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Hemochromatosis Gene Test (HFE Test)

Test Overview

Hemochromatosis gene (HFE) testing is a blood test used to check for hereditary hemochromatosis, an inherited disorder that causes the body to absorb too much iron. The iron then builds up in the blood, liver, heart, pancreas, joints, skin, and other organs.

In its early stages, hemochromatosis can cause joint and belly pain, weakness, lack of energy, and weight loss. It can also cause scarring of the liver (cirrhosis), darkening of the skin, diabetes, infertility, heart failure, irregular heartbeats (arrhythmia), and arthritis. But many people do not have symptoms in the early stages.

In men, hereditary hemochromatosis is usually found at ages 40 to 60. In women, it is not usually found until after menopause because, until that time, women regularly lose blood and iron during their monthly periods.

Why It Is Done

HFE testing is used to find out if a person has an increased chance of having hemochromatosis. It is often recommended for people who have a close family member—parent, brother, sister, or child—with this disease.

This test might be done if you have high iron levels in your blood. This test helps to find out if you have hemochromatosis.

HFE testing locates and identifies mutations in the HFE genes. These gene mutations are called C282Y and H63D.

How To Prepare

Generally, no special preparation is required before having a hemochromatosis gene test.

Genetic test results often have ethical, legal, or social implications. You may want to talk to a genetic counselor before making a decision about testing. Genetic counselors are trained to explain the test and its results clearly. A genetic counselor can help you make well-informed decisions.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

How It Is Done

You might have a cheek test or a blood test.

For a cheek test, a health professional will gently swab or scrape the inside of your cheek to get a sample of cells.

For a blood test, the health professional taking a sample of your blood will:

  • Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
  • Clean the needle site with alcohol.
  • Put the needle into the vein. More than one needle stick may be needed.
  • Attach a tube to the needle to fill it with blood.
  • Remove the band from your arm when enough blood is collected.
  • Put a gauze pad or cotton ball over the needle site as the needle is removed.
  • Put pressure on the site and then put on a bandage.

How It Feels

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

If you get a cheek test, you will feel gentle pressure on the inside of your cheek from the swab.

You may worry or feel nervous before you have the test or while you are waiting for the results.

Risks

There is very little chance of a problem from having a cheek test or from having a blood sample taken from a vein. If you have a blood test:

  • You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
  • In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.
  • Ongoing bleeding can be a problem for people with bleeding disorders. Aspirin, warfarin (Coumadin), and other blood-thinning medicines can make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medicine, tell your doctor before your blood sample is taken.

Results

Hemochromatosis gene (HFE) testing is a blood test used to check for hereditary hemochromatosis, a disorder that is passed from a parent to a child (inherited) and causes the body to absorb too much iron. This HFE gene test is usually not used to check for other, less common causes of inherited hemochromatosis.

Hemochromatosis gene (HFE)
Normal:

Mutations (C282Y or H63D) are not found in the HFE gene. Normal results are called negative.

Abnormal:

Mutations (C282Y or H63D) are found in the HFE gene test. Abnormal results are called positive.

An abnormal test result does not mean that you have hemochromatosis or that you will have hemochromatosis. It means that you have a mutation in the HFE gene. Ask your doctor or a genetic counselor to help you understand your test results.

What Affects the Test

There is a very small chance that the results of a hemochromatosis gene test may not be accurate if you have had a blood transfusion done within a week of the test.

What To Think About

  • The discovery of a genetic disease that is not causing symptoms now should not affect your future ability to gain employment or health insurance coverage. A law in the United States, called the Genetic Information Nondiscrimination Act of 2008 (GINA), protects people who have DNA differences that may affect their health. This law does not cover life insurance, disability insurance, or long-term care insurance.
  • The information obtained from an HFE test can have a big impact on your life. Genetic counselors are trained to help you understand your chance for having a child with an inherited (genetic) disease. A genetic counselor can help you make well-informed decisions. Ask to have genetic counseling before making a decision about HFE testing.
  • HFE testing is not able to predict whether you will have hemochromatosis. Although the test locates the most common HFE mutations, there may be other HFE mutations that the test does not find. You may have HFE mutations and not have the disease or you may have symptoms of the disease but gene testing does not find any mutations.
  • HFE gene testing may identify the cause of high iron levels and eliminate the need for other tests, such as a liver biopsy.
  • Iron and ferritin levels may also be checked at the same time as a hemochromatosis gene test. For more information, see the topics Iron and Ferritin.

Other Places To Get Help

Organizations

Genetics Home Reference, U.S. National Library of Medicine
8600 Rockville Pike
Bethesda, MD  20894
Phone: 1-888-FIND-NLM (1-888-346-3656)
Fax: (301) 402-1384
TDD: 1-800-735-2258
Web Address: www.ghr.nlm.nih.gov
 

The Genetics Home Reference provides information on hundreds of genetic conditions. The website has many tools for learning about human genetics and the way genetic changes can cause disease. It also has links to additional resources for people who have genetic conditions and for their families.


Iron Disorders Institute
P.O. Box 675
Taylors, SC  29687
Phone: 1-888-565-IRON (1-888-565-4766)
(864) 292-1175
Fax: (864) 292-1878
Email: patientservices@irondisorders.org
Web Address: www.irondisorders.org
 

The Iron Disorders Institute is a national voluntary health agency that provides information about iron disorders such as hemochromatosis, acquired iron overload, sickle cell anemia, thalassemia, iron deficiency anemia, and anemia of chronic disease. The organization works with a scientific review board as well as various medical professional groups. A free newsletter, idInsight, is available.


National Heart, Lung, and Blood Institute (NHLBI)
P.O. Box 30105
Bethesda, MD  20824-0105
Phone: (301) 592-8573
Fax: (240) 629-3246
TDD: (240) 629-3255
Email: nhlbiinfo@nhlbi.nih.gov
Web Address: www.nhlbi.nih.gov
 

The U.S. National Heart, Lung, and Blood Institute (NHLBI) information center offers information and publications about preventing and treating:

  • Diseases affecting the heart and circulation, such as heart attacks, high cholesterol, high blood pressure, peripheral artery disease, and heart problems present at birth (congenital heart diseases).
  • Diseases that affect the lungs, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea, and pneumonia.
  • Diseases that affect the blood, such as anemia, hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.

References

Other Works Consulted

  • Bacon, BR et al. (2011). Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology, 54(1): 328–343.
  • National Human Genome Research Institute (2010). Learning about hereditary hemochromatosis. Available online: http://www.genome.gov/page.cfm?pageID=10001214.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
  • Powell LW (2012). Hemochromatosis. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 2, pp. 3162–3167. New York: McGraw-Hill.
  • Qaseem A, et al. (2005). Screening for hereditary hemochromatosis: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 143(7): 517–521.
  • U.S. Preventive Services Task Force (2006). Screening for hemochromatosis. Available online: http://www.ahrq.gov/clinic/uspstf06/hemochromatosis/hemochrs.htm.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Brian Leber, MDCM, FRCPC - Hematology
Last Revised October 15, 2012

Last Revised: October 15, 2012

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & Brian Leber, MDCM, FRCPC - Hematology

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