Atrial fibrillation is an irregular heart beat that involves the fluttering of the heart’s upper chambers (atria). It can lead to blood clots, stroke, and heart failure. Several million Americans have it, and it’s more common in older people. Could there be a link between atrial fibrillation and iron?

There certainly could. Consider a report from 2010: Remission of paroxysmal atrial fibrillation with iron reduction in haemophilia A. (If interested, the full paper can be accessed at Sci-Hub.)

Two male cousins, one age 49, the other 57, both with hemophilia, developed atrial fibrillation. They both refused a procedure to reduce or eliminate their arrhythmia due to concerns about bleeding. The effectiveness of drugs was wearing off.

So a course of iron reduction via phlebotomy was decided on.

Major point I want to emphasize: one of the men had a ferritin of 389 ng/ml, the other 305. The Mayo Clinic says that a normal ferritin level for men is 24 to 336 ng/ml. So, one of the men was somewhat above the normal range, the other was within it.

While it’s well known that people with hemochromatosis — pathological iron loading, in which ferritin levels sometimes reach over 1000 or more — are at higher risk of cardiac arrhythmias, these men did not have hemochromatosis. One of these men had a normal ferritin level, the other only somewhat high.

The first patient had 6 units of blood removed over 6 months time — his atrial fibrillation stopped when his ferritin was 68.  Doctors brought the second patient down to a ferritin of 29. His atrial fib also stopped.

The patients had periodic phlebotomy over several years time to keep ferritin at a low level.

Is it possible that iron is involved in other cases of atrial fibrillation?

Consider that many guinea pigs that are iron-loaded die of sudden cardiac death, “presumably from cardiac arrhythmias”. Granted that these animals must have had very high iron levels.

How would iron do this? In a word — or two words — oxidative stress. Iron is a reactive metal that causes oxidation. It builds up in myocardial cells of the heart and damages electrical conduction.

Some natural methods of dealing with atrial fibrillation also seem to work through reduction of oxidative stress: vitamin C, and n-acetylcysteine.

While atrial fibrillation seems to have a number of causes, and is generally poorly controlled by drugs, oxidative stress and inflammation are thought to play a role.


Keeping iron levels in a low normal range, or at least preventing them from rising too high, could have an impact on whether someone gets atrial fibrillation.

From the case study I discussed, it doesn’t appear that iron levels even need to be all that high to result in atrial fibrillation. Of course, other factors are involved, and not everyone with iron levels in that range gets atrial fib.

PS: See my book Dumping Iron for more.

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  1. Ed says:

    Interestingly, I came to this site looking for answers because my problem is the opposite, meaning I have diagnosed Atrial Fibrillation, had an unsuccessful ablation of the heart, and am on medication three times daily to avert symptoms. However, because of the medication going up drastically in price I could not purchase them further.

    This became a real problem, having to endure two more cardioversions at the hospital.

    Long story short, my older sister (72) has also been diagnosed with the same affliction and after talking to her, she indicated iron pills seemed to help her. She only takes Metoprolol, the beta-blocker, but I was on Metoprolol and Rythmol SR, 225 mgs, three times daily instead of twice daily because of severity of symptoms.

    From there, not really believing it would help, and my concern of potentially causing iron deposits (Hemochromatosis), I initially added nine milligrams to my daily diet with concomitant vitamin C intake. Surprisingly, the next day, my symptoms had decreased somewhat but I could not yet really attribute it to the iron.

    The last three months with the use of a diary, I have discovered that for my biochemistry the iron reduces my symptoms drastically. After taking iron for three weeks at a dose of about 32 milligrams (half a standard dose of 65 mg inorganic iron), my symptoms were nearly ninety percent reduced. Every time I would stop the iron, the symptoms would gradually reappear, and every time I would go back on this dose the symptoms would gradually reappear.

    I’m certainly aware that I could still be developing Hemochromatosis regardless of the benefits of reducing the arrhythmia. I need to get a ferritin-level test done which I’m scheduled for. All previous tests of iron and hemoglobin have been normal.

    The article mentioned oxidative stress as a potential inducer of said arrhythmia, but I’m big advocate for antioxidants and take in Vitamin C, NAC, and numerous other antioxidants daily. I’ve taken them for years and with experience have noticed they help reduce the incidence and severity of my arrhythmia, but not by much. I’m a pancreatic cancer survivor (Whipple surgery – half my pancreas removed but no chemo or radiation) and have nutritionally recovered since eight years ago.

    My question is, is it possible that the “oxidative stress” and/or the potential of iron to cause electrical conduction problems, actually, in my case, cause some improved electrical conductivity or alternate pathways of conduction in the heart that reduces electrical instability (arrhythmia)?

    Any insight would be greatly appreciated. Thank you.

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