X-linked sideroblastic anemia is an inherited disorder of red blood cells. Although these cells have an adequate amount of iron, they are unable to use it to make hemoglobin. Hemoglobin is an iron-containing molecule that carries oxygen in the blood. The symptoms of this disorder range from mild to severe and usually begin during the first three decades of life. Signs and symptoms include pale skin, fatigue, dizziness, and an enlarged spleen and liver. Heart disease, liver damage, and kidney failure are severe symptoms that can result from increased levels of iron in the blood.