Iron & HHT
Iron is a mineral vital to the proper function of haemoglobin, a protein needed to transport oxygen in the blood.
Certain individuals, like children and teens, menstruating or pregnant women, and athletic individuals, are at an increased risk of iron deficiency. HHT also increases your risk of iron deficiency. A shortage of iron in the blood can lead to a range of serious health problems, including iron deficiency anaemia.
Symptoms of iron deficiency anaemia include fatigue, lack of energy, pale skin, depressed immune function, and reduced mental performance.
Iron & HHT
The average daily foods and supplements:
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in children aged 2–11 years: is 13-15mg
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in children and teens aged 12–19 years: day 16mg/day
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in men: and 1–20 mg/day
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in women older than 19: 17–18 mg/day
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in pregnant women is 14mg/day
It is recommended that you talk with your doctor. He/she will advise you if you should take your iron daily or on alternate days.
How does my body absorb iron?
Iron enters the stomach where it is exposed to stomach acid and changed into a form that allows it to be absorbed. The portion of the small intestine called the duodenum is the chief area where iron absorption takes place.
Heme-iron (from meat) is more easily absorbed by the body. Because vegetarians only consume non-Heme iron, they are at a higher risk for iron deficiency. But other factors (eg Calcium) influence how your body absorbs iron as well. If you are deficient in iron, your body will absorb more of it from food than it would if you had good iron stores
Increase your intake and absorption of iron:
Consume iron with a source of vitamin C. Many fruits, vegetables, and juices are good sources of vitamin C, including citrus fruits and juices, strawberries, broccoli, peppers, and tomatoes.
Meat aids absorption of non-heme iron, e.g. beef in chili will help you absorb the iron in kidney beans.
Where is iron found?
There are two types of iron found in foods.
Heme iron is found only in animal sources, such as beef, chicken, turkey and in shellfish eg Oysters & Shrimp.
Non-Heme iron is found in animal & plant sources. Plant Sources include pumpkin seeds, tofu, soybeans, lentils, and legumes, nuts, eggs, baked beans, blackstrap molasses.
Some fruits and vegetables e.g. cooked spinach, dried fruits like apricots, cooked green peas, and tomato sauce are all other good sources of non-heme iron.
For more information about sources of iron, talk to your dietician
Iron medications
Since people with HHT often need extra iron, your doctor might recommend iron replacement therapy. Iron is available in capsule, tablet, chewable tablet, and liquid form.
Take your iron pills on an empty stomach, which means 2 hours after the last meal or 1 hour before eating. If you experience stomach cramps, nausea, or diarrhea when taking iron, you may take it with a small amount of food.
Vitamin C helps you absorb iron so you can take your iron pill with a glass of orange juice.
Don’t drink milk or take calcium supplements or antacids at the same time as your iron – wait at least 2 hours before taking your iron after consuming these.
Avoid the following foods when consuming your iron pills, because they decrease absorption:
- Foods containing phytates: e.g. legumes, rice, whole grains
- Foods containing polyphenols: e.g. coffee, tea, red wine, oregano
- Foods containing vegetable proteins: e.g. soybeans
- Foods containing calcium: e.g. dairy products
Ask your doctor or pharmacist about your other medications. Some antibiotics (e.g. tetracycline, penicillin, etc…) and other drugs don’t work as well if you take them at the same time as iron – wait at least two hours in between. Also, if you take acid suppressant medications (e.g. ranitidine, omeprazole, pantoprazole and others), talk to your doctor or pharmacist about what time of day to take your different pills.
Iron Deficiency in HHT
Iron deficiency is a common and important manifestation of HHT. Lack of iron makes it harder to produce red blood cells (RBCs), has symptoms similar to anemia, and makes anemia more likely to occur with active bleeding as the body will not have the necessary iron available to replace the lost RBCs. Approximately 50% of patients with HHT develop anemia. However, many patients can be iron deficient but not anaemic.
There are many iron-rich foods that can help increase iron absorption. An iron-rich diet can help offset iron deficiencies, but it’s also important to know which foods can prevent iron from being absorbed. Learn more with this inclusive factsheet from CureHHT
People who have chronic bleeding and have low levels of iron in their bodies may need more iron than the above. Every individual is unique, so talk to your doctor about your own personal needs.
CBC - Complete Blood Count
“Perhaps it’s a good idea to keep this list handy for when you visit your local haematology unit for blood tests. Your haematologist will advise you more.”
Informative information from CureHHT and the National Library of Medicine.
Statement on Iron replacement – CureHHT
https://curehht.org/resource/policy-statement-iron-replacement-in-hht/
Anaemia Iron Deficiency
A National Library of medicine Report on the “Effect of Intravenous Iron Supplementation on Iron Stores in Non-Anemic Iron-Deficient Patients with Hereditary Hemorrhagic Telangiectasia” by Torbjörn Karlsson and Honar Cherif from the Department of Hematology and Center for Osler’s Disease, Uppsala University Hospital, Uppsala, Sweden
Ferritin >100 recommended: See ‘Discussion’.
