Do you have hemochromatosis? Be aware that a suitable diet can allow you to stabilize the disease and lower ferritin levels. With Doctor Victor Simon, gastroenterologist, we are trying to better understand the disease to know what to eat.
What is hemochromatosis?
“People with hemochromatosis have an anomaly of excessive absorption of iron ingested in the diet and do not eliminate it correctly. This accumulates in several organs of the body, mainly the liver, the heart, the pancreas and the skin. The liver is particularly affected because it has a high iron storage capacity. It gradually deteriorates to cirrhosis or even liver cancer” explains Doctor Victor Simon. “In the later stages of the disease, a combined liver and heart transplant may be required.” he adds.
What is the cause of the disease?
“It is a hereditary genetic disease. The iron overload of genetic hemochromatosis is due to a deficiency in the production of hepcidin by the liver, synthesized mainly by the liver and excreted in the urine”.
What are the symptoms of the illness ?
The accumulation of iron is progressive and the symptoms do not appear before the age of 35-40 years in men and 45-50 years in women. “Thanks to their menstruation, women manage to eliminate part of the iron. At menopause, this is no longer the case and the disease becomes symptomatic. describes the doctor. “The warning signs of the disease are significant fatigue, the appearance of joint disorders, a significant deterioration in general condition, a “slate gray” skin color over the whole body (skin that has a tanned appearance whereas the person has not been exposed to the sun), heart rhythm problems, liver problems, sexual breakdowns”.
What is ferritin?
Ferritin is an intracellular protein, which binds to iron. It is present in the liver, spleen, muscles, bone marrow and bloodstream. “The level of ferritin in the blood, ferritinemia, directly reflects the amount of iron stored in the body. It is a more specific assay than serum iron. To measure it, a simple blood test is necessary. It confirms a diagnosis of hemochromatosis. Its normal rate is 18 to 270 ng/ml in humansof 18 to 160 ng/ml in womenand of 7 to 140 ng/ml in children. During hemochromatosis, this rises to more than 1000 ng/ml“. Dosing ferritin regularly makes it possible to follow the evolution of the disease.
“When the diagnosis of hemochromatosis has been made with certainty, there are two axes for the management of the patient: diet and bloodletting. Some people will not need bloodletting and will be able to compensate for the excess iron with an appropriate diet explains the doctor.
“At the initiation of treatment, bloodletting of 400 ml for women and 500 ml for men are performed weekly until a satisfactory level of ferritin in the blood. Once the objective has been reached, it is possible to space out the bleedings (every 2 to 4 months depending on the patient). This is a lifelong treatment.”.
The blood taken during the bleeding can be donated from the 6th bleeding if the first 5 have gone off without a hitch. Note: many pregnant women receive iron supplementation at the end of pregnancy. Although the disease generally begins at menopause for women, if a woman with hemochromatosis is pregnant, bleeding will be suspended during pregnancy and no iron supplementation will be given.
What is the difference between heme and non-heme iron?
There are two types of iron in the diet: non-heme iron of plant origin and the heme iron of animal origin. The first is much less well absorbed by the body than the second.
This is why people with hemochromatosis should favor vegetables and avoid meat and fish.
What does the special hemochromatosis diet consist of?
“People with the disease will never be cured and will have to follow a special diet all their lives to ensure their health. Thanks to this, patients can delay the occurrence of complications of the disease (liver, heart, pancreas)”.
The diet consists of limiting the intake of heme iron and favoring foods that reduce the absorption of iron in the body, such as calcium. “Indeed, it is necessary to favor dairy products and waters rich in calcium (Hépar, Courmayeur, Contrex)” explains the doctor. “Some green vegetables are also very rich in calcium: spinach (they are rich in iron, but in non-heme iron), lamb’s lettuce, watercress, broccoli, leeks or arugula”.
As proteins of animal origin must be avoided, they must be replaced by eggs or proteins of vegetable origin such as legumes (kidney beans, butter beans, broad beans, chickpeas, lentils), tofu, oilseeds (walnuts, hazelnuts, cashews, sesame, flaxseed or rapeseed).
Tea and coffee contain tannins which limit the absorption of iron. “They should be drunk with meals. Green tea is particularly effective” complements the gastroenterologist. “If drunk with meals, green tea can reduce iron absorption by 70%. If consumed outside the meal, only 20%”.
Fiber is also recommended for people with hemochromatosis. Like calcium, they reduce the absorption of iron in the body. We can mention whole grain products, beets, red fruits, chocolate, sweet potatoes, green peppers…
To sum up, a low iron diet for hemochromatosis will aim to favor vegetable proteins that are sources of non-heme iron and to consume foods that decrease the absorption of iron in the body, which is an excellent diet for your health! It will be a question of adopting a mode opposite to that adopted in the event of iron deficiency (anemia).
What foods should be avoided?
“Foods rich in heme iron can be consumed but in moderation: clams, offal (poultry and beef liver), roast beef, turkey, pork, canned sardines, salmon… avoid drinking alcohol so as not to overload the liver” explains the doctor. “It is not really a treatment but rather lifestyle and dietary rules”.
NO to diets, YES to WW!
It is possible to supplement a diet low in iron with several practical tips to apply on a daily basis:
- Cooking with utensils designed in glass or ceramic instead of cast iron or stainless steel;
- Avoid taking vitamin and mineral supplements : in the event of a diet low in iron, it is obviously inadvisable to take multivitamins containing iron, but also to avoid taking zinc, since its absorption is increased in the event of hemochromatosis. It will also be necessary to avoid vitamin C. Indeed, vitamin C promotes the absorption of iron by the body.
- Consume of smaller portions of meatand red meat or offal no more than once a week;
- Integrate vegetable protein in food : tofu, legumes and oilseeds;
- Greatly reduce alcohol consumption;
- Consume fruits (rich in vitamin C) outside meals;
- Take some dairy products at the end of meals;
- Do not hesitate to drink tea during the meal;
- Avoid processed products that are too fatty and too sweet.
Doctor Victor Simon is the author of “How to succeed in being sick and recovering from it in ten lessons” published by L’Esprit du temps.