Although the genetic mutation that causes hereditary hemochromatosis is present at birth, the signs and symptoms of hemochromatosis do not normally appear until later in life, as it takes time for iron to slowly accumulate in tissues and organs. Early signs and symptoms of hemochromatosis are nonspecific, making it difficult to diagnose against other common conditions. Early symptoms may vary among individuals in severity, range and gender. The early symptoms of hemochromatosis that may occur include joint pain, chronic fatigue, lack of energy, weakness and abdominal pain. As the disease progresses, later symptoms of hemochromatosis may emerge such as, arthritis in joints, diabetes from high blood sugar levels, hypothyroidism from low thyroid function, impotence, amenorrhea, premature menopause, generalized darkening of skin color and heart problems. If hereditary hemochromatosis is undetected and left untreated, excess iron will continue to accumulate in tissues and organs, leading to serious complications. Complications from untreated hemochromatosis can include problems in heart, liver, pancreas, reproductive system and skin. Heart Congestive heart failure may result from excess iron in the heart and circulatory system. Irregular heart beat (arrhythmias) or heart attack may also be caused by hemochromatosis. Liver Permanent scarring of the liver (cirrhosis) may occur due to excess iron in the liver. Enlarged liver, cancer and liver failure are also possible complications that may be result. Pancreas Excess iron storage in the pancreas can cause damage to the pancreas, leading to diabetes. Reproductive system Iron overload can cause impotence and loss of sex drive in males. Loss of menstrual cycle (amenorrhea), premature menopause or infertility may result in females. Skin color Iron deposits in skin cells can result in abnormal pigmentation of the skin, making it look grey or bronze. References: Duchini A, Klachko DM, Sfeir HE (2014). Hemochromatosis. Provided by Iron Disorders Institute. Hemochromatosis. National Heart, Lung, and Blood Institute. National Institutes of Health.