This patient should be advised to avoid eating raw or undercooked seafood. Patients with iron overload syndromes, including those with hereditary hemochromatosis, are at risk for a number of infections with organisms whose virulence is increased in the presence of excess iron. Although the exact mechanisms of increased susceptibility to specific infections are not known, pathogens require mobilization of tissue iron from the host, which is increased in iron overload syndromes. Additionally, excess iron appears to impair host defenses against certain infections, such as decreasing the chemotactic response and compromising the ability of phagocytic cells. The result is increased virulence among specific infectious organisms in patients with iron overload, including Vibrio species (vulnificus,cholerae), Escherichia coli, Yersinia enterocolitica, Listeria monocytogenes, cytomegalovirus, hepatitis B and C viruses, and HIV. Fungi include Aspergillus fumigatus and mucor. V. vulnificus infection is associated with ingestion of raw seafood, especially oysters, and the risk of sepsis and death is significantly increased in persons with hemochromatosis; therefore, these foods should be specifically avoided by these patients.

Oral calcium supplements may bind iron in the gut and inhibit iron absorption and are acceptable to take if needed for another indication. However, this inhibitory effect is small relative to the removal of iron by phlebotomy. Therefore, supplementation for treatment of hemochromatosis in those undergoing phlebotomy is not usually required.

Although red meat contains iron, and excessive meat intake should be avoided, consumption of moderate amounts of meat by those being treated with phlebotomy is reasonable for nutritional purposes. The amount of iron removed by phlebotomy far exceeds the iron content of a moderate intake of meat.

Vitamin C (ascorbic acid) may interact with tissue iron and lead to generation of oxidative radicals with the potential for tissue damage. However, the amount of vitamin C contained in fruits and vegetables is relatively low, and their consumption as part of a normal diet should not be discouraged.