When the diagnosis of hemochromatosis is made it is important to adjust the diet so that too much iron is not being absorbed because of an improper diet. However such adjustment need not be at the expense of enjoying life and good food.
The biggest considerations are not to take medications which contain iron, consume too much alcohol or Vitamin C. Excessive alcohol consumption which has shown to greatly increase iron absorption in those with hemochromatosis is set at a level of 60g a day. Thus it is important to stay well below this level. The limit should be 30g a day in men and 20g a day in women. When a patient has two copies of C282Y and drinks excessive alcohol there is a multiplying affect – not an additive affect – on the absorption of iron. It is deadly to drink too much alcohol if you have hemochromatosis. The effect of excessive alcohol consumption on hemochromatosis cannot be overstressed.
Vitamin C enhances the absorption of iron. It is wise only to consume a moderate amount and not take Vitamin C tablets. Vitamin C has been known to precipitate heart palpitations in those with hemochromatosis.
The ingestion of black tea has been shown to decrease the absorption of iron. African tea which is becoming popular may contain iron so too much should not be consumed.
Patients with hemochromatosis should not take supplements unless there are documented deficiencies. There is evidence that those with hemochromatosis may also have an increased ability to absorb other heavy metals. While iron may be removed by bleeding it is very difficult to remove other excess heavy metals.
Don’t take milk thistle which has often been touted as good for the liver. It can cause severe problems in those with hemochromatosis. It is best to avoid herbal medicines with hemochromatosis as the joint effects have not been adequately studied.
Don’t eat raw shellfish. They may be contaminated with Vibrio vulnificans which thrives in an iron rich environment. There have been fatalities in the northern hemisphere. Cooking inactivates this organism.
Vitamin E – as an antioxidant may be of some help because too much iron may act as an oxidant. However it is probably important not to exceed 400 to 800 IU a day of Vitamin E.
It is non-heme iron or the iron found in sources such as vegetables that is excessively absorbed in hemochromatosis. Thus a patient with hemochromatosis may consume a steak and not be overly concerned. Meat and blood are sources of heme iron.
It is important not to believe that those with hemochromatosis should overly restrict their diet. With the exception of the above pointers restriction of iron intake doesn’t help that much in hemochromatosis. A very strict diet with removal of all other sources of iron will help keep the ferritin level down, however no more than could be achieved by one phlebotomy every 6 months. So it is important to enjoy your food – hemochromatosis is not a barrier to that.