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Secondary iron overload Secondary iron overload is a phenomenon of excessive absorption and subsequent organ deposition, which is unrelated to a known genetic mutation: • Chronic liver Diseases such as hepatitis C and B, alcohol liver disease, MASLD, and porphyria cutanea tarda downregulate hepcidin, resulting in increased iron absorption from the gastrointestinal tract

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Of the 17 that did respond, 10 have adopted or are in the process of adopting the two-tiered threshold system