This article was written by Irene for the latest edition of West & Mid Kerry Live! Inspired by many people who have sought nutrition advice to manage Haemachromatosis.
For a while there has been a raging debate in genetics as to whether Hereditary Haemochromastosis is a Celtic thing or was it introduced to the Celts by Viking invaders and other colonizers. Hereditary haemochromatosis (HH) is a genetic disease that alters the body's ability to regulate iron absorption, resulting in excessive iron building up in cells overtime. What we do know is that the genetic variant (a glitch in our genetic coding) responsible for HH, identified in 1996 as C282Y, only occurred after our ancestors migrated from Central Africa to Northern and Central Europe, 60 to 70 generations ago. Up until then, there is no evidence that HH was in our genes. We also know that countries with the highest prevalence for HH around the North Sea and Western Europe, lie in the path of the once-marauding Vikings, which suggest that the Viking travel had something to do with introducing the defective gene into populations. However, the timeline does not fully explain how the gene mutation is present in Celtic Irish ancestral remains from Rathlin Island dating back to 3000 years before the Vikings hit our shores. The Irish have the highest frequency of C282Y mutation in the world, and specifically in the male population of Connaught.
Although it is known as the “Celtic Curse”, the enhanced ability to store iron probably provided advantages at the time of our first migration to Europe. In particular, it would have helped us adapt to low-iron intakes in our new environment and ward off deficiencies. There is evidence that HH provided resistance to tuberculosis and typhoid infections, as these bacteria require free iron for growth and the way the body stores excess iron, makes it unavailable to these bacteria. The first diagnosis of Haemochromatosis was made during the 1800s through autopsies which showed accumulations of iron in the liver, pancreas, joints and skin. Early physicians established that iron overloads accumulated over a period of 30 to 40 years so symptoms of HH were not seen until life expectancy improved. Our early ancestors would have died long before the effects of excessive iron were apparent.
Nowadays, blood analysis and genetic testing can identify the rogue gene responsible for HH. It is the most common genetic disease in Ireland with 1 out of every 83 people predisposed to HH, yet most people are only diagnosed between the ages of 30 and 50 years when symptoms of iron overload become apparent. Women tend to be diagnosed later due to blood loss through menstruation and pregnancy. Symptoms include chronic pain, joint pain, loss of libido, diabetes, enlarged liver and irregular heartbeat. Iron deposits affect the liver, heart, pancreas, endocrine glands and joints leading to impaired function and eventually disease or organ failure. Treatment involves regular blood-letting (phlebotomy). Initially, treatment may be required weekly or bi-weekly but once safe iron levels are established, may only be needed a few times per year, with regular monitoring.
Along with phlebotomy, it is a good idea to adopt a dietary protocol to manage Haemochromatosis and to protect organs from free radical damage caused by excess iron levels. A wholefood, plant-based diet full of colour, anti-oxidants and unprocessed foods will offer the best protection in the long run. Limit iron-rich foods in the diet, especially heme-iron found in animal meats and offal. Heme-iron is more bioavailable in the human body - it is easier to absorb than non-heme iron. Non-heme iron is a type of iron found mostly in plant foods. Non-heme iron is more difficult to absorb. Some vegetables considered high in iron (non-heme) such as spinach, chard, black beans and green lentils may be eaten in moderation as the phytates and fibre present in these foods inhibit iron absorption. Wholegrains too can be eaten for the same reason.
Increased fibre intake, from a plant-based diet can bind with excess iron for elimination and inhibit the absorption of iron from food. Other foods that inhibit iron absorption include tannins in black tea, calcium-rich foods and healthy fats. Seek advice about using psyllium husk, calcium and any other supplements to minimize iron absorption, as you may well be inhibiting the absorption of other minerals and vital nutrients. Limit or avoid alcohol as it increases the uptake of iron and also may contain iron. Alcohol is an added burden to the liver which is one of the organs most affected by iron-overload.
Avoid “fortified” and “enriched” cereals, breads, flour and other foods. Fortification is added to refined grain products – keep ingredients very natural and as whole as possible to avoid unnecessary addition of iron and vitamin C to everyday foods. Likewise, be wary of supplements which may contain iron and/or vitamin C. Vitamin C rich foods should not be eaten with meat dishes as it increases iron absorption. Yet, vitamin C is needed for many other functions and must not be completely avoided. Use iron-free cookware, ceramic is best but stainless steel is a handier option for most cooking.
