Iron Overload Common, But Diet Not a Key Treatment, Insist Experts

Q. I have been diagnosed with hemochromatosis. Should I be following a special diet?

 

A. That’s not necessary, nor is it an effective way to treat the disease, experts now say. Hereditary hemochromatosis, also called iron overload disease, is caused by a faulty gene, which triggers excessive absorption of iron from both foods and supplements.

 

Danger Commonly Ignored. Though little known or addressed, hemochromatosis is the most common inherited disorder in the U.S., with one of every 200 to 300 people affected, men more severely than women.

   Your body usually gives no clue that extra iron is accumulating in your tissues and organs, except perhaps a bronze look to your skin. After years of buildup, however’typically in middle age?it triggers irreversible damage in whatever organs it has settled, causing arthritis, cirrhosis, impotence, heart disease or diabetes. Often, the underlying reason?iron overload?is never identified.

   Yet diagnosis is relatively simple with the right blood test: A serum transferrin saturation level greater than 50% for men or 60% for postmenopausal women suggests a problem. Ask for the test at your next checkup. If treated early, consequences can be prevented.

 

The Latest Diet Advice. While it may seem logical that cutting down on foods fortified with iron would help, it doesn’t really, say experts.

   ?One or two dietary changes won’t make a very big difference,? says Kris V. Kowdley, M.D., director of the Iron Overload Clinic at the University of Washington School of Medicine in Seattle. The cornerstone of treatment for hereditary hemochromatosis is removal of blood through scheduled blood donations, called phlebotomy.

   ?We can [remove] enough iron with one phlebotomy, so that there’s really no need to alter diet,? says Kowdley. ?However, I do tell my patients who take a multi supplement to choose one without iron.? Several such formulas are available, including Centrum Silver (Wyeth) and Alphabet II, Formula 644 (AARP).

   One dietary practice that’s been shown to help is drinking tea, particularly tannin-rich black tea, which hinders the absorption of iron. In a European study, when people with hereditary hemochromatosis drank tea with meals for one year, body iron stores were reduced by about one-third compared to controls who drank water. However, phlebotomy is still necessary.

 

EN‘s Bottom Line. EN encourages screening for this insidious disease, which is highly treatable if caught early. Screening is crucial if there is a known family history. Once diagnosed, phlebotomy is a must. In addition, drink tea and limit vitamin C in supplements to 100% of the RDA, because C increases iron absorption. Also, avoid iron in supplements and iron-fortified foods when possible. However, wholesale avoidance of dietary iron is not necessary.

Anastasia Schepers, M.S., R.D.

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