider prescribing medications or supplements that contain iron.
  • Avoid unnecessary multivitamins with added iron; choose iron-free or low-iron formulations when appropriate.
  • Certain medications can impact iron or liver health—coordinate care with your clinician to assess compatibility if you have high iron stores.

Lifestyle and monitoring recommendations

  • Get tested: Have serum ferritin and transferrin saturation measured as a starting point. If elevated, repeat testing and consider liver function tests and imaging as advised by a clinician.
  • Follow-up: Frequency depends on initial results—normal results may be rechecked periodically, while elevated results require closer follow-up and possible specialist referral.
  • Consider family testing: If you carry two effect alleles, first-degree relatives may benefit from genetic counseling or testing because hereditary iron overload can run in families.
  • Therapeutic options: When iron overload is confirmed, therapeutic phlebotomy is the standard treatment to remove excess iron. Your healthcare provider can discuss indications and schedules.
  • Watch for symptoms: Fatigue, unexplained joint pain, abdominal pain, darkening of the skin, or new liver enzyme abnormalities warrant evaluation.

When to contact a healthcare provider

Contact your clinician if blood tests show high ferritin or transferrin saturation, if you develop unexplained fatigue, abdominal discomfort, joint pain, signs of liver disease, or if you have questions about medications and supplements. If your genotype indicates increased risk of iron overload, seek guidance for appropriate monitoring and possible referral to a hematologist or liver specialist.

PlexusDx disclaimer

PlexusDx provides educational information about genetic predispositions and does not provide medical advice. This content is intended to help you understand how HFE variants may influence iron metabolism and to offer general lifestyle and monitoring suggestions. Always consult your healthcare provider before making changes to your diet, supplements, or medical care, and before starting or stopping any treatments.