"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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Haemochromatosis

Haemochromatosis is a genetic condition that affects approximately 0.6% of adult European populations and results in a silent accumulation of iron that manifests itself in, usually middle-aged people, in a variety of diverse ways.  Its development would be increased, but not caused, by taking iron supplements including multivitamins containing iron.

Features and Diagnosis of Haemochromatosis

Haemochromatosis can cause a variety of health problems:

  • Fatigue
  • Arthritis
  • Liver disease including mild elevations in liver enzymes and eventually liver failure
  • Type 2 diabetes
  • Loss of libido and sexual function e.g. early menopause
  • Rarely hypoparathyroidism and low blood calcium

Haemochromatosis is usually diagnose by assessment of iron status

  • Elevated iron saturation which is calculated by measuring serum iron and total iron binding capacity.  These tests should be performed in the fasting state and without any iron supplements being taken for 24 hours
  • Measurement of serum ferritin which is elevated but this result can be misleading as the level is often elevated in patients with infection or chronic inflammation
  • Genetic tests to look at several genetic variations in iron-transporting mechanisms that underlie haemochromatosis.  These tests are usually only undertaken if there is evidence of iron excess

Advice for Those with Haemochromatosis

Most of those with haemochromatosis will be under the care of a haematologist or liver specialist and will already have been given the following advice

    • Avoid any supplements that contain iron, which will include many multivitamin preparations and many multimineral preparations
    • Limit supplements of vitamin C to no more than 500 mg per day as is recommended by the National Institutes of Health [external link]
    • Avoid iron-rich foods including game meats and iron-fortified breakfast cereals [Dietary Sources of Essential Nutrients - Minerals]
    • Tea contains tannin, which inhibits the absorption of iron from non-haem sources, and if it is drunk with meals then it will help to limit the rate of iron accumulation.    

    References



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
Tel 01273 487003 Fax: 01273 487576