Diet for Hemachromatosis & Iron Overload
by Sue Kira, Naturopath & Clinical Nutritionist
Hemachromatosis (also spelt haemochromatosis) is a genetic condition where the body absorbs and stores too much iron. There are cases where people can have iron overload without having genetic hemachromatosis, but either way, the result is the same.
The condition is normally treated by having blood drawn regularly which is called phlebotomy or venesection (like donating blood) to reduce the amount of iron in the system. For some, this does not suit them or is not enough support to help them to feel their best.
Many of my clients who had regular phlebotomy sessions said they felt great, but unfortunately many say it drains them too much. If left untreated, hemachromatosis can result in death from cirrhosis, liver cancer, or cardiomyopathy so it is important to treat it correctly.
Phlebotomy is considered the only acceptable course of treatment for those with genetic hemachromatosis. For those with general iron overload or hemachromatosis that doesn’t respond well to phlebotomy treatments, including a dietary approach can help. Diet is great to improve overall health and better responsiveness to phlebotomy treatments.
Seek the advice of your health care provider and doctor before commencing any dietary changes.
There are two types of iron and it is the heme (aka haem) iron from red meats that is the main source of iron that can be a potential issue for iron overload, compared to the non-heme iron from green vegetables, which doesn’t appear to be much of an issue.
This means that a person with hemachromatosis can still have a good healthy balanced diet full of nutrients.
There are certain food compounds that can naturally block the uptake of iron absorption such as calcium, oxalates, polyphenols, tannins and phytates. Examples of some foods that contain these compounds are raw kale, legumes and black tea.
Because most of the excess iron is stored in the liver, anything that puts extra stress on the liver such as drugs and alcohol should be avoided (unless prescribed by your doctor). A diet to support the liver can also make a big difference.
A ketogenic diet of around 65-70% fat, 15-20% protein and 15% carbs helps to reduce the inflammation often seen with hemachromatosis and iron overload. It has been researched to show benefits.
In clinic, I have found this helps some people with hemachromatosis, but not so much for others. The diet for iron overload I recommend is not strictly ketogenic, but certainly contains foods that help to block iron absorption, are rich in anti-inflammatory foods, and very low in sugar, as sugar also encourages iron absorption.
Alcohol is high in sugar and detrimental to the liver, so an alcohol-free lifestyle is advised for those with iron overload and Hemachromatosis. Vitamin C supplements should be avoided as vitamin C also helps to absorb iron.
The following foods help to decrease and block iron absorption. Please choose plenty of these types of foods to help prevent iron overload.
Calcium rich foods: sesame seeds, Tahini, seaweeds, nuts and seeds, shellfish, fish bones from tinned fish and green leafy vegetables (which do contain non-haem iron but are fine in this form)
Oxalate rich foods: spinach is the highest, followed by beets/beetroot, then potatoes, nuts and nut butters, and raw kale
Polyphenol rich foods: cloves, star anise, cocoa powder, oregano, celery seed, dark chocolate, flaxseed meal
Selenium rich foods: Brazil nuts, sunflower seeds, chicken, chia seeds, mushrooms
Tannin rich foods: teas, coffee, most berries (cranberries, strawberries, blueberries), chocolate (with cocoa content 70% and higher), pomegranates, persimmons, grapes and spices such as cinnamon, vanilla, cloves and thyme
Phytate rich foods: brown rice, corn, soy beans, potatoes, peanuts and other legumes
Zinc rich foods: oysters, chia seeds, cashews, pepitas, eggs, mushrooms, cacoa
There are many web information pages stating that it doesn’t matter what a person eats or drinks if they have haemachromatosis, as long as they have their blood taken regularly.
In my clinical experience this isn’t always the case and a diet designed for hemachromatosis can be very supportive for those with iron overload.
While a diet for hemachromatosis and iron overload is not considered a cure, the idea is to eliminate foods considered detrimental and include foods that support your body to do its natural job of healing, which is why all foods should be gluten, dairy, additives and sugar free.
Important: Before you commence a new diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Client name and identifying information changed
James, a personal trainer, came to me feeling so tired that he could no longer work at the gym. He was initially given iron injections by his doctor to build his iron and was also instructed to take iron tablets. This made him feel worse which prompted his doctor to check his iron levels only to find that he had iron overload.
He was checked for the hemochromatosis gene and he had one of the two genes, so he wasn’t considered to have hemochromatosis, just iron overload. It was rather strange that the doctor had given him iron without checking his levels, but the result was that he then had to have blood withdrawals to try and reduce iron overload as his liver was also showing signs of distress. This procedure to draw blood is called phlebotomy (similar to a blood donation).
With each phlebotomy treatment he felt even worse and said it was ‘like the life was being sucked out of him’.
We checked a few other things and his tests revealed high inflammation markers and high liver enzymes. So I started him on a diet to reduce inflammation by taking him off gluten, dairy and sugar and changed his predominantly meat diet to one of fish and seafood to reduce the inflammation and help block any further iron absorption.
He was encouraged to eat lots of spinach, beetroot and kale as these support some non-haem iron, block haem iron absorption, and support a failing liver. We included a dressing for salads and vegies with Tahini (sesame paste) which is rich in calcium to help block iron absorption.
When he wasn’t eating fish, he ate legumes and brown rice. He wasn’t a fan of vegetarian foods so instead he preferred to snack on peanuts. Although iron overload clients often do well on a ketogenic diet, James preferred a good balance of proteins, carbs and fats and after six weeks eating this way he felt much better.
His iron still showed quite high for a while but was not in the critical area anymore and his energy gradually increased each month.
After three months on this diet he felt great and was back full swing at the gym as a personal trainer
Little research has been done on this type of diet for those with full blown genetic hemochromatosis, but some initial studies have been very promising when the diet is used concurrently with phlebotomy therapy.
Because the use of the above foods long-term might create an imbalance in other nutrients, it’s a good idea to check with your health care provider to ensure all your nutrient needs are covered.