Therapy | Hemochromatosis

Therapy

The therapy of hemochromatosis consists of a reduction of body iron. This is usually achieved with the relatively old therapy of bloodletting. The bloodletting therapy consists of two phases: It is important that these bloodletting procedures take place regularly to ensure that new blood is produced evenly.

Dietary measures also play an important role in hemochromatosis, since foods with a high iron content should be reduced. These dietary measures include, for example: drinks containing vitamin C increase iron intake, especially when iron-containing food is taken at the same time. Therefore the vitamin C should be taken two hours after the food intake.

Alcohol also increases the absorption of iron in the gastrointestinal tract and should therefore also be avoided. Drugs from the class of proton pump inhibitors (inhibit the production of stomach acid) prevent the reabsorption of iron in the intestine. If other organs are already affected, these must of course also be treated therapeutically.

In special cases of hemochromatosis, for example, where heart function is severely impaired, iron binders must be used because the heart is not able to compensate for the reduced blood volume (caused by phlebotomies) by an increased heartbeat. In cases where the liver is severely damaged (cirrhosis of the liver), an organ transplant must be considered.

  • The initial therapy starts with bloodletting of 500 ml blood each to reduce the ferritin level to below 50 g/l.
  • Long-term therapy serves to maintain low ferritin levels and includes about 4-12 bloodletting of 500 ml per year.

    This is to prevent iron overload of the body in hemochromatosis. Per bloodletting, about 200mg of iron are withdrawn from the body.

  • Spinach,
  • Cabbage,
  • Lenses,
  • Meat and
  • Grain.

Hemochromatosis is treated by bloodletting therapy. This can be very stressful for the patient under certain circumstances.

Bloodletting empties the overfilled iron stores. For this purpose, about 500ml of blood is drained off at the beginning of the treatment in a one- to two-week cycle. The bloodletting therapy is continued until the serum ferritin reaches a value of 50μg/l.

In the case of advanced hemochromatosis, this may take one to two years. This is followed by the so-called maintenance phase, in which bloodletting is only required every three months to keep the ferritin at a value between 50 and 100 μg/l. Since hemochromatosis is mostly genetic and the cause cannot be eliminated, the therapy must be continued for a lifetime.

In addition to bloodletting therapy, therapy with medication is also possible, but bloodletting therapy is more effective and has fewer side effects. It is important to avoid an accumulation of iron through diet in order not to cancel out the effect of the bloodletting therapy. One should therefore avoid foods with a high iron content such as animal innards.

Otherwise, there are actually no restrictions as far as nutrition is concerned. Drinking black tea or milk with meals reduces the absorption of iron in the small intestine to a small extent and can therefore be helpful for hemochromatosis patients. Since vitamin C promotes the absorption of iron from food, fruit juices containing vitamin C should not be drunk about 2 hours before and after meals.After diagnosis, it is important to avoid alcohol until the iron stores are emptied (after approx.

1 to 1.5 years of bloodletting therapy). It is also advisable to abstain from alcohol beyond this time in order to limit damage to the liver cells. The iron overload caused by hemochromatosis damages the liver and leads to cirrhosis of the liver in three-quarters of patients, an irreversible damage of the liver with scarring and loss of function.

Regular drinking of alcohol also damages the liver cells and can also cause cirrhosis of the liver. Hemochromatosis patients should avoid alcohol for various reasons: Regular alcohol consumption can interfere with the iron metabolism and (even if there is no hemochromatosis) also lead to iron overload. The effects then add up.

Regular alcohol consumption causes additional iron overload in hemochromatosis patients. To prevent additional damage to the liver in hemochromatosis, patients with this disease should refrain from regular alcohol consumption. After diagnosis until the iron stores are emptied by regular bloodletting, alcohol should be avoided completely.