Reducing Iron Intake
It is impossible to completely avoid iron in one’s diet and it is not advisable in any case. Many foods rich in iron also have other essential vitamins and minerals. In the active de-ironing phase, reducing iron intake is almost insignificant compared to the 225 mg of iron that are being removed with each phlebotomy. In the maintenance phase, restricting iron intake may increase the time between phlebotomies but at no time will reducing iron in the diet replace phlebotomies as effective therapy.
Animal & Vegetable Sources of Iron
Iron from animal sources, called heme iron, is much more readily absorbed than iron from vegetable sources (non-heme iron). In fact, much of the iron in vegetables such as spinach is unavailable because other molecules that are too big to be absorbed, bind the iron. Red meat, especially organ meats and venison, have the highest iron content, so would be a good place to start in reducing iron intake. They don’t have to be avoided altogether, but one might consider eating them less frequently. Supplemental iron should be avoided entirely. Highly fortified foods such as breakfast cereals could also be reduced.
Vitamin C enhances the absorption of non-heme iron, so it should not be taken with meals. Calcium, on the other hand, inhibits the absorption of heme iron, so combining dairy products with meat can help diminish the iron absorbed. Other inhibitors are the tannins in tea if taken with a meal, bran, and raw whole grains.
Foods high in anti-oxidants can also be helpful in reducing oxidative stress from unbound iron.
Alcohol in general not only enhances the absorption of iron, but also may be harmful to a compromised liver. No more than four drinks a week is the recommended maximum intake. Red wine, interestingly, actually decreases iron absorption, probably through tannins. Alcohol should be avoided altogether if the liver has been damaged.
Raw shellfish, especially oysters, carry a bacteria called Vibrio vulnificus that can be deadly to people with iron overload because it thrives on iron. Even handling raw shellfish can be dangerous if there are any breaks in the skin.