Further investigation has shown that only some people drinking this sort of beer get an iron overload syndrome, and that a similar syndrome occurred in people of African descent who have had no contact with this kind of beer (e.g., African Americans).

Ferroportin/SLC40A1 Q248H mutation in exon 6 occurs as a polymorphism in individuals of sub-Saharan African descent,[8][9][10] but it was not identified in western Caucasians.

Ferroportin Q248H mutation in African families with dietary iron overload showed lower mean cell volume and higher ferritin concentration.

[13] Increased hepatic iron generates chronic oxidative stress by disrupting the redox balance of the cell, which damages DNA, protein, hepatocytes and lipids.

[14][15][16] Increased lipid peroxidation is thought to be a vital contributor to hepatocellular carcinoma in iron overload.

[17] Oxidative stress leads to lipid peroxidation of unsaturated fatty acids in organelles and cell membrane.

[5] Elevated level of ferritin concentration can be observed in acute or chronic inflammatory process without pathologic iron overload.

[18] Ferritin level above 200 ng/mL (449 pmol/L) in women or 300 ng/mL (674 pmol/L) in men who have no signs of inflammatory disease need additional testing.

[21] Chemical evidence of tissue vitamin C deficiency and mild to moderate liver dysfunction are likely to be seen in individuals with African iron overload.

[5] MRI can detect the degree of magnetic disruption due to iron accumulation.

A physician can provide therapeutic phlebotomy if the patient's hemoglobin level is sufficient to sustain blood removal.