Management of hemochromatosis

Dr Mark Crowther is a professor and chair of the Department of Medicine and the Leo Pharma Chair in Thromboembolism Research at McMaster University.

What diet, medication, and physical activity should be recommended to a patient with hemochromatosis?

Mark Crowther, MD, MSc: A great question. Hemochromatosis. The vast majority of patients who have iron overload are completely clinically well and they should behave as if they are completely clinically well. Probably you can do your usual exercise. For diet, you probably want to take it easy on iron-containing substances.

Most importantly, if you want to have a steak, that is fine, but do not have steak every single day of the week. I tell my patients that I can take blood out of them way faster than they can take iron in, so really it comes down to if they are willing to have phlebotomies, if they are on a regular course of phlebotomy, then they can probably eat anything they want.

If you have a patient, for example, a 34-year-old woman who has got a strong family history of hemochromatosis whose ferritin is a little bit high but she is having menstrual periods, so she is still losing some blood, and her ferritin is 42% saturated, you may think that this woman is at risk of developing iron overload in the future and you may institute in her a little bit more aggressive recommendations around preventing iron intake. But because she has menstrual periods, you also want to make sure that you check her ferritin to make sure she does not become iron deficient, because there is a risk of iron deficiency.