Ironing out a few facts about the Celtic Curse!

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!