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Understanding Your HFE Gene and Iron Balance

Iron is an essential mineral that helps your body produce hemoglobin, the protein in red blood cells that carries oxygen. Iron also supports immune function, energy production, and hormone synthesis. The HFE gene helps regulate how much iron your body absorbs by influencing hepcidin, the hormone that acts as a gatekeeper for iron entry into the bloodstream. Variations in HFE can change iron absorption. Some variants increase absorption, which can lead to excess iron storage over time and may affect organs such as the liver, heart, and pancreas.

Why Genetics Matter for Iron

Your HFE genotype affects how your body balances iron from diet and supplements. If absorption is higher than needed, ferritin and stored iron can rise. Elevated iron stores may be symptomless for years but can contribute to fatigue, joint pain, abdominal discomfort, or organ damage with long term accumulation. Knowing your genotype helps you tailor diet, tests, and lifestyle to maintain healthy iron levels.

How to Use This Information

  • Understand your genetic predisposition. Genetics is one factor among diet, blood loss, pregnancy, and other health conditions.
  • Monitor iron status regularly with appropriate blood tests discussed below.
  • Adjust diet and supplements thoughtfully to avoid unnecessary iron loading if you are at higher genetic risk.
  • Always consult your healthcare provider before making medical decisions. PlexusDx provides educational information and does not give medical advice.

Diet, Supplements, Lifestyle, and Testing Recommendations

This section gives practical steps to help maintain healthy iron balance. These are educational suggestions only. Talk with your healthcare provider before changing diet or stopping or starting supplements.

Diet Recommendations

  • Limit high heme iron sources. Reduce frequent consumption of red meat and organ meats, which are rich in highly absorbable heme iron.
  • Be mindful with fortified foods. Some cereals and processed foods are fortified with iron. Check labels and limit intake if you are at risk for iron accumulation.
  • Include iron absorption inhibitors. Drink tea or coffee with meals and enjoy calcium rich foods like dairy with iron-containing meals to lower iron absorption.
  • Favor nonheme iron from plants. Plant based iron in beans, lentils, and leafy greens is less readily absorbed than animal iron. Pair plant iron with vitamin C sparingly if you need to limit absorption.
  • Choose a balanced, varied diet. Emphasize vegetables, fruits, whole grains, legumes, healthy fats, and appropriate protein portions to support overall health.

Supplement Guidance

  • Avoid unnecessary iron supplements. Do not take iron tablets or multivitamins with iron unless a clinician has confirmed deficiency and recommended therapy.
  • Check multivitamin labels. Many over the counter multivitamins contain iron. Opt for iron-free formulations if tests show normal or elevated iron stores.
  • Consider targeted supplements with clinician oversight. If you have symptoms or confirmed deficiency, a healthcare provider can recommend the right formulation and dose.

Lifestyle Tips

  • Limit alcohol intake. Alcohol can increase iron uptake and raise the risk of liver damage in the setting of excess iron.
  • Avoid raw shellfish if iron overload is suspected. Certain bacteria in raw shellfish can cause severe infection in people with excess iron.
  • Manage weight and metabolic health. Healthy body weight, regular activity, and control of conditions like diabetes support liver and heart health.
  • Be alert to symptoms. Report persistent fatigue, joint pain, abdominal discomfort, or unexplained changes in skin tone to your clinician for evaluation.

Blood Tests to Monitor

  • Serum ferritin. Reflects stored iron. Elevated ferritin suggests increased iron stores but can also rise with inflammation.
  • Transferrin saturation. Helps determine how much iron is bound for transport in blood. High values suggest increased absorption.
  • Serum iron and total iron binding capacity. Provide additional context about circulating iron.
  • Liver function tests. To assess organ health when iron loading is a concern.
  • Genetic testing follow up. Repeat or additional genetic counseling may be recommended if family history is significant.
Two effect alleles (TT) — Increased risk for iron accumulation

If you have the TT genotype for rs1800730, you carry two copies of the effect allele. This genotype is associated with increased ferritin levels and a higher tendency to absorb and store iron. The HFE protein may be less effective at promoting hepcidin, the hormone that limits iron entry into blood. Over time, this can lead to excess iron accumulation in organs such as the liver, heart, and pancreas. You may be more likely to experience symptoms like fatigue, joint discomfort, or abdominal pain if iron becomes elevated.

Practical considerations

  • Schedule baseline and periodic testing of serum ferritin and transferrin saturation with your clinician.
  • Avoid iron supplements unless deficiency is confirmed and treated under medical supervision.
  • Limit red meat and iron fortified foods, include teas or dairy with meals, and control alcohol intake.
  • Discuss screening of family members if hereditary iron overload is a concern based on family history.
One effect allele (AT) — Moderate change to iron regulation

If you have the AT genotype for rs1800730, you carry one copy of the effect allele. This variant may reduce HFE function somewhat, which can lead to mild increases in iron absorption compared with people who carry no effect alleles. Many people with one effect allele have normal iron levels throughout life, but some may show elevated ferritin or higher transferrin saturation.

Practical considerations

  • Check ferritin and transferrin saturation periodically, especially if you have symptoms or other risk factors.
  • Consider dietary adjustments like moderating red meat, limiting fortified foods, and pairing iron containing meals with tea or dairy as appropriate.
  • Avoid routine iron supplementation without testing that shows deficiency.
  • Discuss your results with your healthcare provider to determine the right monitoring schedule.
No effect alleles (AA) — Typical iron regulation

If you have the AA genotype for rs1800730, you carry two copies of the non-effect allele. This is the most common result and is associated with standard iron regulation. Your HFE protein is likely functioning normally to support appropriate hepcidin activity, helping to keep iron absorption in balance. With this genotype, your genetic risk for iron overload is low.

Practical considerations

  • Routine iron monitoring is usually not required unless you have symptoms or conditions that affect iron status, such as heavy menstrual bleeding or chronic disease.
  • Follow general dietary guidance for balanced iron intake and avoid excessive use of iron supplements unless recommended by a clinician.
  • Maintain regular checkups and report any new symptoms to your healthcare provider.

When to Talk to Your Healthcare Provider

  • If blood tests show elevated ferritin or transferrin saturation.
  • If you experience persistent fatigue, unexplained abdominal pain, joint pain, or skin changes.
  • If you have a family history of hereditary iron overload or organ disease related to iron.
  • Before starting or stopping iron supplements or making major dietary changes related to iron.

PlexusDx provides educational genetic information only. This content does not constitute medical advice. Always consult your healthcare provider to interpret genetic results, confirm diagnoses, and determine appropriate testing or treatment.