Although a symptom of liver failure and cirrhosis, fatigue is often a prominent symptom of precirrhotic haemochromatosis with normal liver function suggesting that it is iron overload per se that causes this symptom. A number of studies have examined the usefulness of a variety of investigations in the assessment of patients presenting with chronic fatigue in general practice. In general such investigations have not proved useful as only a low yield of abnormal results has been found. It is often wrongly thought that premenopausal woman are protedeted from iron overload and organ damage by menstruation and the requirements of pregnancy. However this patient, who had cirrhosis due to haemochromatosis at diagnosis only four years after the menopause, illustrates that even combined blof loss due to blood donation and menstruationmay not prevent iron accumulation may not prevent iron accumulation and subsequent organ damage.
Venesection is required t deplete and maintain iron stores at the lower limit of normal.
Halliday J.W. Primary iron overload. Iron metabolism in health and disease. 3 Bassett M.L., Halliday J.W., Powell L.W. Value of hapatic iron measurements in early haemochromatosis and determination of the critical iron level associated with fibrosis.