Screening of family members of patients with haemochromatosis is supported by the American Association for the Study of Liver Diseases, the American College of Gastroenterology, the British Society for Haematology, and the European Association for the Study of the Liver.[4]Kowdley KV, Brown KE, Ahn J, et al. Correction: ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Dec;114(12):1927.
http://www.ncbi.nlm.nih.gov/pubmed/31724994?tool=bestpractice.com
[7]Kowdley KV, Brown KE, Ahn J, et al. ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Aug;114(8):1202-18.
https://journals.lww.com/ajg/fulltext/2019/08000/acg_clinical_guideline__hereditary_hemochromatosis.11.aspx
http://www.ncbi.nlm.nih.gov/pubmed/31335359?tool=bestpractice.com
[8]European Association for the Study of the Liver. EASL clinical practice guidelines on haemochromatosis. J Hepatol. 2022 Aug;77(2):479-502.
https://www.journal-of-hepatology.eu/article/S0168-8278(22)00211-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35662478?tool=bestpractice.com
[54]Bacon BR, Adams PC, Kowdley KV, et al. Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology. 2011 Jul;54(1):328-43.
http://onlinelibrary.wiley.com/doi/10.1002/hep.24330/full
http://www.ncbi.nlm.nih.gov/pubmed/21452290?tool=bestpractice.com
[55]Fitzsimons EJ, Cullis JO, Thomas DW, et al. Diagnosis and therapy of genetic haemochromatosis (review and 2017 update). Br J Haematol. 2018 May;181(3):293-303.
https://www.doi.org/10.1111/bjh.15164
http://www.ncbi.nlm.nih.gov/pubmed/29663319?tool=bestpractice.com
Screening may include fasting transferrin saturation, ferritin levels, and/or genetic testing, in adult family members, and screening is recommended for siblings and children of affected patients. However, if the spouse of the patient with haemochromatosis is not a carrier then the children cannot be homozygous for the mutation, and thus do not need testing.[78]Adams PC. Implications of genotyping of spouses to limit investigation of children in genetic hemochromatosis. Clin Genet. 1998 Mar;53(3):176-8.
http://www.ncbi.nlm.nih.gov/pubmed/9630070?tool=bestpractice.com
Patients with haemochromatosis should be advised to avoid additional supplementation of vitamin C and iron; naturally occurring sources are considered acceptable.[4]Kowdley KV, Brown KE, Ahn J, et al. Correction: ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Dec;114(12):1927.
http://www.ncbi.nlm.nih.gov/pubmed/31724994?tool=bestpractice.com
[7]Kowdley KV, Brown KE, Ahn J, et al. ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Aug;114(8):1202-18.
https://journals.lww.com/ajg/fulltext/2019/08000/acg_clinical_guideline__hereditary_hemochromatosis.11.aspx
http://www.ncbi.nlm.nih.gov/pubmed/31335359?tool=bestpractice.com
[8]European Association for the Study of the Liver. EASL clinical practice guidelines on haemochromatosis. J Hepatol. 2022 Aug;77(2):479-502.
https://www.journal-of-hepatology.eu/article/S0168-8278(22)00211-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35662478?tool=bestpractice.com
Some patients may be advised to take a low dose of vitamin C if they are being treated with iron chelation therapy to increase the excretion of iron.