Scheduled blood removal reliably lowers the body's iron. For adults carrying too much iron, modest, carefully tested draws appear low-risk and may improve metabolic and blood-pressure markers, though heart and longevity benefits remain unproven. For those with normal iron, the likely result is harmful iron shortage rather than gain. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Ferritin | ~30–75 ng/mL (avoid <30) | Primary marker of body iron and the target of phlebotomy |
| Transferrin saturation (TSAT) | ~20–45% | Reflects circulating iron; high values flag overload |
| Hemoglobin / CBC | ~13–15 g/dL (men), ~12–14 g/dL (women) | Ensures draws are not causing anemia; safety gate |
| hs-CRP | <1.0 mg/L | Distinguishes true overload from inflammation-driven high ferritin |
| Fasting glucose & insulin (HOMA-IR) | Glucose 70–90 mg/dL; HOMA-IR <1.5 | Tracks the proposed metabolic benefit of iron reduction |
| Liver enzymes (ALT) | <25 U/L (men), <20 U/L (women) | Monitors the liver-related benefit in fatty liver disease |
| Blood pressure | <120/80 mmHg | Captures the possible vascular benefit seen in trials |
Cadence: Ferritin and hemoglobin before each draw; fuller panel at baseline, ~3 months into an active phase, then every 6–12 months during maintenance