Bloodletting is sometimes used as an example of a medical treatment that we once thought plausible, but now view as ridiculous. It is compared with chiropractic, homeopathy, and other “Alternative Medicine” disciplines in order to ridicule them. However, we might have been unfair. It appears that bloodletting may actually be more valuable than the Alt Med treatments it is compared to.
Bloodletting is actually still used now. And for good reason. It is used as a regular treatment for the iron storage disorder ‘haemochromatosis’.
The Haemochromatosis Society has pages describing the disorder, the symptoms, how it is inherited, the tests for haemochromatosis, and recommendations regarding diet. I will quote from some of their pages here, but please note that for more information you should visit their site.
It is not possible to treat GH with a low iron diet. A nutritional natural diet is recommended […] We make the following recommendations:
Avoid vitamin supplements or tonics containing iron, and breakfast cereals heavily fortified with iron. Large doses of vitamin C should also be avoided, as it makes the process of depositing iron in some organs easier and enhances the absorption of iron from the diet. [Note: I wonder if food supplement companies and nutritionists ask their customers about haemochromatosis prior to making recommendations about supplementation.]
Reduce intake of offal (liver, kidney etc.) and red meat. The rate of iron absorption from red meat is 20 to 30% whereas vegetables and grains have less iron and a 1 to 20% rate of absorption.
Minimise alcohol intake, particularly with meals, as it may increase iron absorption and it can also cause liver disease. Tea and all milk products taken with a meal reduce the amount of iron absorbed.
The simple and effective treatment consists of regular removal of blood. Known as venesection therapy or phlebotomy, the procedure is the same as for blood donors. Every pint of blood removed contains a quarter of a gram of iron. […] Venesection will usually be performed once a week, depending on the degree of iron overload. Treatment may need to be continued at this frequency for up to 2 years, occasionally longer.
This is not the end of the story. Excess iron will continue to be absorbed so the individual will need occasional venesections (maintenance therapy), on average every 3 to 4 months, for the rest of his or her life. Monitoring of transferrin saturation and serum ferritin is used to assess whether venesection is required more or less often. The transferrin saturation should be maintained below 50% and the serum ferritin below 50µg/l.
Venesection treatment will cause tissue iron to be mobilised and iron stores will return to normal. However, it will not cure some serious clinical conditions such as diabetes or cirrhosis if they are already present at the time treatment is started. This emphasises the need for early diagnosis.
With regard to the mention of diabetes, there is a page here on the American Diabetes Association website that provides information on haemochromatosis:
- Hemochromatosis is a single-gene disease that causes iron accumulation in the tissues of the body.
- Diabetes is a primary complication if hemochromatosis, sometimes referred to as “bronze diabetes,” goes untreated.
- It’s fairly common, but often goes undiagnosed and untreated.
- It’s treated effectively with frequent phlebotomy (blood letting).
Hereditary hemochromatosis is the most common single-gene disease in Western populations, affecting 1 out of every 200-300 people. Yet it is almost unheard of by the general public, and many health professionals are insufficiently aware of it. Because the disorder can cause diabetes via damage to the pancreas, it is something that deserves greater recognition in the American Diabetes Association community.
It appears that bloodletting has been unfairly maligned as a treatment where it has been compared with, for example, homeopathy.
Bloodletting is an effective treatment for haemochromatosis, the effects can be monitored by testing transferrin saturation and serum ferritin, and the treatment can help to prevent serious complications of the disorder if diagnosed in a timely fashion.
Homeopathy (particularly as advocated by those in favour of high dilutions), on the other hand, is utterly implausible, cannot be justified on the basis of the available evidence, and would seem to be unjustifiably promoted by some homeopaths.
[There is also concern regarding the possibility that reckless promotion of homeopathic remedies could potentially endanger patients who fail to seek proper medical attention. I should stress that I am not sure that such reckless promotion of homeopathy is widespread, but it is something that I feel homeopaths should guard against.]
This blog post should not be construed as providing medical advice. The appropriate person to ask about diabetes or haemochromatosis would probably be your doctor, rather than some random bloke from the internet.
Credit is due to Jo Brodie for reminding me that bloodletting has its uses. I thank you.