While HH is still considered a curse, particularly to those who are affected, it is part of who we are and helped us survive through challenging times. Modern treatment options and advances in genetics will make it less of a curse in the future and hopefully downgrade its risk to the same status as our pale skin and freckles!
"It hath flown against me. It hath attacked me. O seven heavens, seven earths, seven winds, seven fires, by heaven be ye exorcised." If you suffered from Tinnitus in Mesopotamian times (4000BC-500BC), this chant would be whispered in your ear until the demon spirit was expelled or the patient faked recovery, favouring the illness over the cure! In ancient Egypt they used infused oil, frankincense, tree sap, herbs and soil and administered the mixture via a reed stalk that they put in the external ear.
The Greco-Roman medicine folk were first to distinguish two types of tinnitus, one stemming from a cold (respiratory) and the other from the head (vascular) – either way, their cure was placing radish, cucumber juice, honey and vinegar in the ear and hoping for the best. In the Middle Ages, they continued with this pouring of things into the ear - a Welsh treatment recommended to take “a loaf of hot bread, divide it in two, and put it in each ear as hot as you could take it and thus perspire and by the help of God you would be cured”! These days, a cure for tinnitus remains elusive and treatment options are as varied as the people who suffer from it, but nutrition can play a positive role its management although it has more to do with eating the right food rather than sticking it in your ear!
Tinnitus is the perception of noise, buzzing, hissing or ringing in the ears, coming from within the ear rather than an external source. Affecting around 20% of the population, tinnitus isn't a condition itself per se, rather it is a symptom of an underlying condition, such as age-related hearing loss, ear injury, wax build-up or cardiovascular system disorder. There is good information of risk factors – prolonged exposure to loud noises, stress, ear wax and blockages, smoking and the natural aging process. Medical conditions associated with tinnitus include high blood pressure, cardiovascular disease, circulatory problems, anaemia, allergies, an underactive thyroid gland and diabetes. Conventional treatment is largely dependent on these risk factors and the management of underlying issues with medication. Nutrition is an overlooked option for many yet most of the associated health conditions are well managed through diet and lifestyle measures.
Excess consumption of sodium is directly linked to tinnitus. It restricts blood vessels, increases blood pressure, and significantly reduces blood flow to the cochlea in the ear. It is also involved in the maintenance of cellular fluid balance which can affect the ear as well as other areas in the body. In Traditional Chinese Medicine, the kidney and ear are associated organs – not only are they similar in appearance, but also share common adversaries. A low-sodium diet involves using little or no salt in cooking, and never adding salt to your food at the table. Processed meats, ready-made foods, canned/powder soups, commercial bread products, many breakfast cereals and certain cheese are especially high in salt which is used as a preservative to increase shelf life.
Sugar metabolism is a factor worth noting, particularly if you also have type 2 diabetes or pre-diabetes. The cochlea of the ear affected by tinnitus have a limited supply of nutrition, with only oxygen and glucose really making any impact to support proper function. Impaired sugar metabolism can directly affect the ear, as it can contribute to many of the conditions associated with tinnitus including diabetes and cardiovascular disease.
Do not be tempted to substitute sugar with artificial sweeteners such as aspartame, even though it is marketed as a diabetic-friendly option. Aspartame and flavour-enhancer MSG are excitatory neurotransmitters. That is, they excite brain neurons and increase levels of electrical activity in the brain and the auditory cortex, the area where tinnitus is perceived. Studies have shown that people with tinnitus may have an elevated level of electrical activity and reducing this activity is helpful. Increasing electrical activity increases intensity and duration of tinnitus.
A diet rich in saturated animal fats and trans fats have a detrimental effect on our vascular system, clogging up the blood vessels and inhibiting the smooth flow of blood and nutrients to organs including the ear. Similarly, elimination of toxins out of organs can be impeded by restricted blood flow to and from organs. Healthy fats such omega 3 from oily fish, nuts and seeds, maintains blood flow by keeping blood thinner and supporting the walls of blood vessels for optimal circulation. A Mediterranean-style diet is the most studied and appropriate diet for both cardiovascular health and tinnitus as it can help prevent many of their common risk factors.
Eating foods that are close to their natural state, varied wholefoods, vegetables and fruits and simple, uncomplicated ingredients offer the best overall management for tinnitus and many of the conditions that are linked with it. For those unwilling to look to diet, I refer you back to the chanting and wish you luck!
Researched and written by Irene :)
Firstly, congratulations to everyone who has signed up for the upcoming Dingle marathon and half marathon. Best of luck to ye all!
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