When and how do you initiate therapeutic phlebotomy for patients with hereditary hemochromatosis without evidence of end-organ injury?  

Since the management of asymptomatic HH is seamless, if a patient's iron parameters are reflective of iron overload and there is zero evidence of end-organ damage, I recommend that they become blood donors, starting with every 56 days. I monitor on a regular basis to try to get them closer to low no...