Metazoans require heme as an essential cofactor and synthesize it in the mitochondria. Caenorhabditis elegans and related helminths are an exception as they are unable to synthesize heme de novo but instead acquire heme from dietary sources for their growth and development. Heme is imported from the apical surface of the intestine by HRG-1-related importers and exported by MRP-5/ABCC5 from the basolateral surface. Loss of
mrp-5 causes heme deficiency in extra-intestinal tissues and embryonic lethality, which can be suppressed by dietary heme supplementation raising the possibility that heme export in the absence of
mrp-5 could be mediated by alternate pathways. Here we show, by performing a forward genetic screen in an
mrp-5 null mutant, that loss-of-function in vesicular transport adaptor protein complexes fully restores heme homeostasis and normal growth and development in
mrp-5 mutants. We screened over 160,000 haploid genomes and identified thirty-two bypass suppressors of
mrp-5(
ok2067). Deep-sequencing and variant analyses revealed three suppressors, each containing mutations in different adaptor protein 3 (AP3) complex subunits. RNAi depletion of individual subunits for either AP3 or AP2 phenocopies the
mrp-5 bypass suppressors. Remarkably, loss of AP3 subunits in the
mrp-5 mutants reversed intestinal accumulation of fluorescent heme analog; resistance to gallium protoporphyrin IX toxicity; extra-intestinal heme deficiencies; and neuronal abnormalities including glial migration and synaptogenesis. Taken together, our results show that cargo transport by vesicular adaptor proteins play a previously unanticipated role in systemic heme homeostasis and that multiple routes govern intra- and intercellular heme trafficking in metazoans.