Reduced phenotypic expression in genetic hemochromatosis with time: role of exposure to nongenetic modifiers.

•HFE hemochromatosis has become less and less severe over the last 30 years despite older age at diagnosis.•Chronic fatigue and distal arthralgias remain the most frequent opening symptoms.•Reduced alcohol intake and more overweight patients may explain decreased long-term iron load in hemochromatosis.•Tobacco smoking may aggravate iron loading.