How effective is treatment?

Venesection treatment will cause tissue iron to be mobilised and iron stores will return to normal. However, it will not cure some serious clinical conditions such as diabetes or cirrhosis if they are already present at the time treatment is started. This emphasises the need for early diagnosis.

Fatigue, lethargy and abdominal pain should decrease.
Cardiomyopathy should improve providing cardiac damage is not severe. In severe cases iron chelation treatment can reverse congestive heart failure.
Bronzing of the skin should fade.
Cirrhosis will stay the same.
Sexual dysfunction and arthritis do not usually improve. Indeed arthritis may appear later even if absent at the time of diagnosis and treatment.
Providing there is not a massive, long-standing iron overload present at the time treatment is started; those who undergo treatment have a normal life expectancy.

Diet

It is not possible to treat GH with a low iron diet. The iron absorbed weekly from a normal diet is around 60mg, and if you attempt to keep your iron intake very low by restricting your diet you may well not get adequate nutrition. The iron absorbed from a portion of spinach, red wine or Guinness is about 1mg and red meat would only contribute 2 or 3mg.  A single venesection will remove about 250mg.

We make the following recommendations:

+ Avoid vitamin supplements or tonics containing iron, and breakfast cereals heavily fortified with iron. Large doses of vitamin C should also be avoided, as it makes the process of depositing iron in some organs easier and enhances the absorption of iron from the diet.

+ Reduce intake of offal (liver, kidney etc.) and red meat. The rate of iron absorption from red meat is 20 to 30% whereas vegetables and grains have less iron and a 1 to 20% rate of absorption.

+ Minimise alcohol intake, particularly with meals, as it may increase iron absorption and it can also cause liver disease. Anyone who has cirrhosis should avoid all alcohol. Tea and all milk products taken with a meal reduce the amount of iron absorbed.

 

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