Table 1.

Iron overload categories adapted from the HealthIron study

Classification	Criteria
No evidence of iron overload (HI 1)	Normal or elevated ferritin with normal transferrin saturation
Provisional iron overload (HI 2)	1. Elevated SF (>300 μg/L for men and postmenopausal women, >200 μg/L for premenopausal women) and 2. Elevated transferrin saturation (>55% for men and >45% for women)
Documented iron overload (HI 3)	1. Increased iron content shown by hepatic iron staining 3 or 4, iron concentration >90 μmol/g or hepatic iron index >1.9, OR 2. SF > 1,000 μg/L at baseline with documented therapeutic venesection
Iron overload-related disease (HI 4)	Documented iron overload plus one of the following: HCC, cirrhosis, fibrosis, elevated AST, ALT, arthritis involving second and third metacarpophalangeal joints, and symptoms diagnosed by MD as associated with HH

ALT, alanine aminotransferase; AST, aspartate aminotransferase; HCC, hepatocellular carcinoma; HH, Hereditary Hemochromatosis; HI, Health Iron; SF, serum ferritin. From Allen KJ, Gurrin LC, Constantine CC, et al. Iron-Overload–Related Disease in HFE Hereditary Hemochromatosis. N Engl J Med 2008;358(3):221-30. Copyright @ 2008 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.