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HFE Gene, Iron Balance, and Pregnancy: What Your Genotype Means

Pregnancy increases maternal iron needs to support blood volume expansion and fetal development. The HFE gene helps regulate how much iron your intestine absorbs. Certain variants in HFE can lead to increased iron absorption and higher iron stores. While iron is essential, too much iron can create oxidative stress and interfere with absorption of other minerals such as manganese, which is important for fetal growth and development.

Why this matters during pregnancy

During pregnancy the body needs more iron, but the balance between enough iron and too much iron can be delicate. Excess iron can contribute to oxidative stress, inflammation, and reduced manganese levels by competing for shared transport pathways. Manganese supports bone formation, metabolism, and brain development in the fetus. Understanding your HFE genotype can help guide dietary choices, supplement decisions, and the timing of blood testing under the care of your healthcare provider.

Tests to discuss with your provider

  • Serum ferritin to measure iron stores
  • Transferrin saturation to assess iron availability
  • Complete blood count to check hemoglobin and red blood cell indices
  • Serum manganese if there is concern about low manganese levels
  • Repeat testing across pregnancy as recommended by your provider

Genetic interpretations

AA genotype (two effect alleles) — Higher risk of hereditary hemochromatosis

The AA genotype at rs1800562 is associated with the most common cause of hereditary hemochromatosis, a genetic tendency to absorb and store excess iron. People with this genotype often have higher ferritin and transferrin saturation levels over time.

In pregnancy this could mean:

  • Preexisting higher iron stores may reduce risk of iron deficiency early in pregnancy.
  • There is increased potential for iron overload, which may raise oxidative stress and impact placental and fetal health if not monitored.
  • Elevated iron can reduce manganese absorption, which may affect fetal developmental processes that rely on manganese.

Practical recommendations to discuss with your healthcare provider:

  • Do not take routine iron supplements unless testing shows iron deficiency.
  • Limit intake of high-iron foods if your ferritin or transferrin saturation are elevated.
  • Avoid taking large amounts of vitamin C with iron rich meals or supplements, because vitamin C enhances iron absorption.
  • Prioritize manganese-rich foods: whole grains, nuts (almonds, walnuts), seeds, legumes, leafy greens such as spinach and Swiss chard, and brown rice.
  • Consider periodic monitoring of ferritin and transferrin saturation during pregnancy and postpartum.
  • If tests show clinically significant iron overload, your provider may discuss further evaluation and management options.
AG genotype (one effect allele) — Mildly increased iron absorption risk

The AG genotype at rs1800562 indicates you carry one copy of the effect allele. This can moderately influence iron absorption and is associated with a tendency toward higher ferritin and lower manganese compared with the typical genotype.

During pregnancy this could mean:

  • You may start pregnancy with adequate iron stores and face less risk of deficiency early on.
  • You may absorb slightly more iron than average, which can reduce manganese availability.
  • Careful monitoring is useful to ensure iron levels stay within a healthy range for mother and baby.

Practical recommendations to discuss with your healthcare provider:

  • Follow standard prenatal screening and only add iron supplements if laboratory testing indicates deficiency.
  • Include manganese-rich foods daily: whole grains, nuts, seeds, legumes, and leafy greens.
  • Limit consumption of concentrated iron sources such as heme-rich red meat or high-dose iron supplements unless advised by your provider.
  • Avoid pairing iron supplements with large doses of vitamin C without medical need.
  • Request ferritin and transferrin saturation testing at least once each trimester or as recommended by your provider.
GG genotype (zero effect alleles) — Typical iron regulation

The GG genotype at rs1800562 is the common form and indicates you do not carry the A allele linked to hereditary hemochromatosis. Your HFE gene functions typically, and you are not at increased genetic risk for iron overload from this variant.

During pregnancy this could mean:

  • Your body is likely to maintain a typical iron balance and follow standard prenatal trajectories for iron needs.
  • You do not face the genetically elevated risk of oxidative stress or lower manganese levels associated with HFE effect alleles.

Practical recommendations to discuss with your healthcare provider:

  • Follow routine prenatal guidelines, including iron supplementation when testing shows iron deficiency or when your provider recommends it.
  • Include manganese-rich foods as part of a balanced diet for fetal support.
  • Have routine iron tests as recommended during pregnancy to guide supplementation and dietary adjustments.

Diet and supplement guidance

  • Focus on a balanced prenatal diet with a variety of whole grains, legumes, nuts, seeds, dairy or fortified alternatives, fruits, vegetables, and lean protein sources.
  • Choose manganese-rich foods: whole grains, brown rice, oats, nuts, seeds, legumes, spinach, kale, and other leafy greens.
  • If iron supplementation is recommended, discuss dose and timing with your provider and avoid taking it with high vitamin C doses unless needed.
  • Avoid excessive iron-containing supplements if you have elevated ferritin or transferrin saturation values.
  • Consider a prenatal vitamin that provides baseline nutrients including folate, iodine, vitamin D, and appropriate amounts of iron only when advised.

Lifestyle and monitoring

  • Schedule and follow recommended prenatal blood testing so iron and other nutrient levels are monitored throughout pregnancy.
  • Maintain a nutritious, varied diet and moderate exercise as recommended by your provider.
  • Avoid self-prescribing high dose mineral supplements without laboratory evidence of deficiency.
  • Keep a record of blood test results and share them with specialists if referred for evaluation of iron overload.

Important note and disclaimer

PlexusDx provides educational information about genetic predispositions only. This article does not provide medical advice. Always consult your healthcare provider before making changes to diet, supplements, or medical care. Your provider can interpret genetic results alongside laboratory testing, medical history, and pregnancy status to create a care plan tailored to you.