Ask Dr. Gourmet

What diet is best for those with hemochromatosis?

I've been diagnosed with hemochromatosis. Can you recommend a diet that is low in iron and iron retaining content?

Dr. Gourmet Says....

Hemochromatosis (for those readers who are unaware of this issue) is a genetic condition where the body doesn't store iron properly. The result is iron overload in the body that can lead to many problems, including liver and heart damage. It is actually a fairly common condition, with some research showing 1 - 6% of the population having some degree of problem.

In people like yourself who have been diagnosed the treatment is to remove blood on a regular basis until the iron levels return to normal. This is called "phlebotomy." Once the levels are within an acceptable range they are maintained by ongoing but less frequent phlebotomy.

The key dietary guideline is to limit iron-rich foods. Here's a fairly comprehensive list from the USDA of iron content in foods (PDF), and a shorter, one-page list of the most common sources of iron in foods (PDF)

Here are some general recommendations made by an expert panel convened by the CDC (here's the CDC site on Hemochromatosis):

• Avoid iron supplements.
• Read the label of multivitamins to make sure they do not contain iron.
• Limit vitamin C supplementation to 500 mg/day. Vitamin C speeds up intestinal iron absorption. Eating natural foods that contain vitamin C is fine.
• Avoid eating raw shellfish. Hemochromatosis patients are susceptible to infections with Vibrio vulnificus and Salmonella enteriditis; raw shellfish can contain these bacteria.
• Avoid more than moderate alcohol consumption, one drink per day for females, no more than two per day for males. Patients with liver damage should avoid alcohol.

These are echoed in a useful handout from the Iron Disorders Institute: Diet Recommendations for Hemochromatosis (PDF)

There are a few other considerations that have not been proven but may help. Eating a high fiber diet can retard the absorption of iron as can tea. Some advise eating foods that are rich in Vitamin C like fruits and fruit juices between meals so as to decrease the absorption of iron when Vitamin C is present. It's probably a good idea to avoid cooking foods in iron cookware.

Overall, eating a healthy diet is something you should be able to do along with phlebotomy as directed by your physician.

Thanks for writing,

Timothy S. Harlan, MD, FACP, CCMS
Dr. Gourmet