Presentation
A 63-year-old Mediterranean man presented with continuous thirst, frequent urination, increased appetite, recurrent tooth infections, headaches, and anxiety. The patient had a two-year history of type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia .His past medical history included no alcohol consumption or iron therapy, and no personal or family history of hemolytic anemia or hereditary hemochromatosis (HH).However, he did have a family history of ischemic heart disease and was an active smoker.

Examination
The patient was overweight (BMI 28.08 kg/m²) and had no signs of chronic inflammation or organomegaly. Blood pressure readings were elevated (145–160/100–105 mmHg).Clinical findings did not suggest HH or chronic liver disease.

Diagnosis
Routine blood tests showed raised serum ferritin (SF) of 1370 ng/L. The  transferrin saturation, liver and renal function, lipid profile, and complete blood count were normal. Imaging showed fatty liver, mild prostatic enlargement, and vascular calcification of the abdominal aorta and renal arteries. Despite the high ferritin level, HH and other iron overload syndromes were excluded via hematologic, oncologic, and imaging evaluations. Normal transferrin saturation also ruled out HH. The patient was diagnosed with T2DM and hypertension with hyperferritinemia.

Management
Instead of initiating iron chelation therapy, the patient received subcutaneous epinephrine (0.6 mcg/kg) twice daily (5 days/week for 6 weeks) under ECG and BP monitoring. Within four weeks, hypoglycemia and hypotension developed. The patient was advised for temporary withdrawal of oral hypoglycemics and antihypertensives. Dietary and glucose/BP monitoring protocols were also recommended.

Follow-up
After treatment, the patient demonstrated complete resolution of hyperglycemia and normalization of serum ferritin and HbA1c within four months. Blood pressure also returned to normal. The patient was under regular supervision with no adverse effects from epinephrine use.