Iron intake should be adequate to avoid iron deficiency. Women with heavy menstrual blood loss and patients who have had frequent blood drawings due to illness and hospitalization may require greater intakes of iron. Iron deficiency can compromise heme synthesis and may exacerbate porphyria. Therefore, iron deficiency should be avoided in porphyria. Early iron deficiency occurs before there is anemia.
Anemia means having a low blood count.
Also an early iron deficiency can be detected by tests such as serum iron and iron-binding capacity, and serum ferritin. All alcoholic beverages should be avoided by porphyric patients. Alcohol stimulates the heme biosynthetic pathway in the liver and can itself exacerbate porphyria. Medical drugs books list alcohol as being contraindicated for porphyrics. Alcohol has other harmful effects and can lead to weight gain.