Nutrition and HHT

Your diet plays a significant role in your overall health and wellbeing, and that's true whether you're already healthy and problem-free or you have a serious health condition. Even Hereditary Hemorrhagic Telangiectasia (HHT), a condition not obviously connected to nutrition, can be improved with a few simple dietary changes.

What Foods to Eat When You Have HHT

A 2020 study gave a food frequency questionnaire to 149 patients with HHT and asked them to report on potential dietary influences that improved and worsened epistaxis. (1)

18% of patients reported that red berries, legumes, and green vegetables all seemed to improve epistaxis, and the study concluded that a healthy and balanced diet was best.

It also advocated for the consumption of foods with a high iron content, which is one of the main dietary considerations for people with HHT.

Iron deficiency is common among HHT patients and occurs as a result of bleeding, often from the nose.

Recommended dietary iron intake is between 16.3 and 18.2 mg/day for men and 12.6 and 13.5 mg/day for women, and it may be higher in people with HHT. (2)

Women are more likely to suffer from iron deficiency than men and it's thought that as many as 50% of pregnant women are deficient in this micronutrient. (3)

The best sources of dietary iron are meats, seafood, and offal, including beef, liver, mussels, oysters, chicken, ham, turkey, haddock, tuna, and salmon.

Vegetarian/vegan sources include spinach, beans, and lentils. These plant-based sources are not as well absorbed, though, and if you're vegan and suffering from HHT and recurrent nosebleeds, you should speak to your physician about iron supplementation.

What Foods To Avoid When You Have HHT

A UK study conducted on patients with HHT found a number of potentially problematic foods. (4)

Chocolate was one of the main ones, with 14% of the study's participants noting that chocolate brought on their nosebleeds.

Surprisingly, there were similar issues with strawberries (9.6%) and citrus fruits (8%), all of which may trigger nosebleeds in patients with HHT.

There were also suggestions that savory biscuits, beans, lentils, and berries could produce similar results, albeit to a lesser extent.

Studies on epistaxis and HHT have found that the following foods could increase the risk of nosebleeds: (5) (6)

  • Alcohol (Red Wine in particular)
  • Coffee
  • Spices
  • Garlic
  • Ginger
  • Oily Fish
  • Ginseng

Does this mean that you should avoid all of these foods? Not at all. Everyone reacts differently and many of the above foods only triggered nosebleeds in 10% or fewer participants.

What matters is that you concentrate on eating a healthy and balanced diet and address any vitamin and micronutrient deficiencies that could be impacting your health.

Keeping daily food diaries will help you to track your food and nutrient intake, ensuring you're meeting your macro and micronutrient needs. You can then check those diaries when you experience a nosebleed and pinpoint the potential dietary influences.

These food diary assessments are an essential part of the process and are also used to highlight triggers for everything from inflammatory bowel disease to food allergies and intolerances.

Why Do Some Foods Trigger Nosebleeds?

It is thought that foods like red wine and coffee trigger nosebleeds because they are high in salicylates. These compounds thin the blood and could prolong nosebleeds and make the bleeding more intense.

Salicylates are the same compounds found in aspirin, which has a very similar effect. They are commonly used as preservatives in foods like wine, processed meats, chocolate, and fruit juices.

Foods that are high in sodium could also increase the risk of nosebleeds by raising blood pressure, although this is something that typically happens after prolonged exposure.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574540/
  2. https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
  3. https://www.webmd.com/diet/iron-rich-foods
  4. https://pubmed.ncbi.nlm.nih.gov/23404156/
  5. https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0576-6
  6. https://pubmed.ncbi.nlm.nih.gov/23404156/