What is Haemochromatosis?

Minerals, Joint disorders, fatigue | March 8, 2017 | Author: Naturopath

liver

What is Haemochromatosis?

Haemochromatosis is one of the most frequent genetic diseases found in white populations – affecting one in 200 people from northern European descent. It is an inherited disorder of iron metabolism and is characterized by the loading of excess iron in the liver, heart and pancreas. This results in iron overload and if left untreated can lead to organ failure, cirrhosis, liver cancer, diabetes mellitus, arthritis, endocrine and sexual dysfunction and decreased life expectancy.

We all know that not enough iron is a problem but few realise that too much iron is also a major concern. The good news is, that if found early enough hereditary haemochromatosis is easily treated and can allow a person to lead a happy, long life.

Normal absorption of iron

Iron is a trace mineral that we get from the foods we eat. It is essential for the production of haemoglobin. Haemoglobin is a protein found inside red blood cells that is needed to transport oxygen around the body.

Our bodies are usually very clever at only absorbing the amount of iron we need.

However, in people with haemochromatosis too much iron is absorbed which is then stored in the body in excessive amounts.

 

Symptoms 

Symptoms vary from person to person, with some people displaying none. Sometimes the symptoms develop slowly over a period of time, as iron levels gradually accumulate in the body.

The most common symptoms include:

  • Fatigue, weakness and lethargy
  • Joint pains leading to osteoarthritis

Other symptoms include:

  • Diabetes mellitus
  • Abdominal pain
  • Weight loss
  • Liver disorders; enlarged, cirrhosis etc.
  • Sexual disorders; loss of sex drive in both males and females, impotence in men, absent or scanty menstrual periods and early menopause in women
  • Decrease in body hair
  • Discoloured or bronzed skin
  • Disease of the heart muscle (cardiomyopathy)
  • Neurological/psychiatric disorders; mood swings, irritability, depression and impaired memory

Diagnosis

Hereditary haemochromatosis is diagnosed by simple blood tests. Usually a doctor will order a test that measures transferrin saturation and serum ferritin. If these tests exceed the norm, a genetic test that looks for specific genetic markers of haemochromatosis can be performed. If you are aware that a close relative has this disorder, it is important to get tested yourself. This test can also determine if you are a carrier of this genetic disorder.

Treatment

Your doctor will advise you on available treatment options. This often consists of removal of blood by venesection (similar to giving blood). Up to 500mls of blood is removed at regular intervals until iron levels have returned to within normal range. Once normal levels have been achieved, venesections are performed less frequently to maintain results.

Reducing iron in the diet

Because people with hemochromatosis absorb too much iron from their foods it is important for some individuals to reduce the amount of iron in the diet. The higher your iron levels are the more careful you need to be about the iron content in foods. Haem iron from animal products is very well absorbed and is found in high amounts in fish, liver and meat, especially red meat. These foods can still be consumed as part of a healthy diet but for people with high levels of iron they should consider restricting their consumption. Non-haem irons are poorly absorbed and are found in green leafy vegetables, beans and lentils. They contribute in a very small way to iron levels and if eaten in moderation are part of a healthy diet.

Avoid alcohol and raw seafood

It is important to restrict alcohol consumption so as not to place any additional strain on the liver. The liver is the most compromised organ in hemochromatosis. Alcohol also increases the absorption of iron from food, which is another reason to avoid its consumption.

Avoiding eating raw seafood to reduce the risk bacterial infection from organisms who thrive in an environment where there is too much iron. Though very rare, these bacterial infections have caused serious complications and even death in individuals with hemochromatosis.

Supplements to avoid

Iron in supplements and iron fortified foods should also be avoided. Even too much supplemental vitamin C and beta-carotene in individuals with high iron levels should be minimised as these vitamins increase the absorption of iron. If they are being consumed, take away from foods that contain iron.

Inhibitors of iron absorption

Calcium

Calcium has been shown to have a negative effect on the absorption of iron from both plant and animal sources. Inhibitory effects were seen when calcium was supplemented at doses of 75-300mg and at doses of 165mg from dairy products. This suggests that eating dairy products in moderation can reduce the amount of iron absorbed and supplementing calcium into the diet may also be of assistance
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Magnesium

Magnesium is another mineral that competes with iron for absorption and is a common deficiency in Australians. Magnesium is also found in dairy products and raw nuts and seeds.
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Polyphenols

Polyphenols occur in various amounts in plant foods and beverages, such as vegetables, fruit, some cereals and legumes, tea and coffee.

The inhibiting effect of polyphenols from black and green tea on iron absorption is the strongest. One study found black tea consumed with a meal, reduced the increase in iron storage by one third compared to that of the control group. The researchers suggested that regular tea drinking reduces the frequency of having to donate blood in patients with hemochromatosis.

Chili and turmeric are also dietary sources of polyphenols, with chili being shown to reduce iron absorption in one study. Turmeric has the benefit of being an antioxidant, can help reduce inflammation and acts as a liver tonic.
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Milk thistle

One of the most popular liver herbs has been shown to reduce iron absorption in patients with hereditary hemochromatosis. Silybin, the main active constituent of St Mary’s thistle was taken at a dose of 140mg during a vegetarian meal containing iron. The silybin significantly reduced the amount of iron absorbed and has been suggested to be an effective treatment for people with hemochromatosis. It also has the additional benefit of protecting the liver from damage.
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References

http://haemochromatosis.org.au/

Hopfner M, et al. Yersinia enterocolitica infection with multiple liver abscesses uncovering a primary hemochromatosis. Scand J Gastroenterol. 2001 Feb;36(2):220-4

https://www.ncbi.nlm.nih.gov/pubmed/11252417

Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010 May;91(5):1461S-1467S

http://ajcn.nutrition.org/content/91/5/1461S.long

Fan FS. Iron deficiency anaemia due to excessive green tea drinking. Clin Case Rep. 2016 Oct 5;4(11):1053-56

https://www.ncbi.nlm.nih.gov/pubmed/27830072

Kaltwasser JP, et al. Clinical trial on the effect of regular tea drinking on iron accumulation in genetic haemochromatosis. Gut 1998 Nov;43(5):699-704

https://www.ncbi.nlm.nih.gov/pubmed/9824354

Hutchinson C, et al. The iron-chelating potential of silybin in patients with hereditary haemochromatosis. Eur J Clin Nutr. 2010 Oct;64(10):1239-41

https://www.ncbi.nlm.nih.gov/pubmed/20628405

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